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Cartwright Inquiry

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150-605: The Cartwright Inquiry was a committee of inquiry held in New Zealand from 1987 to 1988 that was commissioned by the Minister of Health , Michael Bassett , to investigate whether, as alleged in an article in Metro magazine , there had been a failure to treat patients adequately with cervical carcinoma in situ (CIS) at National Women’s Hospital (NWH) by Herbert Green , a specialist obstetrician and gynaecologist and associate professor at

300-557: A minority government can be formed if support from other parties during confidence and supply votes is assured. The governor-general appoints ministers under advice from the prime minister, who is by convention the parliamentary leader of the governing party or coalition. Cabinet , formed by ministers and led by the prime minister, is the highest policy-making body in government and responsible for deciding significant government actions. Members of Cabinet make major decisions collectively and are therefore collectively responsible for

450-468: A protectionist and highly regulated economy to a liberalised free-trade economy. Unemployment peaked just above 10% in 1991 and 1992, following the 1987 share market crash , but eventually fell to 3.7% in 2007 (ranking third from twenty-seven comparable OECD nations). However, the global financial crisis that followed had a major effect on New Zealand, with the GDP shrinking for five consecutive quarters,

600-732: A 1988 inquiry into issues related to cervical cancer and its treatment at Auckland's National Women's Hospital, known as the Cartwright Inquiry . Cartwright has previously served on the Committee on the Elimination of Discrimination against Women , and played a major role in the drafting of the Optional Protocol to the Convention on the Elimination of All Forms of Discrimination against Women . In 2007, in recognition for Cartwright's work as

750-525: A Committee of Inquiry to inquire into the treatment of cervical cancer at the National Women's Hospital and other matters. The terms of reference for the inquiry were to investigate (as alleged in the Metro article): The first preliminary hearing was held on 18 June 1987. Three medical advisers were appointed to assist and advise Judge Cartwright, Professor E V MacKay, Professor of Obstetrics and Gynaecology at

900-416: A cancer risk ten times higher than women initially treated with curative intent.  The authors concluded that "during the ‘clinical study’ (1965–1974), women underwent numerous interventions that were aimed to observe rather than treat their condition, and their risk of cancer was substantially increased". In 2018, Outcomes for women without conventional treatment for stage 1A (microinvasive) carcinoma of

1050-481: A case study. A review of case notes by the medical advisors of women with CIS diagnosed from 1955 to 1976 identified women who might require further treatment or advice. The review also examined outcomes within 10 years of diagnosis of cervical CIS. This identified 1965 to 1974 as the time period with "a marked and statistically significant elevation in risk of developing invasion within 1-10 years", compared to time periods before and after, and within one year –

1200-426: A diagnosis of CIS under the age of 35, with positive smears and no colposcopic evidence of invasive cancer and without a ring or cone biopsy, would be followed. The Minutes recorded that Green stated that 'his aim was to attempt to prove that carcinoma-in-situ is not a pre-malignant disease'. He also said that if at any stage concern was felt for the safety of a patient, a cone biopsy would be performed. Green published

1350-421: A dramatic rise in the number of invasive cancers diagnosed within 10 years in patients with an initial diagnosis of CIS during the time period that Green was recruiting  patients for his study (1965-1974, 7.7%) compared to before (1955–64, 1.7%)  or after (1975-76, 1.7%). It was estimated that an additional 30 women developed invasive cancer in the middle period. The subsequent re-examination of data from

1500-498: A feminist challenge to patriarchal medical structures. Coney and Bunkle created the popular groundswell of opinion that led to the inquiry. The inquiry hastened the introduction of cervical screening which was already being considered by the Health Department and Cancer Society prior to the inquiry, following recommendations by a working party chaired by Skegg. The reforms initiated changes in ethics committees recommended by

1650-500: A high level of innovation . Poverty in New Zealand is characterised by growing income inequality; wealth in New Zealand is highly concentrated , with the top 1% of the population owning 16% of the country's wealth, and the richest 5% owning 38%, leaving a stark contrast where half the population, including state beneficiaries and pensioners, receive less than $ 24,000. Moreover, child poverty in New Zealand has been identified by

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1800-710: A lawyer, the Auckland Women Lawyers' Association established a lecture known as the Dame Silvia Cartwright Lecture Series. Cartwright's term as Governor-General of New Zealand was from 4 April 2001 to 4 August 2006. She was succeeded by Anand Satyanand at midday on 23 August 2006. During the intervening period, Chief Justice Dame Sian Elias was the Administrator of the Government (acting governor-general). On 16 June 2002, Cartwright made

1950-766: A party must win at least one electorate or 5% of the total party vote before it is eligible for a seat. Elections since the 1930s have been dominated by two political parties , National and Labour . More parties have been represented in Parliament since the introduction of MMP. New Zealand's judiciary , headed by the chief justice , includes the Supreme Court , Court of Appeal , the High Court , and subordinate courts. Judges and judicial officers are appointed non-politically and under strict rules regarding tenure to help maintain judicial independence . This theoretically allows

2100-400: A series of conflicts between the colonial government and Māori tribes resulted in the alienation and confiscation of large amounts of Māori land. New Zealand became a dominion in 1907; it gained full statutory independence in 1947, retaining the monarch as head of state . Today, the majority of New Zealand's population of 5.25 million is of European descent ; the indigenous Māori are

2250-399: A similar trend to dairy, the number of vineyards doubling over the same period, overtaking wool exports for the first time in 2007. Silvia Cartwright Dame Silvia Rose Cartwright ONZ PCNZM DBE QSO DStJ (née Poulter ; born 7 November 1943) is a New Zealand jurist who served as the 18th Governor-General of New Zealand , from 2001 to 2006. She

2400-681: A speech at the Annual General Meeting of Save The Children 's New Zealand branch, in which she criticised section 59 of the Crimes Act 1961 , which allowed parents to use "reasonable force" to discipline their children. A number of groups criticised this position, such as the Society for the Promotion of Community Standards – the Monarchist League stated that these comments were "overstepping

2550-614: A trade which provided the basis for strong economic growth in New Zealand. High demand for agricultural products from the United Kingdom and the United States helped New Zealanders achieve higher living standards than both Australia and Western Europe in the 1950s and 1960s. In 1973, New Zealand's export market was reduced when the United Kingdom joined the European Economic Community and other compounding factors, such as

2700-484: A yearly average of more than 2,000 hours of sunshine. The southern and southwestern parts of the South Island have a cooler and cloudier climate, with around 1,400–1,600 hours; the northern and northeastern parts of the South Island are the sunniest areas of the country and receive about 2,400–2,500 hours. The general snow season is early June until early October, though cold snaps can occur outside this season. Snowfall

2850-609: Is a constitutional monarchy with a parliamentary democracy , although its constitution is not codified . Charles III is the King of New Zealand and thus the head of state . The king is represented by the governor-general , whom he appoints on the advice of the prime minister . The governor-general can exercise the Crown 's prerogative powers , such as reviewing cases of injustice and making appointments of ministers , ambassadors, and other key public officials, and in rare situations,

3000-704: Is a member of the United Nations , the Commonwealth of Nations and the Organisation for Economic Co-operation and Development (OECD), and participates in the Five Power Defence Arrangements . Today, New Zealand enjoys particularly close relations with the United States and is one of its major non-NATO allies , as well as with Australia , with a " Trans-Tasman " identity between citizens of

