Humanising government inquiry: A realist examination of a restorative approach to surgical mesh harm in Aotearoa New Zealand (7 October 2026)

Summary

Evidence is limited on how people experience government-commissioned inquiries, what they value about them and the impacts of procedures. This study applies realist logic to examine the experiences of those designing and participating in a government-commissioned restorative approach to harm associated with surgical mesh use in Aotearoa New Zealand. Attention is paid to divergent perspectives about harm and responsibility, desired outcomes, and the multiple identities that shaped people's responses to the programme.

Content

Compounded harm arises when the different ways individuals make sense of the cognitive, moral and emotional significance of harm are overlooked. It may also arise when governments and providers do not proactively disclose the inherent risks of healthcare, or the trade-off between the ideal state and what is possible within constrained resources. Three mechanisms contributed to the restoration of dignity, wellbeing and trust: collaborative and adaptive restorative design, dignifying storytelling and responsiveness to the potentially traumatising nature of healthcare harm.

Findings underscore the critical importance of acknowledging the prevalence and lived experience of harm, nurturing basic and relational trust, including diverse perspectives, and remaining adaptable if public inquiries are to be effective. Practical recommendations for those commissioning public inquiries emphasise restorative strategies that foster dignity, wellbeing, trust and adaptability while balancing complexity, dynamic human needs, and institutional responsibilities.