Addressing inequity among concerns for M¯aori agency
Porirua health professionals and local iwi have great expectations for the forthcoming Ma¯ ori Health Authority, as the community grapples with high deprivation, high concentrations of patients with complex needs, inequity and access concerns.
Health Minister Andrew Little foreshadowed the authority’s creation as part of a major announcement on Wednesday which also spelt the end of the fragmented district health board (DHB) system set to be replaced by a centralised agency, Health NZ.
While specific details on the Ma¯ori authority were yet to be ironed out, including the level of funding it would be responsible for, Little confirmed it would have commissioning powers, and would be able to make joint decisions alongside Health NZ.
Te Ru¯ nanga o Toa Rangatira chief executive Helmut Modlik said funding equity would be key. However, the Nga¯ ti Toa iwi leader was optimistic work already under way to establish a new community health network in the city would be afforded support.
Working in conjunction with Capital & Coast District Health Board ‘‘for over the past year’’, Nga¯ ti Toa will lead a collective of primary care services, with the possibility other secondary care services could be relocated into Porirua.
‘‘I am hoping it means we can proceed even more ambitiously than what the DHB was contemplating, so we’ll see . . . the catalyst for [the network] was because the total amount of money being spent in the Porirua area wasn’t marrying up with the health outcomes,’’ Modlik said.
Such an endeavour would help tackle what Modlik believed was the most urgent issue facing health services in Porirua – access with affordability, location, and clinician availability.
Dr Bryan Betty, also the medical director at the Royal New Zealand College of General Practitioners, treats diabetes patients at twice the rate seen in the general population at his Cannons Creek practice. About 90 per cent of patients there were deemed high needs. With worryingly-high levels of ischaemic heart disease, obesity, and mental health issues present in Porirua, more funding was needed to achieve better health outcomes to rebalance underinvestment, Betty said.
‘‘We’ve now had years of inequitable healthcare delivery to Ma¯ ori, particularly in Porirua, an area of high need with high concentrations of very complex patients.
‘‘Where you’ve got a high concentration of patients with highlycomplex needs, you need to resource in terms of your doctor numbers, allied health numbers, social workers, community workers. And we have continually, over the last generation, underfunded those services. It’s been a total failure in the system.
‘‘Something has to change,’’ he said. Waitangirua’s Marearoa Marae Health Services chief executive Simon Phillips agreed.