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In the 2020 New Year Honours, Hay was appointed an Officer of the New Zealand Order of Merit, for services to broadcasting and the music industry.

It was too much change for some of the audience. She had a New Zealand accent in an era when BBC style received pronunciation was compulsory for New Zealand television presenters, and they were required to attend elocution lessons. She either refused to attend, or was let off. Hay was the first New Zealand television presenter to speak with a New Zealand accent. Journalist Veronica Schmidt recalled that “although the BBC plum was no longer stuffed in every announcer’s mouth, appearing with an entirely raw Kiwi accent was still unheard of”. Listener writer Diana Wichtel remembered her unreconstructed Kiwi vowels as "depending on your point of view, the end of civilization as we knew it or a breath of indigenous fresh air". For her part, Hay was unrepentant, telling the New Zealand Listener “I’m a New Zealander. I’m not ashamed of my New Zealand accent.”

In February 2018 she began a late night radio show on RNZ National Lately, With Karyn Hay.

Her third novel, Winged Helmet, White Horse was published in New Zealand in 2018 with the NZ Listener calling Hay "a smart, gutsy writer ... it’s impossible to read this book without hearing her trademark vocal delivery. She isn’t afraid of flawed characters or loose ends, and throws in plot twists you won’t see coming. Good at witty dialogue, she also takes a few comic and barbed pokes at middle-class life and the literary world".

In Spring 2018 she was a resident at the Michael King Writers' Centre.

Her second novel, The March of the Foxgloves, was published in New Zealand in 2016. Set in 1893, the book touches on the 19th century trade in erotic photography. A deluxe hardcover edition included photographs by fine-art photographer Vicky Papas Vergara, featuring Australian burlesque artist Miss Sina King. The March Of The Foxgloves was No. 1 on the New Zealand fiction charts.

Emerald Budgies was described in the blurb as "a darkly comic tale of drug addiction and betrayal". It was first published in England, in 2000, under the nom de plume Lee Maxwell (her middle names). She had wanted to throw off her previous public image but, on the promotional tour that followed, she said she felt like an imposter in a spy movie. "I started thinking, maybe I don't want to be this new person, maybe it's not so bad being Karyn Hay." Kate Camp described Emerald Budgies as ‘raw, thoughtful and very funny’. Chris Knox said it 'was not for the queasy... Imagine 1980s Doris Lessing crossed with Bret Easton Ellis and you’re some way to imagining what this book reads like'. For Denis Welch it was, “A relentlessly bleak — if extremely funny — vision of modern life with no redemption whatsoever for anyone anywhere . . . There are times when Emerald Budgies makes Trainspotting look like Rebecca of Sunnybrook Farm.’ Emerald Budgies won the NZSA Hubert Church Best First Book Award for Fiction in the 2001 Montana Book Awards. and Hay was awarded a Frank Sargeson Fellowship in 2004.

In 1987 Hay moved to London with partner Andrew Fagan, ex-lead singer of rock band The Mockers. The couple lived on a houseboat on the River Thames . It was here that she wrote her first novel Emerald Budgies. Karyn returned to New Zealand with Andrew in 1989. They returned to England in 1996 where she had two children She returned to television presenting in 2008 for Rocked the Nation and the 2015 documentary NZ Women in Rock.

Her stint with Radio with Pictures ran for five years. She left in 1986, later recalling that, “Being a TV personality or whatever, celebrity just wasn’t me in a way…I didn’t want to be stuck.”

Her television career began in 1981 when she wrote to Television New Zealand suggesting they might like a new presenter for alternative music show Radio with Pictures. Producer Peter Blake thought “she was right for the times...after the whole punk new wave thing, the music was changing, and the programme with it."

Karyn Hay ONZM (born 1959 in Auckland) is a New Zealand author and broadcaster. She came to fame as the presenter of 1980s music TV show Radio with Pictures before going on to an extensive career in television and radio.