First do no harm

A troubling tale has a troubling sequel. Be aware some of the language quoted in this post is offensive. I’ve left it uncensored because I want readers to make their own judgements about the character of the people I’m quoting.  

Like plenty of others, I rushed out to buy Dirty work, Nicky Hager’s latest. Dirty work is about the machinations of the far right in Aotearoa – the Taxpayers’ Union and the network of similar organisations they’re part of. The morning after the launch, almost the moment the bookshop opened, I was there. At the display stand, I exchanged knowing looks with another buyer as we grabbed our copies.

I’m with Hager. This far right network is eroding our democracy in plain sight. The media often cuts them slack, glossing over their track record or even profiling them, as if they're neutral commentators or experts. This veneer of respectability gives them power. If I can help in some small way to remove that veneer, I’m all over it.  

It’s personal, too. This network has targeted people in my life.

It goes like this. An aggressive letter arrives, implying some kind of misconduct, or a public allegation is made. It’s rubbish, but the target may need to engage a lawyer to respond. That costs the target money, but it also costs them time, bandwidth, or even peace of mind. The threat often goes nowhere, or the false allegation is retracted. But the damage is done, and the network knows it. As they also know, the kind of people they’ve whipped up don’t read retractions.

In April, I wrote a piece called The grift of the gab. It focused on the Free Speech Union, the Taxpayers’ Union’s ugly cousin, and their fight to undermine professional regulation in health. If this sounds a bit dry, I promise it’s not. I’ll explain.

Organisations like the Medical Council and Nursing Council exist to protect the safety of the public within the health system. That means making sure doctors and nurses are up to scratch, with the right skills and ethics. Health professionals may work in shifts, but their ethics need to run 24/7. That includes being careful about their public comments. Say you saw your GP acting up on Facebook, maybe hating on Māori or rainbow folks or spreading conspiracies. You might feel reluctant to seek their help, and that could harm your health.  

But the consequences go deeper. Health professionals are trusted members of society, so if they go around saying dodgy things they can do way more damage than the average Joe. An example: more than twenty years after Andrew Wakefield was exposed as a conman, the lie that vaccines cause autism seems as widespread as ever.

As most health professionals know, racism, homophobia and transphobia are more than just shitty behaviour: they’re a health hazard. That’s one reason the Medical Council and Nursing Council care what doctors and nurses say off the clock. But for other folks, shitty behaviour is a recruiting tool. Rage clicks lead to donation buttons, and those fill the coffers of the far right network.

You get my drift – and their grift.

Working on The grift of the gab, I found myself down a rabbit hole. I was convinced the Free Speech Union were unqualified to talk about regulation of health professionals. I was wrong. As I browsed the Free Speech Union council, a guy called Roderick Mulgan caught my attention. He’s a medical doctor.

Why would a doctor work against the standards of his own profession? Researching further, I wondered if I’d found a clue.

Mulgan has a side gig: a business called Lifeguard Health. Out of sheer irritation, I spent an hour or more reading the Lifeguard Health website.

I found this audacious mission statement: “At Lifeguard Health, developing what we call 'life-saving technology' is quite simply at the heart of everything we do”. I found sciencey-sounding claims with no real meaning, about products being “doctor-formulated” with “trusted GP oversight”. I found claims about the ingredients in Lifeguard Health’s products – things like passionflower and pine bark – but no evidence the products themselves do anything. Across all of this, worrying health terms were dropped in: arthritis, heart disease, dementia and cancer.

A person could read all that and join the wrong dots, believing they were buying an actual treatment for a serious condition – especially if they were vulnerable, in pain or out of hope. They’d be wrong.

Mulgan’s products are dietary supplements. Most of these are known to be little use. In fact, Health New Zealand recommends spending your money on decent kai instead. Dietary supplements count as food, not medicine, so sellers like Mulgan can make looser advertising claims about them. And saddest of all? I found a whole website section dedicated to customer stories, seemingly written by people with real health problems; people convinced to pay $69 per small bottle, one month’s supply, sixty capsules full of bugger all.    

I couldn’t tell if Mulgan had broken any rules, but this much was clear. His business model relied on the ability to make loose claims about his products – and on a professional regulator that didn’t mind him doing it. That seemed like the say-what-you-please kind of regime the Free Speech Union might support.  

Mulgan was only a sidebar in The grift of the gab. I left his story and turned to others, until July, when I spied a news item that took me by surprise. A bunch of new people had been appointed to the Medical Council, and Mulgan was one of them. But if his situation was already weird – medical doctor, herbal pill salesman, and now someone happy to serve on the Medical Council he’d been criticising – it was about to get weirder.

