We already have separatist healthcare

John Tamihere

OPINION The response to the government’s announcement of a Ma¯ ori Health Authority triggered white New Zealanders to vent on social media with a venom that Ma¯ ori are confronted with most days of their lives.

Let’s look at how separatism and apartheid in the New Zealand health system plays out.

There are multiple examples that I can use that happen on a daily basis.

Examples show that in a firstworld country, Ma¯ ori do not receive equal services compared to white New Zealanders who share Aotearoa.

We are told to never doubt our scientists and experts in this pandemic environment.

Those same experts know that Ma¯ ori contract cancer 10 years in advance of their fellow white New Zealanders. Are those Ma¯ ori screened for these cancers early to ensure that they get a better shot at recovery or longevity?

The answer is: no.

Someone has clearly made a decision that Ma¯ ori will be consigned to a more gory death by blocking access to early cancer testing.

If the shoe was on the other foot, it would mean no white person in New Zealand would be screened for cancer until they were 70. Can you imagine the storming of Parliament by white folk if they had that visited upon them?

Right now in the largest city in this country, there are 60,000

Ma¯ ori enrolled within the Primary Health Care services, run by and for general practioners. But while members of this group are enrolled, they are not engaged by their GP.

If you do the maths, every Kiwi adult going to a GP is worth on average $350 a year, paid by the government. This is before the GP charges the co-payment. Doctors draw down every month this entitlement called a Capitation Fund – including the 60,000 Ma¯ ori, even though the GP has never engaged with them.

That is taking money from

Ma¯ ori under false pretences –

$24 million a year to be precise.

In one DHB area in the middle of the North Island where 34 per cent of enrolled patients are

Ma¯ ori, the district health board called me into a meeting to determine why Ma¯ ori presented at their hospitals with severe and acute illnesses.

Because of the size of population of Ma¯ ori in this district, we were able to explore their primary health records.

This showed that non-Ma¯ ori received more blood checks and analyses, and far more referrals to specialists than a Ma¯ ori from the same clinic.

The question is why did white New Zealanders receive a better deal across the whole of the primary health interface in that district than their fellow Ma¯ ori citizens? It’s because we receive a separate, substandard service.

Ma¯ ori rights to elective procedures and surgeries are also a telling piece of evidence. For some reason, Ma¯ ori are placed to the back of the queue.

Let’s look at this separatism in another way.

Money is voted to the health system on a per capita basis. At times extra weightings are provided on a deprivation status to communities in difficulty.

In simple terms: a dollar is voted to a Ma¯ ori for their health from Treasury, through Parliament. That dollar is handed over to the Ministry of Health. Without any knowledge or consent, 25 cents is deducted from the Ma¯ ori dollar as soon as it lands at the Ministry of Health. Then 75 cents is handed to the

District Health Board, where a further 65 cents is deducted. The rest is frittered across a wide health network – predominantly white New Zealand organisations. Ultimately 2 cents of that dollar finally lands in the hands of a to Ma¯ ori by Ma¯ ori for Ma¯ ori organisation in their community.

Ninety eight per cent of all decisions in health, are made by white folk. This is economic apartheid in practice. This is social apartheid in practice.

So when a politician like Judith Collins states that we have a health system that is separatist, she is absolutely right. Ma¯ ori are consistently separated for secondclass treatment, and this plays out across every government service.

Health must be the first mega ministry to be unbundled but others will follow.

Bizarrely, we have just finished the numbers. Ma¯ ori get 2 per cent of Oranga Tamariki funding to build capacity to fix their communities. For three decades we have been purposely locked out.

Non-Ma¯ ori received more blood checks and analyses, and far more referrals to specialists than a Ma¯ ori from the same clinic.

John Tamihere is a former Labour MP and Cabinet Minister and is CEO of urban Ma¯ ori organisation Te Wha¯ nau o Waipareira and the Wha¯ nau Ora Commissioning Agency.