3150-473: Is also consistent with a much debated questionable third line of oral evidence, traditional genealogies ( whakapapa ) which point to around 1350 as a probable arrival date for many of the founding canoes ( waka ) from which many Māori trace their descent. Some Māori later migrated to the Chatham Islands where they developed their distinct Moriori culture. A later 1835 invasion by Māori resulted in

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3300-564: Is classified as a non-self-governing territory , but is administered by a council of three elders (one from each Tokelauan atoll ). The Ross Dependency is New Zealand's territorial claim in Antarctica , where it operates the Scott Base research facility. New Zealand nationality law treats all parts of the realm equally, so most people born in New Zealand, the Cook Islands, Niue, Tokelau, and

3450-869: Is common in the eastern and southern parts of the South Island and mountain areas across the country. New Zealand's geographic isolation for 80 million years and island biogeography has influenced evolution of the country's species of animals , fungi and plants . Physical isolation has caused biological isolation, resulting in a dynamic evolutionary ecology with examples of distinctive plants and animals as well as populations of widespread species. The flora and fauna of New Zealand were originally thought to have originated from New Zealand's fragmentation off from Gondwana, however more recent evidence postulates species resulted from dispersal. About 82% of New Zealand's indigenous vascular plants are endemic , covering 1,944 species across 65 genera . The number of fungi recorded from New Zealand, including lichen-forming species,

3600-459: Is equivalent to 15% of the population of New Zealand. New Zealand has a strong presence among the Pacific Island countries, and enjoys strong diplomatic relations with Samoa , Fiji , and Tonga , and among smaller nations. A large proportion of New Zealand's aid goes to these countries, and many Pacific people migrate to New Zealand for employment. The increase of this since the 1960s led to

3750-453: Is exercised by the Government , led by the prime minister , currently Christopher Luxon . Charles III is the country's king and is represented by the governor-general , Cindy Kiro . In addition, New Zealand is organised into 11 regional councils and 67 territorial authorities for local government purposes. The Realm of New Zealand also includes Tokelau (a dependent territory );

3900-440: Is heavily dependent on international trade, particularly in agricultural products. Exports account for 24% of its output, making New Zealand vulnerable to international commodity prices and global economic slowdowns . Food products made up 55% of the value of all the country's exports in 2014; wood was the second largest earner (7%). New Zealand's main trading partners, as at June 2018 , are China ( NZ$ 27.8b), Australia ($ 26.2b),

4050-650: Is made up of two main islands and more than 700 smaller islands . The two main islands (the North Island , or Te Ika-a-Māui , and the South Island , or Te Waipounamu ) are separated by Cook Strait , 22 kilometres (14 mi) wide at its narrowest point. Besides the North and South Islands, the five largest inhabited islands are Stewart Island (across the Foveaux Strait ), Chatham Island , Great Barrier Island (in

4200-436: Is not known, nor is the proportion of those fungi which are endemic, but one estimate suggests there are about 2,300 species of lichen-forming fungi in New Zealand and 40% of these are endemic. The two main types of forest are those dominated by broadleaf trees with emergent podocarps , or by southern beech in cooler climates. The remaining vegetation types consist of grasslands, the majority of which are tussock . Before

4350-472: Is that CIS will progress to invasive cancer in only a very small proportion of cases if at all. This inference is incorrect and reliance on it has been dangerous to patients." The New Zealand Medical Council accepted that the 1978 protocols laid down by the Hospital Medical Committee spelled the end of the 'trial'. The International Federation of Gynecology and Obstetrics published statistics from

4500-452: Is that, whether or not some settlers arrived before 1314, the main settlement period was in the subsequent decades, possibly involving a coordinated mass migration. It is also the broad consensus of historians that the Polynesian settlement of New Zealand was planned and deliberate. Over the centuries that followed, the settlers developed a distinct culture now known as Māori. This scenario

4650-509: Is to regulate "the natural environment with particular emphasis on resource management ", while territorial authorities are responsible for sewage, water, local roads, building consents, and other local matters. Five of the territorial councils are unitary authorities and also act as regional councils. The territorial authorities consist of 13 city councils, 53 district councils, and the Chatham Islands Council. While officially

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4800-559: Is we clearly are no longer a dominion of Britain where the Governor-General is exactly like the Queen". On Waitangi Day 2004, following National leader Don Brash 's controversial Orewa Speech on race relations, Cartwright controversially gave a different interpretation of the phrase "He iwi tahi tatou". Following the 2005 general election , former National deputy leader Gerry Brownlee stated that Cartwright had not allowed National

4950-629: The 1973 oil and 1979 energy crises, led to a severe economic depression . Living standards in New Zealand fell behind those of Australia and Western Europe, and by 1982 New Zealand had the lowest per-capita income of all the developed nations surveyed by the World Bank . In the mid-1980s New Zealand deregulated its agricultural sector by phasing out subsidies over a three-year period. Since 1984, successive governments engaged in major macroeconomic restructuring (known first as Rogernomics and then Ruthanasia ), rapidly transforming New Zealand from

5100-827: The ANZAC tradition it shares with Australia. In addition to Vietnam and the two world wars, New Zealand fought in the Second Boer War , the Korean War , the Malayan Emergency , the Gulf War , and the Afghanistan War . It has contributed forces to several regional and global peacekeeping missions, such as those in Cyprus , Somalia , Bosnia and Herzegovina , the Sinai , Angola , Cambodia ,

5250-605: The Cook Islands and Niue (self-governing states in free association with New Zealand); and the Ross Dependency , which is New Zealand's territorial claim in Antarctica . The first European visitor to New Zealand, Dutch explorer Abel Tasman , named the islands Staten Land , believing they were part of the Staten Landt that Jacob Le Maire had sighted off the southern end of South America. Hendrik Brouwer proved that

5400-671: The European Union ($ 22.9b), the United States ($ 17.6b), and Japan ($ 8.4b). On 7 April 2008, New Zealand and China signed the New Zealand–China Free Trade Agreement , the first such agreement China has signed with a developed country. In July 2023, New Zealand and the European Union entered into the EU–New Zealand Free Trade Agreement , which eliminated tariffs on several goods traded between

5550-692: The Gondwanan supercontinent. About 25 million years ago, a shift in plate tectonic movements began to contort and crumple the region. This is now most evident in the Southern Alps, formed by compression of the crust beside the Alpine Fault . Elsewhere, the plate boundary involves the subduction of one plate under the other, producing the Puysegur Trench to the south, the Hikurangi Trough east of

5700-605: The Great Depression . The depression led to the election of the first Labour Government and the establishment of a comprehensive welfare state and a protectionist economy. New Zealand experienced increasing prosperity following the Second World War, and Māori began to leave their traditional rural life and move to the cities in search of work. A Māori protest movement developed, which criticised Eurocentrism and worked for greater recognition of Māori culture and of

5850-614: The Hauraki Gulf ), D'Urville Island (in the Marlborough Sounds ) and Waiheke Island (about 22 km (14 mi) from central Auckland). New Zealand is long and narrow—over 1,600 kilometres (990 mi) along its north-north-east axis with a maximum width of 400 kilometres (250 mi) —with about 15,000 km (9,300 mi) of coastline and a total land area of 268,000 square kilometres (103,500 sq mi). Because of its far-flung outlying islands and long coastline,

