Māori Health inequity as a humanitarian crisis in Aotearoa?

Over the next few weeks we will be showcasing developments and thinking from across our network and will share some of the cool, interesting or challenging things we’re doing. 

Today, we’re kicking off our posts with a note from our Chief Executive, Simon Royal. Simon is a named claimant in Wai 2687, a contemporary Waitangi Tribunal claim that is being heard by the Tribunal later this year as part of its Kaupapa Inquiry into health.

When I talk to people across the country one of the questions I often get is “why are you getting yourselves caught up in a Waitangi Tribunal claim?”  After two decades working in Māori health, the answer is simple: there’s a huge gulf between what the health system currently delivers for Māori, and what it should do.

I’m convinced we can have a better hauora system that delivers for Māori and builds off considerable Māori knowledge and expertise. But there needs to be significant change to make that happen.

I know change doesn’t just happen by itself - it comes about because of people who challenge the status quo. And that is what NHC Trustee Henare Mason and I are doing, through our Waitangi Tribunal Claim.

The National Hauora Coalition is the country’s largest Māori Primary Health Organisation, with over 130,000 people enrolled for our primary care services. Even with our significant size, I have seen first hand how hard it is for Māori providers to be on even footing with mainstream organisations when were just trying to deliver high quality care for people who need it most.

This is a Treaty issue but it’s also an issue of indigenous rights.  In August last year the UN Committee on the Elimination of Racial Discrimination said that it was concerned about inequities for Maori . It went on to note that “despite the Māori Health Strategy (He Korowai Oranga) and the Healthy Families NZ initiative, Māori needs are not adequately integrated in health policies or in the administration of health services, and …  Māori encounter significant barriers in accessing basic health services on an equal footing with other New Zealanders. The Committee is concerned by reports that structural biases exist in the health care system; that Māori providers are marginalized and their input into policy decisions is discounted; and that a negative differential compensation for Māori providers is maintained”

It may be hard to read such excoriating criticism of ‘egalitarian Aotearoa’ from an international body.  But from where I sit these comments are valid. We need to ask ourselves whether the health situation for Māori in this country has now got so bad that it constitutes a humanitarian crisis?  This is a human disaster on the scale of the Christchurch earthquake and it deserves an equally swift and decisive intervention.  Something must be done.

As a country we need to ask what we can do to counter the stark inequity and institutional racism; to stop  relying on the perceived wisdom of the established political, social and economic elite. This elite is making decisions based on their own values and viewpoints without being visible to everyday New Zealanders. And frankly they are making bad policy.

So that’s why we are looking to the Waitangi Tribunal process—to challenge these views and help set the record straight about our lived experience.  The Crown needs to address the fact it hasn’t done well for Māori so far, and the structural racism that has allowed this failure.  The health system was not designed to work for Māori in the first instance.

With the recently announced Health Sector Review, it is clear that the Labour-led Government is ready for some kind of change. Designing the health system for Māori should be the top priority.  Māori must be be at the forefront of any public sector hauora reform. And at NHC we fully intend to be part of a new conversation about the future. The time is right for us as Māori to control our own destiny, and the health system.

The Waitangi Tribunal is set to hear evidence on stage one of the Kaupapa Inquiry in October. And the Health Sector Review is expected to take on the Tribunal’s findings before it reports back in January 2020. In the meantime, National Hauora Coalition is continuing its focus on serving its enrolled population of over 130,000 enrolled patients under its vision of Mana Whānau - Whānau Ora.