Pharmac director quits over government's Treaty directive

Pharmac director Dr Anthony Jordan has quit over the government's Treaty directive, the Pharmac Minister's office says.

Associate health minister David Seymour this week told Pharmac it was inappropriate for the agency to keep considering the Treaty of Waitangi's place in the health sector.

Seymour has released his letter to the Pharmac board chairperson Paula Bennett, setting out his expectations for the agency.

"Pharmac's role should focus on delivering improved health outcomes underpinned by robust data and evidence, in accordance with its statutory responsibilities," he wrote.

Dr Jordan joined the Pharmac Board in December 2021 and his term was due to end in December 2024.

He said he "could not with good conscience" continue to work for the agency following directions to stop factoring Te Tiriti o Waitangi into its decisions.

Speaking to RNZ, Jordan said he received the directions earlier this week.

"I was comfortable with most of the things in there, however, I was not comfortable with the statements around Te Tiriti. I waited until the stand-up with Paula Bennett and the Minister.

"I listened to the questioning they received around that. I was still not convinced that what they were saying aligned with my views of the work we had done at Pharmac."

"I couldn't, with good conscience, represent the Crown if that was their view on it," he said.

Jordan said the evidence in favour continuing to factor the Treaty into decision making was clear.

"Equity adjusters we made for Māori, and also Pacific, when we funded SGL-2 inhibitors for diabetes ... there is evidence that did improve uptake of those medicines. It was even more improved for people who had cardiovascular and renal risk factors where there is even more evidence those medicines to well."

"That's the robust evidence. If he wants to look at some, he should look at that."

"It is not good to be a Māori man, in terms of morbidity and mortality, compared to your Pākeha counterparts. And, sadly, it's the same for our wāhine. This is not new information, it is published year on year," he said.

The quick timeframe of his resignation meant he did not get a chance to speak with other board members, he said.

Despite the rhetoric, Jordan said he still had hope Pharmac would provide better health outcomes for Māori.

"You can't unlearn the things you've already learned while working toward a Te Tiriti-based model. You learn about the things that work and don't work."

"A letter of expectation can't change that," he said.

Jordan said after receiving the Treaty directive issued earlier this week, he quit effective immediately following a media conference where Bennett and Seymour spoke.

The removal of Treaty principles from Pharmac did not align with his own morals and ethics, he said.

Seymour told RNZ Jordan informed Bennett he was quitting several days ago.

"He's indicated that he disagrees with the direction set out in my letter of expectation and I actually respect him for making the call.

"If someone doesn't like where an organisation is going, I think the respectable thing is to say it publicly, step down and let others who do agree with the direction get on with it."

Seymour said Jordan's resignation had not given him pause for thought about his letter of expectation - "not at all".

"If there are people who believe that the Treaty and embedding it was more important than equal treatment based on medical need, as Pharmac goes forward, then I actually think it's right for them to be open about that and step down."

Seymour said it would take a minimum of three to four weeks to appoint a replacement for Jordan.

Bennett in a statement said Jordan's decision to resign was effective immediately.

"I am told Dr Jordan has made a significant contribution to Pharmac's strategic direction and operational focus over the past few years.

"Other board members, the chief executive and the teams at Pharmac have greatly appreciated the clinical expertise and insights he has brought to his role on the Board, and we wish him all the best for the future."

Seymour would appoint a new board member in due course, she said.

In his letter to Pharmac, Seymour had also said there were some illnesses and treatments where ethnicity was a factor, and that he had never argued that ethnicity should not be considered in cases where it genuinely was a factor.

Bennett said Seymour's letter had set out clearly the need for Pharmac to consider the voices of all New Zealanders, and highlighted the focus on a social investment approach.

As part of National's coalition agreement with ACT, Seymour has been tasked with reforming Pharmac's funding model, to account for positive fiscal impacts on the Crown of funding more medicines.

Pharmac will be required to update its statement of intent to reflect the government's priorities, and continue to outline how it is implementing the findings from the 2022 review.