Ma¯ ori health woes need circuit-break
Consider what you may do or achieve in the last seven years of your life — be it travel, writing letters to the newspaper or spending time with grandchildren. These years are likely to be denied your Ma¯ ori neighbours. Ma¯ ori life expectancy is still seven years below non-Ma¯ ori and Ma¯ ori fare worse in nearly every area of healthcare from cancer rates to child hospital admissions and access to health services.
The latest call for action about this appalling inequity is the release this week from the Waitangi Tribunal of Hauora: Report on Stage One of the Health Services and Outcomes Kaupapa Inquiry 2019.
Some point out Ma¯ ori often suffer from poor individual choices but to dismiss such levels of inequity is simple sophistry.
The tribunal says the Crown should consider establishing a Ma¯ ori primary health authority to control and monitor Ma¯ ori health-related spending and policy, and consider compensation for underfunding of Ma¯ ori health providers over the past 20 years.
PHOs have allowed community-led healthcare with funding provided for clinics based on members rather than appointments and Ma¯ ori groups have established their own PHOs as a means to take control of their healthcare.
However, claimants 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 received less than 2 per cent of health funding overall.
There has been report after report. One report is simply the list of reports carried out by the Ministry of Health over 24 years — Ministry of Health reports on Ma¯ ori health outcomes and disparity in outcomes between Ma¯ ori and non-Ma¯ ori from 1992 to 2016. Out of these reports have come innumerable recommendations and initiatives to tackle the issue.
New Zealand’s current overarching Ma¯ ori health strategy, He Korowai Oranga — literally, the cloak of wellness — was first established in 2002 and refreshed in 2014.
The Wellbeing Budget in May committed $80 million over four years to expand the coverage and impact of Wha¯ nau Ora, under Te Puni Kokiri, a small agency with broad responsibilities.
Five years on, the Waitangi Tribunal has reviewed the evidence and says not enough is being progressed.
The fact is, Ma¯ ori are at the sharp and tragic end of a flagging health system, as painfully illustrated by the Herald’s recent Fair Care series.
Twenty health boards is probably too many for a country our size.
There simply isn’t enough money to sustain the current unacceptable level of healthcare, let alone improve it.
This current Labour-led Government, keen to ko¯ rero about well-being, needs to take the bit between the teeth and address the whole healthcare crisis for everyone’s sake.