6000-515: The Iran–Iraq border, Bougainville , East Timor , and the Solomon Islands . New Zealand has an advanced market economy , ranked 13th in the 2021 Human Development Index , and fourth in the 2022 Index of Economic Freedom . It is a high-income economy with a nominal gross domestic product (GDP) per capita of US$ 36,254. The currency is the New Zealand dollar , informally known as

6150-566: The Legislative Council , until this was abolished in 1950. The supremacy of parliament over the Crown and other government institutions was established in England by the Bill of Rights 1689 and has been ratified as law in New Zealand. The House of Representatives is democratically elected, and a government is formed from the party or coalition with the majority of seats. If no majority is formed,

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6300-594: The Pacific Community and the Pacific Islands Forum . It enjoys particularly close relations with the United States and is one of its major non-NATO allies ; the United Kingdom; Samoa , Fiji , and Tonga ; and with Australia , with a shared Trans-Tasman identity between the two countries stemming from centuries of British colonisation. Nationally, legislative authority is vested in an elected, unicameral Parliament , while executive political power

6450-529: The Report found that the 1966 trial was a research study into the natural history of CIS. The 1966 trial was approved by the NWH Hospital Medical Committee on 20 June 1966.The great majority of patients did not know, except intuitively, that they were participants in the trial. ‘Had patients been informed of their inclusion in the trial, informed of the types of treatment available to them, informed of

6600-623: The Report , and defending Green's claims to the inquiry that there was no experiment and that his ‘treatment’ was not ‘unfortunate,’ but was a cautious approach reflective of medical uncertainties relating to the significance of positive smears and concerns about over-treatment. Bryder’s account has been both praised and criticised. Complaints to the University of Auckland about Bryder’s interpretation can be found here: http://www.cartwrightinquiry.com/?page_id=92 By contrast to these criticisms, historian of medicine Ilana Lowy who has written extensively on

6750-520: The Report of the Cervical Cancer Inquiry 1988 contributed to sweeping changes in law and practice around health and disability services’ consumers' rights in the 1990s and beyond. An independent patient advocate was to be appointed at National Women’s Hospital, whose duty was to protect the patient and ensure that she received full information and the opportunity to consent to all procedures in which she might participate. In 1989 Lynda Williams

6900-535: The Southern Alps , owe much to tectonic uplift and volcanic eruptions. New Zealand's capital city is Wellington , and its most populous city is Auckland . The islands of New Zealand were the last large habitable land to be settled by humans. Between about 1280 and 1350, Polynesians began to settle in the islands and subsequently developed a distinctive Māori culture . In 1642, the Dutch explorer Abel Tasman became

7050-666: The Statute of Westminster , confirming that the British Parliament could no longer legislate for the country without its consent. The British government's residual legislative powers were later removed by the Constitution Act 1986 , and final rights of appeal to British courts were abolished in 2003. Early in the 20th century , New Zealand was involved in world affairs, fighting in the First and Second World Wars and suffering through

7200-698: The United Kingdom and negotiate a treaty with the Māori. The Treaty of Waitangi was first signed in the Bay of Islands on 6 February 1840. In response to the New Zealand Company's attempts to establish an independent settlement in Wellington , Hobson declared British sovereignty over all of New Zealand on 21 May 1840, even though copies of the treaty were still circulating throughout the country for Māori to sign. With

7350-600: The United States Department of State noted that the New Zealand government generally respected the rights of individuals, but voiced concerns regarding the social status of the Māori population. In terms of structural discrimination , the New Zealand Human Rights Commission has asserted that there is strong, consistent evidence that it is a real and ongoing socioeconomic issue. One example of structural inequality in New Zealand can be seen in

7500-621: The University of Queensland , Dr Charlotte Paul , Epidemiologist , University of Otago Medical School and Dr Linda Holloway , Pathologist , University of Otago Wellington School of Medicine . Counsel assisting the inquiry were Lowell Goddard QC and Philippa Cunningham. Public hearings commenced on 3 August 1987 and ran for seven months. Evidence was heard from 59 witnesses, including from medical experts brought from around New Zealand, as well as from Australia, United States, Japan, UK, and Norway. Twelve patients or former patients, including ‘Ruth’, and two relatives of patients gave evidence in

7650-401: The West Coast of the South Island to semi-arid in Central Otago and the Mackenzie Basin of inland Canterbury and subtropical in Northland . Of the seven largest cities, Christchurch is the driest, receiving on average only 618 millimetres (24.3 in) of rain per year and Wellington the wettest, receiving almost twice that amount. Auckland, Wellington and Christchurch all receive

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7800-424: The caldera of one of the world's most active supervolcanoes . New Zealand is prone to earthquakes . The country owes its varied topography, and perhaps even its emergence above the waves, to the dynamic boundary it straddles between the Pacific and Indo-Australian Plates . New Zealand is part of Zealandia , a microcontinent nearly half the size of Australia that gradually submerged after breaking away from

7950-430: The reserve powers (e.g. the power to dissolve Parliament or refuse the royal assent of a bill into law). The powers of the monarch and the governor-general are limited by constitutional constraints, and they cannot normally be exercised without the advice of ministers. The New Zealand Parliament holds legislative power and consists of the king and the House of Representatives . It also included an upper house,

8100-444: The seven-continent model. New Zealand's climate is predominantly temperate maritime ( Köppen : Cfb), with mean annual temperatures ranging from 10 °C (50 °F) in the south to 16 °C (61 °F) in the north. Historical maxima and minima are 42.4 °C (108.32 °F) in Rangiora , Canterbury and −25.6 °C (−14.08 °F) in Ranfurly , Otago . Conditions vary sharply across regions from extremely wet on

8250-446: The "Kiwi dollar"; it also circulates in the Cook Islands (see Cook Islands dollar ), Niue, Tokelau, and the Pitcairn Islands . Historically, extractive industries have contributed strongly to New Zealand's economy, focusing at different times on sealing, whaling, flax , gold, kauri gum , and native timber. The first shipment of refrigerated meat on the Dunedin in 1882 led to the establishment of meat and dairy exports to Britain,

8400-412: The 'Unfortunate Experiment. ' Doctors in Denial was reviewed by bioethicist Carl Elliott in the Boston Review in November 2017 and by Linda Bryder in the Journal of New Zealand & Pacific Studies in 2019. At the 2017 launch of the book, the New Zealand Committee of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists apologised to Clare Matheson, who was ‘Ruth’ in

8550-437: The 1980s, which transformed it from a protectionist to a liberalised free-trade economy. The service sector dominates the national economy , followed by the industrial sector, and agriculture ; international tourism is also a significant source of revenue. New Zealand is a member of the United Nations , Commonwealth of Nations , ANZUS , UKUSA , Five Eyes , OECD , ASEAN Plus Six , Asia-Pacific Economic Cooperation ,

8700-410: The 1984 McIndoe et al paper, published an insider’s account in 2017, having been on the staff of NWH as an obstetrician and gynaecologist from 1973. He notes a systematic failure by medical staff (except the whistle blowers) to address the central issue of patient safety, and records belated acknowledgement by senior medical staff that they turned a blind eye. See Doctors in Denial: The Forgotten Women in

