Māori health leaders react to damning Waitangi Tribunal report

Ngā Mataapuna Oranga managing director Janice Kuka. Photo / Andrew Warner

For decades, poor health outcomes of Māori have become almost commonplace. Health leaders in the Bay of Plenty and rest of New Zealand have repetitively drawn attention to the need for extra funding and support for Māori health. Now, the Waitangi Tribunal has released a report claiming the Crown has breached the Treaty of Waitangi due to Māori health outcomes in New Zealand. Reporter Jean Bell investigates where it all went wrong.

Bay of Plenty health leaders have welcomed a damning Waitangi Tribunal report into Māori health and have joined national calls for a system overhaul.

The Waitangi Tribunal report stated the Crown breached the Treaty of Waitangi by failing to set up and run the primary health system in a way that reduced the gap between Māori and non-Māori health outcomes.

The tribunal - which investigates any Government actions or laws which could break Treaty promises - made two key recommendations: Crown consideration of a Māori primary health authority, and consideration of compensation for underfunding of Māori health providers over the past 20 years.

The tribunal, which released the report last week, gave the Crown until January 20 to respond to its recommendations.

Ngā Mataapuna Oranga managing director Janice Kuka said the tribunal was courageous in releasing its "game-changing" report.

In addition to structural reforms of the healthcare system, she called for a refreshed look at legislation in relation to the Treaty to ensure it meet the needs of people in modern life.

Kuka, of Ngāi Te Rangi and Ngāti Ranginui descent and was one of the claimants, believed the current Primary Health Organisation system did not work for all New Zealanders, while Māori received the shortest end of the stick.

"[Māori] feel the brunt force of a system that isn't working."

The organisation serviced around 20,000 people throughout the Western Bay of Plenty, including the 12,000 people enrolled in its four GP clinics - Te Puna, Gate Pā, Pāpāmoa and Te Puke.

Kuka said the organisation's clinics were constantly under the pump, working with a number of chronically ill people visiting three or four times a week.

"Our clinics are always overwhelmed."

A lack of funding combined with clients battling social issues, such as poverty, meant there could be huge barriers for people needing health care, she said.

"Some people live in crisis, all the time."

Aside from medical care, Kuka said better support services for addiction, mental health and family violence were needed to address other social issues.

"It would take resources now, but in the long term we would get better results."

Kuka said Māori knew what worked for Māori and that voice needed to drive the system's structure and funding.

Western Bay of Plenty PHO co-chair and Ngāi Te Rangi chief executive Paora Stanley said it was no surprise that Māori health in New Zealand was an "abysmal failure."

"For decades, resources have not been matched with the need in Māori health."

"We've got a huge Māori health problem and we're staring it right in the face.

Western Bay of Plenty PHO co-chair and Ngāi Te Rangi chief executive Paora Stanley said it was no surprise that Māori health in New Zealand was an "abysmal failure. Photo / File

"The Crown will throw money into fighting us, but when it comes to looking after us they don't have any money."

Stanley said Māori were more likely to get cheaper and less effective medicine than non-Māori and called for the implementation of a health care system called Nuka which had been used for indigenous people in Alaska.

Nuka halved hospital admissions for chronic health problems in indigenous peoples there and had great potential in New Zealand, Stanley said.

Associate Minister of Health for Māori Health, Peeni Henare, said in a written statement it was important to note the Government had already acknowledged the current state of Māori health was unacceptable and considerable work was needed to achieve equitable health outcomes between Māori and non-Māori.

This Government has invested significantly in improving access to Māori Health services and to ensuring new services continue to grow, including $20 million in the 2018 budget and $24m in this year's budget to the Māori Health innovation fund, he said.

The 2019 Budget also invested more in the Māori health workforce, with $10m dedicated to this over the next four years, he said.

The Māori Health Gap
• Māori life expectancy 7.3 years (males) and 6.8 years (female) lower than non-Māori

• Māori 1.7 times as likely to die from their cancer compared to non-Māori

• Māori deaths from heart disease more than twice as high as non-Māori

• Māori rheumatic fever rates five times higher than non-Māori

• Young Māori twice as likely to be hospitalised for asthma

• 88.9 per cent of Māori immunised compared to 91.9 per cent for non-Māori

• Sudden unexplained death rate five times higher for Māori infants than non-Māori

• Māori more likely to have not seen a GP in last 12 months, not collected a prescription, accessed services later, and faced cost barriers to healthcare, than non-Māori

Source - Hauora: Report on Stage One of the Health Services and Outcomes Kaupapa Inquiry 2019