This piece started last week, when I opened my inbox to find an angry email from the Free Speech Union; one of many since they added me to their distribution list without permission. The email concerned a nurse in trouble for unspecified social media comments. The Nursing Council had taken her to the Health Practitioners Disciplinary Tribunal. Now she’d been suspended for two months, something the Free Speech Union tried desperately to spin as a success.

And who’d supported the nurse through the Tribunal process? None other than Roderick Mulgan. Now I was irked. And why?

The Medical Council’s not the Nursing Council, but their jobs have strong similarities. It looked to me like Mulgan was wearing two hats, and they were in ethical tension. With his Medical Council hat, he’s meant to uphold professional standards in a neutral way. With his Free Speech Union hat, he was helping someone alleged to have broken those professional standards. Pick a hat, matey.

I was now extra irked. I found myself doubling back to my original concern: Mulgan’s dietary supplements business. When I wrote The grift of the gab, Mulgan was a sidebar. I didn’t speculate whether Lifeguard Health had broken any rules because I never looked the rules up. Those rules took just a second to find on the Medical Council website – and guess what they said?

As a doctor, you must ensure that you advertise in a way that is responsible and ethical, and does not exploit or damage the trust and confidence that patients and the public have in doctors.

Testimonials can create unrealistic patient expectations and must not be used in your advertisement or quoted on any platforms you control that advertise your services.

You should not use your position as a doctor to endorse any medical products or methods of treatment in your advertisement.

Was Mulgan within the rules? I don’t know – but I now discovered other, more qualified folks had asked the same question. Writing this piece, I headed back to the Lifeguard Health website, and I noticed something. Its more audacious language had been scaled back, if not its prices. The customer stories had disappeared, but the disappearance was incomplete: ‘Testimonials’, a sheepish hyperlink to nowhere, remained.

You’ve seen how my original story involving Mulgan has a sequel – but there’s more to come. Mulgan’s not just a medical doctor and herbal pill salesman. He’s not just a guy willing to serve on both the Medical Council and Free Speech Union, one organisation attacking the other.  

Now we get to the part that’s not just weird, but which I find double-troubling. Mulgan has another hat, and it’s a doozy. He’s also a criminal defence lawyer.

I’m not bagging lawyers. Every accused person deserves a defence, and someone’s got to do the mahi. But as far as I can tell, most law practices advertise themselves with a bit of restraint, talking in broad terms about their areas of specialty. Not Mulgan. He’s all about the testimonials. It’s kind of tacky.

Some testimonials are from health professionals Mulgan has supported through disciplinary procedures (although he no longer helps doctors in trouble with the Medical Council). Some involve disorderly behaviour, careless driving, and even careless driving causing death. Still, if tackiness was the biggest problem here, we wouldn’t be talking.

One testimonial made my jaw drop.

CHARGES INCLUDED ATTEMPTED RAPE AND STRANGULATION

I am writing this with the deepest and most sincere gratitude for the incredible work you have done for our family. You have been absolutely vital to this victory, and we are so thankful for your dedication. 

To walk away with seven “Not Guilty” counts is a testament to your hard work, your expertise, and the sincere way you handled our case. While the journey was difficult, your presence gave us the confidence we needed to face it. 

You haven’t just won a case; you have given us our lives back. Please know that: You have our gratitude for life.

The testimonial was signed ‘Wife of accused’.

What’s wrong with this?

To be crystal clear: I’m not saying this man accused of attempted rape and strangulation was guilty. But when a defence lawyer markets himself this way, it’s to people who’ve broken the law, as well as ones who haven’t – including men who really did attempt rape and strangulation. Of course, Mulgan will do his best to make sure these men avoid consequences. That's a lawyer's job; but once again, my problem is the hats Mulgan’s wearing.

At some point on Mulgan’s watch, the Medical Council will deal with a complaint of sexual misconduct, as it has many times before. Most likely, the complainant will be a woman. To tease out why some hats don’t go well together, we’re going to put ourselves in this hypothetical woman’s shoes.

She pores over her draft email that lays out, detail by detail, what he did. If she could find a way to leave it all in the past – just flick some kind of switch in her head – then she would. But it doesn’t work like that. Her anxiety intrudes into the present. So does her shame. She’s asked herself so many times, Do I really want to go up against this man who harmed me, who’s powerful and well-connected? What would I stand to lose? At the same time, her own voice counters. Who else could be hurt if I don’t act? Who already has been?

She was always the careful type, even before what happened. She thinks before she acts, researching carefully. The Medical Council: yes. That’s who she’ll send her complaint to. But who are they, exactly? She browses their names, looking up each of them online. One of those names is Roderick Mulgan.

