Sir Ashley Bloomfield backs top public health official after smokefree outrage criticised

Sir Ashley Bloomfield is defending a top public health official who railed against the government's repeal of the smokefree generation law.

Te Whatu Ora released emails which showed that some of the government's top public health advisors were so concerned by its decision to repeal the smokefree law, that at least one, Dr Nick Chamberlain, considered resigning.

As the national public health director, Chamberlain is one of the government's most important health officials. He reports only to the CEO of Te Whatu Ora, Margie Apa, who said his comments did not meet her expectations for "conducting work with integrity and political neutrality".

Bloomfield says it's a daily challenge for public health experts whose advice conflicts with government policy, but he doesn't believe anyone in the Beehive would be surprised to know public health experts weren't happy to have the smokefree law torn up.

Why it matters

The smokefree law was history-making, earning headlines across the globe. Other nations, including the UK, looked to follow New Zealand's move by introducing their own smokefree generation plans.

When the new government announced plans to reverse the ban, emails released this month showed showed outright anger from top health officials who discussed being "demoralised" by the move.

Chamberlain, alongside other senior health officials, said he felt the policy was conflicting with the oath he took becoming a doctor.

"I'm sure we have all been challenged ethically and morally by the notion, firstly that our government will repeal the smokefree legislation, and even more so that this will help fund tax cuts," he wrote, in an email from November, released earlier this month by Te Whatu Ora.

"I'm sure anyone working in public health will feel pretty demoralised by this, but I'm aware that we signed an oath."

Dr Bloomfield told Stuff this conflict between personal beliefs and professional obligations was a common issue for those in the public service.

However, in this case, he said it wouldn't have come as any surprise to ministers to hear public health workers were angry about cigarette access liberalised.

The breakdown

Early this year, the coalition government repealed law - passed by the Labour government in 2022 - that would have stopped the sale of cigarettes. Health officials labelled that law "the endgame for tobacco", as it would have outlawed the sale of cigarettes to anyone born after 2008.

Chamberlain, alongside Director-General of Health Dr Diana Sarfati and Apa, worked with other top health advisors to provide urgent advice to Cabinet about repealing the smokefree legislation.

They discussed strategies, including focusing on the financial burden of smoking and the political risk of repealing the law - both domestically and for New Zealand's international reputation.

Who said what

Bloomfield said it was important for public servants, including health officials, to maintain political neutrality - but he said that didn't mean those officials needed to see eye-to-eye on everything.

"I don't think it would come as a surprise to anyone that the officials responsible for the public health of the nation would feel this kind of tension between their professional commitments and their oaths, say the Hippocratic Oath, and what a particular policy might be," he said.

Medical workers take the Hippocratic Oath when they start their careers, promising "I will do no harm". In discussions between health officials, they raised concerns about increased mortality resulting from repealing the smokefree generation law.

To convince the government not to remove that law, Apa suggested they focus on cost - including lost taxes from early deaths and increased strain on hospitals.

"We need to make legislation look like the cheapest option," she said.

Bloomfield, who served four years as Director General of Health and is now a professor of public health, said managing professional and personal conflicts was "a daily issue" for many in the public service.

"There are always trade offs," he said.

"But ultimately, as a public servant, you are there to serve the government of the day."

While Apa had said the comments were not appropriate, Bloomfield said they shouldn't be an issue for those officials being able to do their jobs.

At the time, one official summed up her dismay: "It's hard to explain this to the kids."

Bloomfield said ministers and officials often had heated discussion "behind closed doors".

"In this case, something was written down," he said.

"I think it will be easy to move past this. I don't think that ministers of health would be surprised at all."

He also said he agreed with Chamberlain, who in a statement said he had been an effective public health official for over a decade. "He's a really big contributor, and I know he will continue to do so," said Bloomfield.

Chamberlain, in an earlier statement, said: "I regret how this played out."

"As a public servant, I remain committed, as I have been throughout my careers, to working to achieve better health outcomes for all New Zealanders," he said.

Stuff followed up asking what he regretted. Did he regret that the law was repealed, or how he'd responded to the issue? But there was no response.

This story was first published by Stuff.