Royal flushed

The effects of our colonial past are still felt in health inequities for Māori

In the search for news not related to infectious diseases, be they coronavirus, influenza or Johnny-come-lately monkeypox, I happened upon specialist GP Dermot Coffey’s wee germ of an idea – ditching the RNZCGP’s royal title. Dr Coffey, RNZ reports, has put forward a motion to be considered at the annual general meeting at this week’s college conference in Christchurch.

He would like the college board to consider cancelling the royal warrant for the use of the prefix “Royal” in its name.

Christchurch-based Dr Coffey, an environmental campaigner, is not looking for an immediate revolution.

He’s aware that, right this minute, another crown holds us in thrall. The “corona” virus has general practice bowed.

But Dr Coffey presents food for thought. He has a point when he suggests the term “royal” is not neutral and, as the effects of our colonial past are still felt in health inequities for Māori, a little reflection on why the name is or is not important might be in order. That’s what AGMs are for.

And he’s not the first one to question the use of the prefix by medical colleges beyond the shores of the United Kingdom.

A 2021 paper in the Australia and New Zealand Journal of Psychiatry asks of the Royal Australasian College of Psychiatrists, “Should we be Royal?”

The Aussie authors, in their inimitably direct manner ask: “Is it time to individuate from foreign knights, monarchs and institutions who oversaw slavery and the willing or unwitting displacement of cultures?”

Dr Coffey has similar concerns.

I was surprised to learn the conferring of “Royal” was relatively recent for the psychiatrists; it took place in 1978.

That makes them younger “royals” than the RNZCGP, which received its Royal prefix in 1974, along with a coat of arms and motto Cum Scientia Caritas (with knowledge, compassion), borrowed from its UK “parent”. It’s not a long history in the scheme of things.

As the Aussie authors write, back in the 1970s and earlier, the word “Royal” was recognised as evidence of maturity and legitimacy. But, they write, it was also a time when women not being paid equal wages for equal work was condoned; most medical practitioners were men; homosexuality was a mental disorder in DSM-II. And times were changing; the college adopted the prefix just as legal links to Britain were ending.

A more recent Royal arrival locally is the Royal New Zealand College of Urgent Care, ennobled in 2014 by governor-general Sir Jerry Mateparae, then receiving a coat of arms and a motto Semper Sanamus (care or cure at all times).

At that time, specialist GP and sector leader Jonathan Simon argued the world was awash with “royal” colleges, so it might be time for the Royal College of Self-Care. But I digress.

There’s no doubting Royal is popular – only six of the 16 members of the Council of Medical Colleges are without the prefix.

We know names matter. Whether historical, quaint, heraldic or cutesy, they send a message.

I recall being surprised, when on my OE, to find the UK had a Royal Society for the Prevention of Cruelty to Animals but only a National Society for Prevention of Cruelty to Children.

Locally, a “Royal” commission ups the ante, though sadly, not necessarily the long-term outcome.

The recent dawn ceremony held at Kerikeri to launch Te Whatu Ora – Health New Zealand and Te Aka Whai Ora – Māori Health Authority revealed names that send a strong signal to the sector about the intended culture and aims of these new entities.

And, because of that, I expect we will cease using the English titles in a relatively short period as the new names take hold.

College members will need time to mull over Dr Coffey’s proposal – we don’t change names lightly.

I suspect the only news of royal titles for a while will be the continuing sagas of Prince Andrew, no longer named “His Royal Highness”, and of his nephew Prince Harry, who supposedly dropped his HRH by choice.