NZ health failings stir change call
Ma¯ ori leaders urge revamp of flawed system amid damning stats
Health leaders say the current system is failing Ma¯ ori and are calling for a Ma¯oriled agency to turn it around.
On average, Ma¯ ori die seven years earlier than non-Ma¯ori. They are twice as likely to die from cardiovascular disease or heart failure, and 1.5 times more likely to die from stroke or cancer than non-Ma¯ori.
Rheumatic heart disease rates are five times higher and diabetes twice as high.
“If these problems were for the majority population, we’d be doing something about them,” said Lady Tureiti Moxon, managing director of primary health organisation Te Ko¯hao Health.
Moxon presented evidence last week in the first stage of the WAI 2575 Health Services and Outcomes Waitangi Tribunal hearing at Tu¯ rangawaewae marae, in Ngaruawahia.
There have been more than 200 claims for the inquiry, which has been split into three stages. The first stage had been focusing on claims from Ma¯ori primary health organisations and providers in claim WAI 1315, and the National Hauora Coalition in WAI 2687.
Claimants from both groups say institutionalised racism and inequity are at the heart of the disparities in outcomes, and they want Ma¯ori at the forefront of a new system based on mana motuhake, or self-determination.
Moxon, presenting on behalf of WAI 1315, lodged her claim 13 years ago, yet said the issues facing Ma¯ori remained the same. “Diabetes is at epidemic proportions, with four times more Ma¯ori having to have limbs amputated.
“Is there an outcry? No, we just let the inequalities carry on, getting bigger and bigger. But it is time for a change.”
Contributing to the disparities in health statistics, Ma¯ori were twice as likely to experience discrimination in health and were three times more likely to receive differential treatment to non-Ma¯ori as a result of discrimination.
In the 2000s, PHOs came in, allowing community-led healthcare, with funding based on members, rather than appointments.
Ma¯ori groups established their own PHOs to take control of their healthcare and turn around the inequality.
But claimants have said the funding model was not adequate for Ma¯ori PHOs, where members were often in poorer health, making it more expensive to look after than those of an average practice. Ma¯ori PHOs also got less than 2 per cent of health funding.
Moxon’s group sought an apology, and repayment of 16 years of underfunding, estimated at $348 million.
They also sought a legislated mechanism for providing primary healthcare for Ma¯ori by Ma¯ori, and funding, controlled by Ma¯ori, and an Independent Ma¯ori Health Commissioning Agency.
“We want our own primary health system, to be able to run it ourselves, to focus on the services we need, so it is not always at the whim of the politics of the day.”
The second claimant group, WAI 2687, had similar concerns with the current health system and also wanted a new Ma¯ori-led agency established.
“We need our own agency, to assist and drive health outcomes for Ma¯ori,” said Simon Royal, chief of the National Hauora Coalition, the largest Ma¯ori primary health group.
Ministry of Health director general Ashley Bloomfield said the state of health for Ma¯ori was “unacceptable” but outcomes could be improved within the current system.
The hearing of stage one continues this week and next week. Late next year is stage two, looking at Ma¯ori mental health, disability, alcohol and substance abuse. The final stage’s focus is unknown.