8850-629: The 2024 Global Peace Index , New Zealand is the 4th most peaceful country in the world. New Zealand's military services—the New Zealand Defence Force —comprise the New Zealand Army , the Royal New Zealand Air Force , and the Royal New Zealand Navy . New Zealand's national defence needs are modest since a direct attack is unlikely. However, its military has had a global presence . The country fought in both world wars, with notable campaigns in Gallipoli , Crete , El Alamein , and Cassino . The Gallipoli campaign played an important part in fostering New Zealand's national identity and strengthened

9000-451: The Cartwright Inquiry itself (chapter 8). Case study 8.5 within an international textbook on screening emphasises that Green's vulnerability to attack for his conservative approach stemmed from the worldwide uncertainty of evidence about cervical screening in the 1960s and the lack of agreed policy and quality standards for delivering a programme.  The authors conclude that 'the practice that led subsequently to condemnation of Herbert Green

9150-597: The Chatham Islands Council is not a unitary authority, it undertakes many functions of a regional council. The Realm of New Zealand, one of 15 Commonwealth realms , is the entire area over which the king or queen of New Zealand is sovereign and comprises New Zealand, Tokelau , the Ross Dependency , the Cook Islands , and Niue . The Cook Islands and Niue are self-governing states in free association with New Zealand. The New Zealand Parliament cannot pass legislation for these countries, but with their consent can act on behalf of them in foreign affairs and defence. Tokelau

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9300-424: The Government as a major societal issue; the country has 12.0% of children living in low-income households that had less than 50% of the median equivalised disposable household income as of June 2022 . Poverty has a disproportionately high effect in ethnic-minority households, with a quarter (23.3%) of Māori children and almost a third (28.6%) of Pacific Islander children living in poverty as of 2020 . New Zealand

9450-430: The High Court, she was granted the use of the style "The Honourable" for life. In 1990, Cartwright received the New Zealand 1990 Commemoration Medal , and in 1993 she was awarded the New Zealand Suffrage Centennial Medal . She was made a Principal Companion of the New Zealand Order of Merit in 2001, and she was awarded the Queen's Service Order at the State luncheon at Parliament to farewell her on 2 August 2006. In

9600-410: The MMP system, each person has two votes; one is for a candidate standing in the voter's electorate , and the other is for a party. Based on the 2018 census data, there are 72 electorates (which include seven Māori electorates in which only Māori can optionally vote), and the remaining 48 of the 120 seats are assigned so that representation in Parliament reflects the party vote, with the threshold that

9750-415: The Medical Council of New Zealand, despite an earlier attempt to persuade a court to stay the charges failing. Valerie Smith, a friend of Green’s, and his colleague, Dr Bruce Faris filed judicial review proceedings in the High Court, seeking to challenge Judge Cartwright’s findings in the Report . Mr Justice Barber struck out the proceedings by consent. Valerie Smith said "She now realised after listening to

9900-423: The Metro article, on behalf of the women involved in the experiment. This was followed in August 2018, some 30 years later, by a written admission and apology to Matheson by the Auckland District Health Board. Matheson died less than a month later. The New Zealand Cancer Society funded a re-examination of all the patient data, led by Australian epidemiologist Dr Margaret McCredie. This had two aims: (1) to re-examine

10050-553: The Māori of later years. According to an early European synthesized interpretation of various Māori traditional accounts, around 750 CE the heroic explorer, Kupe , had discovered New Zealand and later, around 1350, one great fleet of settlers set out from Hawaiki in eastern Polynesia. However, from the late 20th century, this story has been increasingly relegated to the realm of legend and myth. An alternative view has emerged from fresh archaeological and scientific evidence, which correlates with doubts raised by historians everywhere as to

10200-710: The North Island and South Island had never been formalised, and names and alternative names were formalised in 2013. This set the names as North Island or Te Ika-a-Māui , and South Island or Te Waipounamu . For each island, either its English or Māori name can be used, or both can be used together. Similarly the Māori and English names for the whole country are sometimes used together ( Aotearoa New Zealand ); however, this has no official recognition. The first people to reach New Zealand were Polynesians in ocean going waka (canoes). Their arrival likely occurred in several waves, approximately between 1280 and 1350 CE. Those Polynesian settlers, isolated in New Zealand, became

10350-426: The North Island, and the Kermadec and Tonga Trenches further north. New Zealand, together with Australia, is part of a wider region known as Australasia . It also forms the southwestern extremity of the geographic and ethnographic region called Polynesia . Oceania is a wider region encompassing the Australian continent , New Zealand, and various island countries in the Pacific Ocean that are not included in

10500-489: The North Island, saw thousands of imperial troops and the Royal Navy come to New Zealand and became known as the New Zealand Wars . Following these armed conflicts, large areas of Māori land were confiscated by the government to meet settler demands. The colony gained a representative government in 1852 , and the first Parliament met in 1854. In 1856 the colony effectively became self-governing, gaining responsibility over all domestic matters (except native policy, which

10650-737: The Postgraduate School of Obstetrics and Gynaecology, University of Auckland. The inquiry was headed by District Court Judge Silvia Cartwright , later High Court Justice, Dame and Governor-General of New Zealand . The Report of the Cervical Cancer Inquiry was released on 5 August 1988. A 1984 medical paper published in Obstetrics and Gynecology by colposcopist Bill McIndoe, pathologist Jock McLean and  gynaecologist Ron Jones, who were all employed at NWH and colleagues of Green, as well as statistician Peter Mullins, described an audit of 948 women who had been diagnosed with cervical carcinoma in situ (CIS) at New Zealand 's National Women's Hospital from 1955 to 1976. The authors retrospectively divided

10800-560: The Postgraduate School) guilty of disgraceful conduct, confirming the factual findings of the inquiry. In July 1990 two members of a working party charged, in 1975, with investigating complaints about Green’s trial and which recommended continuation, Dr Bruce Faris and Dr Richard Seddon, were each found guilty of ‘conduct unbecoming a medical practitioner’ on charges brought by the Preliminary Proceedings Committee of

10950-623: The Ross Dependency are New Zealand citizens. During the period of the New Zealand colony, Britain was responsible for external trade and foreign relations. The 1923 and 1926 Imperial Conferences decided that New Zealand should be allowed to negotiate its own political treaties , and the first commercial treaty was ratified in 1928 with Japan. On 3 September 1939, New Zealand allied itself with Britain and declared war on Germany with Prime Minister Michael Joseph Savage proclaiming, "Where she goes, we go; where she stands, we stand". In 1951,

11100-528: The Solicitor General’s submissions that she was wrong in thinking Judge Cartwright had relied on a Metro magazine article in her findings" and realised that Cartwright had not misinterpreted the McIndoe paper. Eventually 19 women who took legal action received compensation in an out-of-court settlement which stated that no fault or liability was admitted by the doctors or the institutions involved. The inquiry

11250-658: The South American land was a small island in 1643, and Dutch cartographers subsequently renamed Tasman's discovery Nova Zeelandia from Latin , after the Dutch province of Zeeland . This name was later anglicised to New Zealand . This was written as Nu Tireni in the Māori language (spelled Nu Tirani in Te Tiriti o Waitangi). In 1834 a document written in Māori and entitled " He Wakaputanga o te Rangatiratanga o Nu Tireni "

