Dr Rawiri Jansen at Middlemore Hospital. Photo / Dean Purcell
Matthew Rosenberg, Local Democracy Reporter
The Associate Minister of Health is disappointed more Māori have not stepped up to take the vaccine, but has acknowledged the healthcare system delivering it is racist.
Labour's Peeni Henare made the comments on the back of criticism levelled at the Government over a vaccine rollout strategy which advocates say disadvantages tangata whenua.
For every one non-Māori or Pacific person who gets their first dose of the vaccine, just 0.61 Māori get theirs.
"I travelled the country to continue to promote the vaccine amongst our people," he said.
"For whatever reason, our people didn't come forward to get the vaccine.
"So now what we have is [that] Delta has come to New Zealand, we find ourselves in lockdown, there's a sense of urgency about it, and I'm glad to see that the Māori numbers are improving."
But those numbers are not improving as quickly as Māori health advocates would like.
Dr Rawiri Jansen — who quit the Government's immunisation advisory group in April over concerns his voice was not being heard — said the rollout strategy was consistent with a racist system that disadvantaged tangata whenua.
Data released by the Ministry of Health shows vaccine uptake among Māori is lower by proportion of population than any other ethnic group in New Zealand.
Jansen said that outcome was predictable.
"I'm disappointed in the Ministry of Health and their inability to achieve what they promised in the beginning which was equity in the vaccination programme," he said.
"It is consistent with a health system which consistently, persistently, underserves Māori. And we know that racism is a feature of that system."
Research in The New Zealand Medical Journal released last September showed Māori were 50 per cent more likely to die from Covid-19.
Jansen said there was evidence that Māori aged 40 had a similar risk to their health as Pākehā aged 65.
In order for equity to be achieved in the rollout, he advocated for Māori and Pacific communities to be given access to the vaccine at a younger age.
Jansen also took issue with a "colour-blind" booking system that was at odds with good outcomes for Māori because it defaulted to "mainstream Pākehā settings".
"Māori and Pacific people have found it much harder to engage with text messages to tell them to go to a booking app, so that hasn't worked well for us.
"It was predicted, and it was predictable, and it underserved our population."
He said he agreed with Prof Papaarangi Reid's comments last week that the unfolding situation was a breach of the Treaty.
Jansen's sentiments are echoed by Dr John Mutu-Grigg, an orthopaedic surgeon based in Auckland who serves as chairman of the Royal Australasian College of Surgeon's Māori health advisory group.
Mutu-Grigg agreed the Government's programme had not been designed with equity in mind.
Māori and Pasifika people had a lower life expectancy and were prone to disease at a younger age, which was a key point the Government should have taken into consideration, he said.
"Because we started with the higher age groups, we just get less Māori in those groups by design.
"It hasn't taken into account that Māori will be more at risk at a younger age.
"Māori are more likely to live in intergenerational households so therefore they're more at risk of passing this on. This hasn't really been taken into account in this process."
But even when Māori were able to access a vaccination clinic, they still faced issues.
In Kaitaia, disgruntled non-Māori who were not able to access the vaccine at times that suited them had forced the hand of the district health board to refer them to Māori providers, Mutu-Grigg said.
The result was a "swamped" Māori clinic that ran out of vaccines and was not able to service the needs of its own community.
The Northland District Health Board was approached for comment but did not respond.
"It's unfortunate because everything we told the Government would happen, has."
Henare did not disagree that the health system was systemically racist and inequitable, saying Government had already acknowledged that.
But his conversations with Māori health workers on the frontlines showed they were already stretched to capacity, and low uptake was not because of a lack of effort.
"It is extremely disappointing [the low numbers].
"We poured a fair bit of money to allow iwi and hapū to send messages to their whānau to continue to promote it.
"For whatever reason, we find ourselves lagging behind."
Henare said the low numbers were not for lack of trying.
In Invercargill, which Henare visited as part of a nationwide promotional tour, Awarua Whānau Services chief executive Mata Cherrington had also experienced issues with her DHBs in regards to rollout strategy.
Although she had a good relationship with the DHB overall, she believed it, alongside the Ministry of Health, was removed from the reality of frontline work.
In the early days of Covid-19, the ministry had dictated what information was given out to the community.
"That's not helpful to us," she said.
Ministry group manager for Covid-19 equity Jason Moses said the ministry had taken a whānau-centred approach to boost Māori vaccinations.
"This means that when any member of the whānau is eligible to book, they can book in other members of their whānau to be vaccinated at the same time," Moses said.
He said district health boards were targeting Māori communities and getting "great feedback".
The ministry has dedicated a $39 million package to improve Māori health outcomes. That includes building provider infrastructure and workforce capability, a national virtual support network, and funding vaccine champions.
According to the Ministry of Health's latest data, 181,482 Māori have had their first dose of the vaccine — almost a third of the eligible Māori population.
It comes after case numbers spiked in May, June, July and again in September.