ONZ History is important, explaining the present and guiding the future
The Royal Australian and New Zealand College of Ophthalmologists (RANZCO) evolved from state-based Australian medical societies, beginning in Victoria in 1899 and expanding nationally with the establishment of the Australian College of Ophthalmology in 1969. It gained ‘Royal’ status in 1977, becoming RACO. In parallel, New Zealand ophthalmologists formed the Ophthalmological Society of New Zealand (OSNZ) in 1946. Discussions of trans-Tasman collaboration gained strong momentum in the 1990s under the leadership of Bruce Hadden, then Chair of OSNZ (1994–95). Following a supportive ballot in 1996, the two bodies amalgamated in 1997, adopting the name RANZCO in 2000. This integration reflected a shared commitment to high standards in training, ethics, and continuing professional development, with Dr Bruce Hadden later becoming the first New Zealand-based President of RANZCO in 2002.
RANZCO’s strength lies in its role as the authoritative body for academic standards, clinical training, and professional ethics. To maintain credibility, it must remain independent of commercial and political pressures. However, this limits its ability to engage in medico-political advocacy, particularly in dealing with government agencies, hospital systems, insurers, and regulatory pressures. This gap has long been recognised. In Australia, it led to the formation of the Australian Society of Ophthalmologists (ASO) in 1982, which matured into a strong advocacy body during periods of financial pressure, including Medicare changes affecting cataract surgery fees.
In New Zealand, similar challenges emerged through the 1990s and 2000s, including Commerce Commission investigations, increasing government influence, changes by the Medical Council of New Zealand reducing colleges’ authority over qualifications, and growing pressure from insurers and other professions expanding into ophthalmic care. These developments highlighted the need for a dedicated organisation to advocate for both patients and ophthalmologists within the local political and funding environment—something neither RANZCO nor the Australian-based ASO could fulfil.
RANZCO therefore initiated the establishment of Ophthalmology New Zealand (ONZ) in 2012. Despite early challenges and limited initial support, key figures, including Dr Mike O’Rourke and Dr Stephen Best, played important roles in its formation. ONZ was designed to complement RANZCO by focusing on medico-political advocacy, protecting professional standards, and supporting equitable patient care. Over time, ONZ has grown in capability and influence, though its effectiveness remains closely tied to membership support.
The contrast with Australia is notable: ASO maintains strong membership despite higher fees, reflecting recognition of its value. In New Zealand, some ophthalmologists underestimate the importance of advocacy until significant challenges arise—by which time it may be too late. Early examples, such as difficulties securing insurance funding for femtosecond laser cataract surgery around 2012, illustrate the consequences of limited advocacy capacity during ONZ’s formative years.
Ultimately, the history of RANZCO and ONZ demonstrates the importance of both strong professional standards and effective advocacy. While RANZCO safeguards clinical excellence, ONZ plays a vital role in navigating the political and financial landscape. Sustained engagement and membership are essential to ensure the profession can shape its future, rather than react to external pressures.