11400-471: The Tarawera eruption except for three of a decade or so earlier. Radiocarbon dating and pollen evidence of widespread forest fires shortly before the eruption might also indicate a pre-eruption human presence. Additionally, mitochondrial DNA variability within the Māori populations suggest that Eastern Polynesians first settled the New Zealand archipelago between 1250 and 1300, Therefore, current opinion

11550-466: The Treaty of Waitangi. In 1975, a Waitangi Tribunal was set up to investigate alleged breaches of the Treaty, and it was enabled to investigate historic grievances in 1985. The government has negotiated settlements of these grievances with many iwi, although Māori claims to the foreshore and seabed proved controversial in the 2000s. New Zealand is located near the centre of the water hemisphere and

11700-651: The Trial Chamber of the Cambodia Tribunal by Cambodia 's Supreme Council of Magistracy. Multiple Defence requests that she stand down from this position have been consistently rejected by both the Trial Chamber and Supreme Court Chambers on their merits. In the 1989 Queen's Birthday Honours , Cartwright was appointed a Dame Commander of the Order of the British Empire , for services to women. Upon her retirement from

11850-642: The United Kingdom became increasingly focused on its European interests, while New Zealand joined Australia and the United States in the ANZUS security treaty. The influence of the United States on New Zealand weakened following protests over the Vietnam War , the refusal of the United States to admonish France after the sinking of the Rainbow Warrior , disagreements over environmental and agricultural trade issues, and New Zealand's nuclear-free policy . Despite

12000-519: The United States's suspension of ANZUS obligations, the treaty remained in effect between New Zealand and Australia, whose foreign policy has followed a similar historical trend. Close political contact is maintained between the two countries, with free trade agreements and travel arrangements that allow citizens to visit, live and work in both countries without restrictions. In 2013 there were about 650,000 New Zealand citizens living in Australia, which

12150-405: The absence of the public and the media. Judge Cartwright heard evidence privately from a further 70 patients. The medical advisers carried out a review and analysis of patient files. Overall 1200 patient files were reviewed. In respect of Term of Reference One (TR1), the Report defined ‘adequate treatment’ of CIS since the 1950s as being that based on generally accepted treatment [at NWH this

12300-438: The arrival of humans, an estimated 80% of the land was covered in forest, with only high alpine , wet, infertile and volcanic areas without trees. Massive deforestation occurred after humans arrived, with around half the forest cover lost to fire after Polynesian settlement. Much of the remaining forest fell after European settlement, being logged or cleared to make room for pastoral farming, leaving forest occupying only 23% of

12450-404: The canoe of Aoraki ' ) for the South Island . Early European maps labelled the islands North (North Island), Middle (South Island), and South ( Stewart Island / Rakiura ). In 1830, mapmakers began to use "North" and "South" on their maps to distinguish the two largest islands, and by 1907, this was the accepted norm. The New Zealand Geographic Board discovered in 2009 that the names of

12600-465: The cervix was published. The authors concluded that "Women with microinvasive carcinoma were included in a natural history study of CIN3; they underwent numerous procedures designed to observe rather than treat their condition, and had a substantial risk of invasive cancer. McIndoe et al in 1984 showed that 29 women diagnosed with CIS, and with evidence of ongoing disease, developed invasive cervical cancer and there were 8 deaths. The Medical Review showed

12750-404: The chance at forming a government. Brownlee said "I have to publicly say that I have lost respect for the Governor-General and I think it is time we sat down now and started to look at a much more formal constitution for New Zealand". In response, Helen Clark said that the governor-general followed a "very, very proper process". Cartwright was appointed to sit as one of two international judges in

12900-474: The consequences of these decisions. The 42nd and current prime minister, since 27 November 2023, is Christopher Luxon . A parliamentary general election must be called no later than three years after the previous election. Almost all general elections between 1853 and 1993 were held under the first-past-the-post voting system. Since the 1996 election , a form of proportional representation called mixed-member proportional (MMP) has been used. Under

13050-461: The country has extensive marine resources. Its exclusive economic zone is one of the largest in the world, covering more than 15 times its land area. The South Island is the largest landmass of New Zealand. It is divided along its length by the Southern Alps . There are 18 peaks over 3,000 metres (9,800 ft), the highest of which is Aoraki / Mount Cook at 3,724 metres (12,218 ft). Fiordland 's steep mountains and deep fiords record

13200-497: The criminal justice system. According to the Ministry of Justice , Māori are overrepresented, comprising 45% of New Zealanders convicted of crimes and 53% of those imprisoned, while only being 16.5% of the population. The early European settlers divided New Zealand into provinces , which had a degree of autonomy. Because of financial pressures and the desire to consolidate railways, education, land sales, and other policies, government

13350-497: The dangers for patients, failure to evaluate the risks to patients if Green’s hypothesis was wrong, failure to note the rising incidence of invasive cancer, to stop the trial and treat the patients as soon as cogent evidence of risk began to emerge, and failure on behalf of some colleagues and the NWH administration to impinge on Green’s clinical freedom and act decisively to stop the trial in the interests of patient safety. In respect of TR2,

13500-686: The early 19th century, Christian missionaries began to settle New Zealand, eventually converting most of the Māori population. The Māori population declined to around 40% of its pre-contact level during the 19th century; introduced diseases were the major factor. The British Government appointed James Busby as British Resident to New Zealand in 1832. His duties, given to him by Governor Bourke in Sydney, were to protect settlers and traders "of good standing", prevent "outrages" against Māori, and apprehend escaped convicts. In 1835, following an announcement of impending French settlement by Charles de Thierry ,

13650-472: The evolving results of his study in the natural history of CIS in a series of papers from 1966 to 1975. In 1969, he wrote about his methods more clearly than in his proposal: "In 1965 [sic] the SMS of NWH initiated a project under the supervision of the author, for patients up to 35 years of age whose only abnormal finding was positive cervical cytology.... a histological diagnosis was to be established by punch biopsy of

13800-460: The extensive ice age glaciation of this southwestern corner of the South Island. The North Island is less mountainous but is marked by volcanism . The highly active Taupō Volcanic Zone has formed a large volcanic plateau , punctuated by the North Island's highest mountain, Mount Ruapehu (2,797 metres (9,177 ft)). The plateau also hosts the country's largest lake, Lake Taupō , nestled in

13950-628: The first European to sight and record New Zealand. In 1769 the British explorer Captain James Cook became the first European to set foot on and map New Zealand. In 1840, representatives of the United Kingdom and Māori chiefs signed the Treaty of Waitangi which paved the way for Britain's declaration of sovereignty later that year and the establishment of the Crown Colony of New Zealand in 1841. Subsequently,

14100-601: The forerunner of CIS, might be present at birth in female babies. When news of the neonatal study broke during the inquiry, there was a public furore, as no provision for parental knowledge or consent had been made. Judge Cartwright heard evidence, also, of disrespectful teaching practices, such as the insertion and removal of intrauterine devices on patients under general anaesthetic for other purposes, and vaginal examinations performed by undergraduates on anaesthetised women, in both cases without their prior knowledge or consent. The Report condemned such practices. Recommendations in

