ATTN: The Official Information Act Coordinator
National Screening Unit
Health New Zealand | Te Whatu Ora

I write pursuant to the Official Information Act 1982 (OIA) to request information held by the National Screening Unit (NSU) within Health New Zealand | Te Whatu Ora. I am an investigative journalist acting in the public interest under the name Penny Marie NZ. My reporting focuses on public accountability and the administration of public health policy in New Zealand.

This request is one of three complementary OIA requests filed as part of a coordinated public-interest inquiry. A primary OIA has been filed with Health New Zealand | Te Whatu Ora regarding the January 2024 rainbow cervical screening campaign materials HE1191 and HE1192, which replaced the terms "women" and "female" with "people with a cervix." A separate secondary OIA has been filed with Te Kawa Mataaho | Public Service Commission regarding whole-of-government language guidance.

This secondary request is directed specifically to the NSU and focuses on: (a) the clinical and operational decision-making process underlying the language change; (b) screening coverage data; (c) health equity analysis conducted prior to the change; (d) the status of actions arising from the 2021 Parliamentary Review Committee report on the NCSP; and (e) complaints and feedback received in relation to the language change. This request does not duplicate, and should be processed independently from, any primary OIA filed regarding HE1191/HE1192 design and procurement.

Part 1: Clinical and Operational Language Decision
1.1 Committee Records and Internal Correspondence
Please provide:
Any NSU clinical advisory, clinical governance, or operational committee minutes or papers, covering the period 1 January 2022 to 31 January 2024, that discussed the language used in cervical screening public communications - specifically, any discussion of the shift from "women" or "female" to "people with a cervix" in materials directed at the general public.
Any correspondence between NSU clinical staff and the communications or health promotion team at Health New Zealand (or its predecessor, the Ministry of Health) regarding the language change in National Cervical Screening Programme (NCSP) materials.
Any clinical evidence review, literature summary, or evidence brief that informed the decision to adopt gender-neutral language in NCSP public materials.
1.2 External Clinical Consultation
Please advise:
Whether any external clinical body was consulted on the language change, including but not limited to: the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), the New Zealand College of Midwives, or the Royal New Zealand College of General Practitioners (RNZCGP). If so, please provide any correspondence or written advice received from those bodies.

Part 2: Screening Coverage Data
2.1 Current Coverage Statistics
Please provide the most recent available NCSP screening coverage rates, broken down by:
(a) Age group
(b) Ethnicity
(c) Gender identity, if currently collected by the NCSP Register
(d) Region or former DHB area

2.2 NCSP Register - Gender Identity and Transgender Records
Please advise:
Whether the NCSP Register currently records gender identity separately from biological sex for enrolled individuals. If so, how many individuals are currently recorded as transgender male, non-binary, or another gender identity distinct from female.
The number of individuals on the NCSP Register who are registered with a male gender marker but who are flagged as eligible for cervical screening.

Part 3: Health Equity Analysis
3.1 Pre-adoption Assessment
Please provide any health equity impact assessment, Tiriti analysis, or population needs analysis conducted before the adoption of gender-neutral language in NCSP materials, specifically addressing:
(a) The estimated size of the AFAB (assigned female at birth) transgender and non-binary population eligible for cervical screening in New Zealand.
(b) Any analysis of whether the use of gender-neutral language in cervical screening materials could reduce screening uptake among cisgender women.
(c) Any evidence or modelling used to conclude that inclusive language would improve screening coverage among gender-diverse people without reducing it among women.

3.2 Invitations Policy for AFAB Transgender and Non-Binary Individuals
Please provide:
The NSU's current written policy on how AFAB transgender and non-binary individuals who are enrolled on the NCSP Register with a male gender marker are invited to attend cervical screening - including whether they receive standard recall invitations, targeted outreach, or neither.

Part 4: Parliamentary Review Committee Recommendations
4.1 Implementation Status
Please provide:
Any NSU action plan, implementation register or formal response document prepared in response to the 2021 Parliamentary Review Committee report on the NCSP, specifically regarding recommendations relating to gender-inclusive language and outreach to gender-diverse people.
The current status of any actions arising from those recommendations, including whether any actions remain open, have been completed, or have been deferred.

Part 5: Complaints and Feedback
5.1 Volume and Nature of Complaints
Please provide:
The number of complaints or feedback items received by the NSU or through the NCSP between 1 January 2023 and the date of this request relating to:
(a) The removal of "women" or "female" from cervical screening materials.
(b) Gender-diverse people being excluded from, or confused by, cervical screening communications.
Any formal review or audit of HE1191 or HE1192 conducted after publication, including any post-publication evaluation of the materials' effectiveness or reach.

Statutory Matters
Response timeframe: I note that section 15(1) of the Official Information Act 1982 requires that this request be responded to as soon as reasonably practicable, and no later than 20 working days after receipt. Should Health New Zealand require an extension of time under section 15A, I ask that I be notified as soon as possible, with reasons.
Reasons for withholding: Should any information be withheld, I request that Health New Zealand provide the specific grounds for withholding under the OIA, and I note my right to seek reasons under section 19 of the Act and to make a complaint to the Ombudsman under section 28.
Format of response: I request that documents be provided in electronic format (PDF or Word) wherever possible. For numerical or statistical data, a tabular format (e.g. Excel or CSV) would be preferred. Where a document is voluminous, a schedule of documents with descriptive metadata would be acceptable as a first step.

I am happy to discuss the scope of this request if that would assist Health New Zealand in processing it efficiently.

Kind regards,

Penny Claridge