Mulgan crops up on The Platform, Sean Plunket’s right wing show. The woman watches as Mulgan, in the months before his own appointment to the Medical Council, runs it down and knocks its cultural competency standards – scoffing at the idea “that there are nebulous biases in the world and in the health system that somehow or other undermine the welfare of Māori just because they are Māori”.

As a wahine Māori, this doesn’t sit well with her. It’s not just that she thinks Mulgan’s straight-up wrong: even back in the day, when she was at university, she studied the evidence on racial bias in healthcare. It’s like Mulgan’s saying the person who believes in racial bias – who’s maybe experienced it – isn’t credible. Is that what he’d think of her?

Watching him talk on The Platform, the woman sees Mulgan is representing something called the Free Speech Union. He’s on the organisation’s council, alongside a guy called Jordan Williams. That name, Jordan Williams, rings a bell, and the woman searches again.

The Free Speech Union work alongside the Taxpayers’ Union. This Jordan Williams guy helped found both, and is a key player in each. The woman blanches.

Williams has plenty of online stories to his name. One of those was an infamous fight with Colin Craig, during which the Court of Appeal described Williams as “harbour[ing] offensive attitudes towards women”, observing he’d exchanged messages with Cam Slater that were “sexually crude and disparaging of women, particularly those of a different political leaning”. In one such exchange, seperately reported by Nicky Hager, Williams said to Slater, “Women, if they didn’t have a fanny between their legs they’d have a bounty on their heads”. Slater replied, “If they didn’t have cunts we’d chuck rocks at them”.

What kind of jokes are these, the woman thinks? If anyone knows violence against women is a serious issue, it’s a health professional. Reading about Williams’ behaviour has left the woman dismayed – and yet Mulgan, a doctor, has chosen to work with him.

Something else catches the woman’s eye. Surprised to learn Mulgan wears yet another hat, she finds out his lawyer website and scrolls it, one testimonial after another.  CHARGES INCLUDED ATTEMPTED RAPE AND STRANGULATION. She stops. She breathes in slowly, then out again. Whenever she reads something like this, the memory of what happened to her feels acute. The anxiety comes back, and the shame.

She wonders, how’s this is meant to work exactly, this being a doctor and a defence lawyer at the same time? Can someone be an advocate one day, going into bat for alleged rulebreakers, then neutrally uphold those same rules the next day? How does he go from treating abused women, something he must have done as a GP, to advertising for alleged abusers as clients? Can he just swap ethical codes like flicking a switch in his head, moving from lawyer to doctor as easily as he’d moved from doctor to herbal pill salesman?

The woman feels sobered. She looks again over her complaint, with its painful details she’s told no one before. She breathes deeply once again, taking a moment before she sends.

As I wrote this, another Free Speech Union email landed in my own inbox. It was the same as any other: dubious facts cherry-picked to stir up rage, followed by a donation button. But this one took aim at a new issue.

The psychology profession has just made an apology to Māori for its historic failures to uphold Te Tiriti o Waitangi. The profession can do what it likes, the Free Speech Union conceded – only they don’t concede it at all. The email says:

It [the apology] has a message for Pākehā psychologists. Any “resistance or discomfort” they feel is “a reflection of defensiveness and fragility”….

In other words, if you disagree or say you’re not to blame, that’s taken as proof of the problem. 

… They’re welcome to that view, but it’s a politically contested ideology and not particularly nuanced, and once it’s dressed up as “values” and enforced by regulators and university panels, there’s no room left for anyone who sees things differently.

The Free Speech Union admit they see values as a problem. Credit where it’s due: this is the most honest thing they’ve ever said.

In these bullshit times, when our democracy is under assault, values and ethics, real evidence and critical thought, are a line of defence. Health professionals stand guard at that line. Of course that makes them a target of the far right.

Towards the end of Dirty work, almost in passing, Nicky Hager makes a fascinating point. Big donors support the far right network, for sure, but it’s the small donors we need to look out for. I guess they lack the cool calculation of big donors, who’ve made fortunes they now use to manipulate the world around them. Small donors may have less to give, but they’re motivated to give it – and there are so many of them that the little they donate adds to a lot. The far right can’t succeed without them.

Small donors just need a shot in the arm, fear or anger or grievance, and someone plausible-sounding to administer it. Never mind the medicine’s worse than a sham. It’s a poison.

Our hypothetical woman, our complainant to the Medical Council, stares at her screen. She finishes her final scan of her draft email. She hits send.

Or she doesn’t. It’s all too opaque and confusing, too unclear how things work; too hard to know what anyone believes these days, too hard to trust.

She clicks the X to discard her unsent message. She is done.