14250-481: The formation of the Pasifika New Zealander pan-ethnic group, the fourth-largest ethnic grouping in the country. Permanent migration is regulated under the 1970 Samoan Quota Scheme and the 2002 Pacific Access Category, which allow up to 1,100 Samoan nationals and up to 750 other Pacific Islanders respectively to become permanent New Zealand residents each year. A seasonal workers scheme for temporary migration

14400-560: The history of cancer, including cervical cancer, in Britain and Europe, in a review in the book, wrote of Bryder’s ‘careful display of the complexities of the management of uncertainty in treatment of cervical malignancies’, and Cambridge Professor Emeritus of Haemotology Robin Carrell praised the book as ‘an outstanding example of the beneficial function of the medical historian.’ Similarly, Raffle et al support Green’s practices in  a new look at

14550-554: The inquiry and introduced the role of the Health and Disability Commissioner six years after the inquiry. There have been many articles over time in the lay and academic press over the last thirty years, with some believed to take a 'revisionist' view of the Unfortunate Experiment. In 2009 University of Auckland Professor of History, Professor Linda Bryder, published an account of Green's study, arguing against almost every aspect of

14700-475: The international Cochrane organisation noted that "the Cartwright Inquiry provides no trustworthy evidence of harm from the adoption of the conservative management introduced by Green" "it is now clear that the treatment and monitoring methods introduced by Herb Green have benefited numerous women through avoidance of major surgery and preservation of fertility." Dr Ron Jones, whistle blower and an author of

14850-411: The invasive potential of CIS of the cervix, collecting new data on invasive cancers and deaths and using censoring techniques; (2) to describe the outcomes for the women who had treatment withheld or delayed, including women with microinvasive cancer. In 2008, Natural history of cervical neoplasia and risk of invasive cancer in women with cervical intraepithelial neoplasia 3: a retrospective cohort study

15000-573: The islands are uninhabited except for about six people at Raoul Island station. These islands put the northern border of New Zealand at 29 degrees South latitude. After the 1982 UNCLOS , the islands contributed significantly to New Zealand's exclusive economic zone . In 1891, the Liberal Party came to power as the first organised political party. The Liberal Government , led by Richard Seddon for most of its period in office, passed many important social and economic measures. In 1893, New Zealand

15150-436: The judiciary to interpret the law based solely on the legislation enacted by Parliament without other influences on their decisions. New Zealand is identified as one of the world's most stable and well-governed states. As of 2017, the country was ranked fourth in the strength of its democratic institutions, and first in government transparency and lack of corruption . LGBT rights in the nation are also recognised as among

15300-511: The land in 1997. The forests were dominated by birds , and the lack of mammalian predators led to some like the kiwi , kākāpō , weka and takahē evolving flightlessness . The arrival of humans, associated changes to habitat, and the introduction of rats , ferrets and other mammals led to the extinction of many bird species, including large birds like the moa and Haast's eagle . Other indigenous animals are represented by reptiles ( tuatara , skinks and geckos ), frogs , such as

15450-403: The largest minority, followed by Asians and Pasifika . Reflecting this, New Zealand's culture is mainly derived from Māori and early British settlers, with recent broadening of culture arising from increased immigration to the country . The official languages are English, Māori , and New Zealand Sign Language , with the local dialect of English being dominant. A developed country , it

15600-600: The last paper, in 1974, Green again described his study: "This series of 750 cases of in situ cervical cancer, and the following of 96 of them with positive cytology for at least two years, represents the nearest approach yet to the classical method of deciding such an issue as the change of one disease state to another – the randomised controlled trial. It has not been randomised and it is not well controlled, but it has at least been prospective." This time, Green reported that 10 cases had apparently progressed to invasion but that only 2 had "no clinical or histologic doubt." [Only one of

15750-511: The late 1970s which showed that the hospital ranked among the best institutions in the world in regard to five-year survival rates for patients with carcinoma of the cervix. For the most comprehensive analysis of the Cartwright Report and its relevance to modern screening programmes, see the 2019 encyclopaedic guide to screening published by Oxford University Press which draws on the Inquiry as

15900-537: The latter "suggesting that management during those years did not result in adequate exclusion of invasive cancer." This implies that new patients were not referred to Green after 1974, though existing patients remained under his care. Other unethical practices exposed at the inquiry were Green's 'baby smears' study, approved by the Hospital Medical Committee in 1963, in which Green proposed to take some two to three thousand cervical smears  from newborn baby girls in an attempt to prove that abnormal cells, which might be

16050-614: The latter being common. New Zealand is a member of the Five Eyes intelligence sharing agreement, known formally as the UKUSA Agreement . The five members of this agreement compromise the core Anglosphere : Australia, Canada, New Zealand, the United Kingdom, and the United States. Since 2012, New Zealand has had a partnership arrangement with NATO under the Partnership Interoperability Initiative. According to

16200-476: The likelihood of parole. ACT New Zealand MP Stephen Franks was critical of the remarks, stating "I don't think she was regarded as one of the most weighty judges and she's putting herself into a difficult constitutional position by weighing in this area", as was the Sensible Sentencing Trust . However, Prime Minister Helen Clark defended the governor-general, stating "One of the challenges for us

16350-456: The long white cloud') is the current Māori name for New Zealand. It is unknown whether Māori had a name for the whole country before the arrival of Europeans; Aotearoa originally referred to just the North Island . Māori had several traditional names for the two main islands, including Te Ika-a-Māui ( ' the fish of Māui ' ) for the North Island and Te Waipounamu ( ' the waters of greenstone ' ) or Te Waka o Aoraki ( '

16500-574: The longest recession in over thirty years, and unemployment rising back to 7% in late 2009. The lowest unemployment rate recorded using the current methodology was in December 2021 during the COVID-19 pandemic , at 3.2%. Unemployment rates for different age groups follow similar trends but are consistently higher among youth. During the September 2021 quarter, the general unemployment rate was around 3.2%, while

16650-796: The mark" for a representative of the Queen, while Green Party MP Sue Bradford welcomed the comments. On 12 August 2002, in a speech at the opening of the Specialised Applied Research Centre of the Victoria University of Wellington , Cartwright questioned whether longer sentences would reduce criminal reoffending rates. This was after the Sentencing Act 2002 and the Parole Act 2002 were passed – Acts for which Cartwright granted Royal Assent on 12 July 2002. The Acts introduced mandatory sentences for criminal convictions, and reduced

16800-450: The massacre and virtual extinction of the Moriori. In a hostile 1642 encounter between Ngāti Tūmatakōkiri and Dutch explorer Abel Tasman 's crew, four of Tasman's crew members were killed, and at least one Māori was hit by canister shot . Europeans did not revisit New Zealand until 1769, when British explorer James Cook mapped almost the entire coastline. Following Cook, New Zealand

16950-538: The medical experience of one of Green's patients as a case study (under the pseudonym 'Ruth') and interviews with staff, a freelance journalist, Sandra Coney , and an academic, Phillida Bunkle , published an exposé, 'An "unfortunate experiment" at National Women’s Hospital', in Metro Magazine in June 1987. The article alleged that Green was carrying out research on his patients without their knowledge or consent and that since

