Radical change on way for Mãori as Little to reveal new health authority
To point to an individual Mãori person walking out of a hospital, cured, is to miss the abiding truth that collectively we die more, and earlier, and get sicker, than those non-Mãori strolling in and out around him.
On average, Mãori die seven years earlier than non-Mãori. In 2015, the heart disease death rate for Mãori per 100,000 people was double that for non-Mãori. (Both excluding Pasifika people)
Cancer, infant mortality, suicide. I could go on. Believe me when I say the stats are appalling and longstanding.
On Wednesday, Health Minister Andrew Little will reveal the Government’s plans for its new Ma¯ ori health authority.
The authority was part of a series of recommendations from the Health and Disability System Review released last year.
The toughest thing will be understanding what it all means. I digested the report myself and was struck by the thought that reading about health shouldn’t force you to selfmedicate.
This maddening love of technical words, jargon, forms like a poisonous crust at the top of the health system.
What is a ‘‘commissioning tool’’, I wondered, reading the report? A pen? A baseball bat? Politicians love this zone: a dark pocket where you can say anything, get away with anything, because nobody really understands you.
It is the worst kind of code to decipher as a journalist: draining your will, and leaving you a passive vessel – much like navigating the health system itself.
Where am I going, you ask yourself? How do I get there? It would be nice to relax, but as an outsider you worry that once the dust settles from your vaporised kidney stone, you’ll limp out with a subtracted gall bladder as a bonus operation.
It is a maze where you are hemmed in by the expertise of others.
The review was completed in March 2020 and aimed to offer a clear path forward for the Government. One of its main jobs was to ‘‘ensure improvements in health outcomes of Ma¯ ori’’.
This problem was crystal
clear, but the panel behind the report couldn’t even keep a lid on its own splits when it came to offering solutions.
Tucked away towards the end of the report, a faction proposed an alternative model for the Mãori authority.
These members said the Mãori authority idea was good, but had a stingy budget and limited purchasing power. It needed to go further.
As far as I can tell, their authority as proposed would be Mãori-owned, governed and operated.
It would get a hefty budget so it could pay for services on its own, and work with iwi and Mãori and district health boards at regional and local levels to support their purchasing as well.
It would start by beefing up kaupapa-Ma¯ ori workforce numbers, facilities and services. Setting the infrastructure in place, I presume.
Over several years it would then start paying for the likes of screening and disease prevention services targeted at Ma¯ ori, and a swathe of frontline health services, like GPs and maternity services, community pharmacies and radiology.
Like a game of reverse Monopoly, where one person owns everything at the beginning and then loses it, we might finally see the money (and thus, power) flow to the people who need it.
In one of the worst-kept secrets of the last few months, it appears the Government has thumbed through to the back of the review and now leans towards the alternative proposal.
It will hand over increased purchasing muscle to the authority.
I think this is good news. Let’s be clear, Ma¯ ori are hyper-capable organisers (myself withstanding). There is nothing iwi and hapu¯ and wha¯ nau cannot do – and do with the clear, big-hearted morality of our ancestors.
Successive Governments have obstructed our development thanks to the complaints of a fearful Pãkehã minority.
On Wednesday, what Health Minister Little owes us, everyone, but especially Mãori, is a clear explanation of what the new health authority is, and what it will do.
He will face the task of boosting its credentials with Mãori, while reassuring other parts of the community that it is anything but radical.
Don’t be fooled though, by jargon and complexities – if done correctly, it is something radically new.
But that is a good thing and will make a bracing departure from decades of radical failure for Mãori.