17100-483: The mid-1960s, he had been withholding conventional treatment from some patients with CIS. Coney and Bunkle took the title of their article from a 1986 letter in the New Zealand Medical Journal by Professor David Skegg , a University of Otago cancer epidemiologist and expert in population screening in which he referred to "the unfortunate experiment at National Women's Hospital" in his reply to Green about

17250-448: The most colposcopically significant area. Provided the biopsy did not remove the entire significant area, or reveal invasive carcinoma, there was to be no further treatment. As of the end of 1967, 33 such patients were studied." Green reported that none of the patients had been subsequently diagnosed with invasive cancer, as of June 1968.   In 1970, Green published further results and described his study: "The only way to settle finally

17400-409: The most conservative estimate of harm is 35 invasive cancers and 14 deaths. This is an underestimate because it does not include the many women who received a ring or cone biopsy or hysterectomy and yet had no treatment for persistent or recurrent disease, including those who were first diagnosed before 1965.  The number harmed also does not include invasive cancers and deaths among women with CIS of

17550-480: The most tolerant in Oceania . New Zealand ranks highly for civic participation in the political process, with 82% voter turnout during recent general elections, compared to an OECD average of 69%. However, this is untrue for local council elections; a historically low 36% of eligible New Zealanders voted in the 2022 local elections , compared with an already low 42% turnout in 2019 . A 2017 human rights report by

17700-690: The nebulous United Tribes of New Zealand sent a Declaration of Independence to King William IV of the United Kingdom asking for protection. Ongoing unrest, the proposed settlement of New Zealand by the New Zealand Company (which had already sent its first ship of surveyors to buy land from Māori) and the dubious legal standing of the Declaration of Independence prompted the Colonial Office to send Captain William Hobson to claim sovereignty for

17850-475: The number of dairy cows doubling between 1990 and 2007, to become New Zealand's largest export earner. In the year to June 2018, dairy products accounted for 17.7% ($ 14.1 billion) of total exports, and the country's largest company, Fonterra , controls almost one-third of the international dairy trade. Other exports in 2017–18 were meat (8.8%), wood and wood products (6.2%), fruit (3.6%), machinery (2.2%) and wine (2.1%). New Zealand's wine industry has followed

18000-416: The patients was under age 35.] He concluded that the present series "offers little proof of the progression hypothesis." Green published nothing else. A later and separate re-evaluation of the invasive potential of CIS, based on a review of NWH patients' files, was published by McIndoe et al, with very different findings. District Court Judge Silvia Cartwright was appointed by warrant dated 10 June 1987 as

18150-453: The problem of what happens to in situ cancer is to follow indefinitely patients with diagnosed but untreated lesions. This is being attempted." Again, he recorded no patients developing invasive cancer. A further paper from 1970 provided mathematical estimates of the invasive potential of CIS by using "follow-up observations on 75 patients who were untreated or incompletely treated". No patients were reported to have developed invasive cancer. In

18300-442: The protected endangered Hamilton's Frog , spiders , insects ( wētā ), and snails. Some, such as the tuatara, are so unique that they have been called living fossils . Three species of bats ( one since extinct) were the only sign of native land mammals in New Zealand until the 2006 discovery of bones from a unique, mouse-sized land mammal at least 16 million years old. Marine mammals, however, are abundant, with almost half

18450-561: The reliability of interpretations drawn from the oral evidence of indigenous peoples, including from Māori. Regarding the arrival of these Polynesian settlers, there are no human remains, artefacts or structures which are confidently dated to earlier than the Kaharoa Tephra, a layer of volcanic debris deposited by the Mount Tarawera eruption around 1314 CE. Samples of rat bone, rat-gnawed shells and seed cases have given dates later than

18600-532: The risks of procedures that were not conventional, definitive treatment for CIS, and given the opportunity to decide whether or not to be part of the trial, then the trial could not be so severely criticised’. Green's published work showed evidence of scientific fraud, according to Judge Cartwright. "An analysis of Dr Green's papers point to misinterpretation or misunderstanding of some data on his part, and on occasions, manipulation of his own data." "The inference to be drawn from Dr Green’s proposal and published papers

18750-429: The same women has reaffirmed these findings: unnecessary multiple biopsies intended for diagnosis and not treatment; a total of 35 women with CIS/CIN3 developing invasive cancer who were initially managed by limited biopsy alone; eight deaths from cervical or vaginal vault cancer among these women, and a further six deaths among women first diagnosed with microinvasion who received non-curative treatment.   Hence

18900-583: The signing of the treaty and declaration of sovereignty, the number of immigrants, particularly from the United Kingdom, began to increase. New Zealand was administered as a dependency of the Colony of New South Wales until becoming a separate Crown colony , the Colony of New Zealand , on 3 May 1841. Armed conflict began between the colonial government and Māori in 1843 with the Wairau Affray over land and disagreements over sovereignty. These conflicts, mainly in

19050-584: The study. The authors claimed that no one could give them an assurance that the study had been stopped. Publication led to such enormous public outrage and concern that within ten days, the Minister of Health , Michael Bassett , established an inquiry. In June 1966, Green received permission from the NWH's Senior Medical Staff (SMS) and the Hospital Medical Committee (HMC) to undertake a study of following women with CIS (now, together with severe dysplasia, termed Cervical Intraepithelial Neoplasia 3, CIN3) without treatment. Green's proposal stated that all patients with

19200-494: The subset of 92 such women who had persistent disease within 24 months. However, cancer risk at 30 years was only 0·7% in 593 women whose initial treatment was deemed adequate or probably adequate, and whose treatment for recurrent disease was conventional. In 2010, Consequences in women of participating in a study of the natural history of cervical intraepithelial neoplasia 3 was published. Among women diagnosed in 1965–1974, those initially managed by punch or wedge biopsy alone had

19350-467: The total workforce in 2016. In 2017, international visitor arrivals were expected to increase at a rate of 5.4% annually up to 2022. Wool was New Zealand's major agricultural export during the late 19th century. Even as late as the 1960s it made up over a third of all export revenues, but since then its price has steadily dropped relative to other commodities, and wool is no longer profitable for many farmers. In contrast, dairy farming increased, with

19500-486: The two regions. This free trade agreement expanded on the pre-existing free trade agreement and saw a reduction in tariffs on meat and dairy in response to feedback from the affected industries. The service sector is the largest sector in the economy, followed by manufacturing and construction and then farming and raw material extraction. Tourism plays a significant role in the economy, contributing $ 12.9 billion (or 5.6%) to New Zealand's total GDP and supporting 7.5% of

19650-481: The unemployment rate for youth aged 15 to 24 was 9.2%. New Zealand has experienced a series of " brain drains " since the 1970s that still continue today. Nearly one-quarter of highly skilled workers live overseas, mostly in Australia and Britain, which is the largest proportion from any developed nation. In recent decades, however, a " brain gain " has brought in educated professionals from Europe and less developed countries. Today New Zealand's economy benefits from

19800-476: The urgent implementation of a nationally organised population-based cervical screening programme, which became operational nationally in 1991. Attempts to bring Green before medical disciplinary authorities failed because he was deemed, at 74, to be not mentally or physically fit enough to be charged. In 1990 the Medical Council of New Zealand found Professor Denis Bonham (Green's head of department and head of

19950-550: The vulva. New Zealand New Zealand is an island country in the southwestern Pacific Ocean . It consists of two main landmasses—the North Island ( Te Ika-a-Māui ) and the South Island ( Te Waipounamu )—and over 700 smaller islands . It is the sixth-largest island country by area and lies east of Australia across the Tasman Sea and south of the islands of New Caledonia , Fiji , and Tonga . The country's varied topography and sharp mountain peaks, including

20100-463: The women with CIS into two groups: those with normal cytology follow-up at two years after initial management (817) and those who continued to have abnormal cytology (positive smears) (131). Among those who continued to have abnormal cytology, a much higher proportion developed invasive cervical or vaginal vault cancer (22% versus 1.5% over five to 28 years). The authors concluded that CIS of the cervix had significant invasive potential. Using that paper,

20250-847: The world's cetaceans (whales, dolphins, and porpoises ) and large numbers of fur seals reported in New Zealand waters. Many seabirds breed in New Zealand, a third of them unique to the country. More penguin species are found in New Zealand than in any other country, with 13 of the world's 18 penguin species. Since human arrival, almost half of the country's vertebrate species have become extinct, including at least fifty-one birds, three frogs, three lizards, one freshwater fish, and one bat. Others are endangered or have had their range severely reduced. However, New Zealand conservationists have pioneered several methods to help threatened wildlife recover, including island sanctuaries, pest control, wildlife translocation, fostering, and ecological restoration of islands and other protected areas . New Zealand

20400-643: Was appointed to the position, becoming New Zealand’s first patient advocate. The recommendation for patient advocacy has since been applied generally with a free nationwide health and disability advocacy service, The Cartwright Report recommended that the Human Rights Commission Act 1977 be amended to provide for a statement of patients' rights, and the appointment of a Health Commissioner. The Code of Health and Disability Services Consumers’ Rights, stating ten rights of health and disability services consumers and correlative duties owed to them by providers,

20550-606: Was automatically the best thing to do for symptomless lesions, particularly in young women who might want children. Green's practice, although motivated by a desire to avoid unnecessary and damaging interventions in symptomless women, was easy for others to condemn due to the lack of any relevant policy, research, or ethical framework for cervical screening at that time.' In a paper in the Journal of Clinical Epidemiology in 2020 Iain Chalmers , champion of evidence-based medicine and co-founder of

20700-569: Was centralised and the provinces were abolished in 1876. The provinces are remembered in regional public holidays and sporting rivalries. Since 1876, various councils have administered local areas under legislation determined by the central government. In 1989, the government reorganised local government into the current two-tier structure of regional councils and territorial authorities . The 249 municipalities that existed in 1975 have now been consolidated into 67 territorial authorities and 11 regional councils. The regional councils' role

20850-418: Was cone biopsy] together with evidence of eradication of the disease, and concluded that, by that standard, there had been a failure to adequately treat a number of women with CIS at NWH, For a minority of women, their management resulted in persisting disease, the development of invasive cancer, and in some cases, death. The reasons for the failure were the implementation of the ‘1966 trial’, failure to recognise

21000-472: Was granted in the mid-1860s). Following concerns that the South Island might form a separate colony, premier Alfred Domett moved a resolution to transfer the capital from Auckland to a locality near Cook Strait . Wellington was chosen for its central location, with Parliament officially sitting there for the first time in 1865. In 1886, New Zealand annexed the volcanic Kermadec Islands , about 1,000 km (620 mi) northeast of Auckland. Since 1937,

21150-595: Was introduced in 2007, and in 2009 about 8,000 Pacific Islanders were employed under it. New Zealand is involved in the Pacific Islands Forum , the Pacific Community , Asia-Pacific Economic Cooperation , and the Association of Southeast Asian Nations Regional Forum (including the East Asia Summit ). New Zealand has been described as a middle power in the Asia-Pacific region, and an emerging power . The country

21300-635: Was passed into law in regulations in 1996. The first Health and Disability Commissioner was appointed in 1994. The complaints regime became operational in July 1996. The Cartwright Report recommended setting in place a system of regional ethics committees, focused on the protection of patients, independent of hospitals, of which half the members would be lay people. New Zealand now has a national system of ethics committees, to which research involving health and disability services consumers must be submitted for ethical approval before it can proceed. The judge recommended

21450-464: Was published in Lancet Oncology. The 1229 women whose treatment was reviewed by the judicial inquiry in 1987–88 were included. Outcomes for 1063 (86% of 1229) women diagnosed with CIN3 at the hospital in 1955–76 were identified, after exclusions. In 143 women managed only by punch or wedge biopsy, cumulative incidence of invasive cancer of the cervix or vaginal vault was 31·3% at 30 years, and 50·3% in

21600-485: Was the fact that for several years during the late 1960s he conducted minimal excision by punch or wedge biopsy, with careful follow-up, for symptomless lesions detected through cytology and histology, including for some patients whose lesions were reported as showing evidence of microinvasion. This was at a time when there was ample scientific reason for concern about the damage caused by hysterectomy or cone biopsy and uncertainty about whether immediate use of these procedures

21750-567: Was the first nation in the world to grant all women the right to vote and pioneered the adoption of compulsory arbitration between employers and unions in 1894. The Liberals also guaranteed a minimum wage in 1894, a world first. In 1907, at the request of the New Zealand Parliament, King Edward VII proclaimed New Zealand a Dominion within the British Empire , reflecting its self-governing status. In 1947, New Zealand adopted

21900-429: Was the first to introduce a minimum wage , and the first to give women the right to vote . It ranks very highly in international measures of quality of life , human rights , and it has one of the lowest levels of perceived corruption in the world. It retains visible levels of inequality , having structural disparities between its Māori and European populations. New Zealand underwent major economic changes during

22050-466: Was the second woman to hold the office, after Dame Catherine Tizard . Cartwright is a former student at Otago Girls' High School , and is a graduate of the University of Otago , where she gained her Bachelor of Laws degree in 1967. In 1989, Cartwright became the first female Chief District Court Judge, and in 1993 she was the first woman to be appointed to the High Court . Cartwright presided over

22200-813: Was translated into English and became the Declaration of the Independence of New Zealand . It was prepared by Te W(h)akaminenga o Nga Rangatiratanga o Nga Hapu o Nu Tireni , the United Tribes of New Zealand , and a copy was sent to King William IV who had already acknowledged the flag of the United Tribes of New Zealand, and who recognised the declaration in a letter from Lord Glenelg . Aotearoa (pronounced [aɔˈtɛaɾɔa] in Māori and / ˌ aʊ t ɛəˈr oʊ . ə / in English; often translated as 'land of

22350-528: Was visited by numerous European and North American whaling , sealing , and trading ships. They traded European food, metal tools, weapons, and other goods for timber, Māori food, artefacts, and water. The introduction of the potato and the musket transformed Māori agriculture and warfare. Potatoes provided a reliable food surplus, which enabled longer and more sustained military campaigns. The resulting intertribal Musket Wars encompassed over 600 battles between 1801 and 1840, killing 30,000–40,000 Māori. From

22500-502: Was widely celebrated as one of the most important leaps forward in women's rights in New Zealand. In her book, Coney says "There was a danger that this significant event would go down as something to do with doctors and lawyers and that the women who initiated it and saw it through would be, like so many of their foremothers, written out of history." The events surrounding the Committee of Inquiry have international importance as an example of

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