John Tamihere: Why the Māori Health Authority will improve the health of our most vulnerable and provide better outcomes for all Kiwis

Health Minister Andrew Little's health restructure will provide better outcomes for Māori. Photo / Mark Mitchell

OPINION:

Tomorrow, July 1, 2022, marks a pivotal and substantial change for the health sector in this country that is going benefit a lot of folks - not just Māori.

The Māori Health Authority is going to even the playing field for everyone because what we see as beneficial for Māori is also beneficial for every vulnerable community.

First of all, the existing system housed too many bureaucrats and too many regulators with not enough focus on the patient. There was too much emphasis on experts and positions.

The other thing is it can only get better for Māori and Pacifica as we were plumbing some big gaps we needed to overturn as the system was just getting out of hand. This new health structural overhaul means it is all about the person and the whānau rather than the professional and the practice. We have to bring the little Kiwi to the front and centre of the health system, with advocacy and transparency about what decisions are made and how it affects them.

I am aware of the cynical landscape that exists with mean-spirited people who believe this is separatism.

Māori had previously been granted around 2 per cent of the overall health budget for years, basically a thin slither of a very large pie. That is separatism right there.

It is a known fact we are more susceptible to certain health conditions, like diabetes and bowel cancer, and our life expectancy is lower. This is also mirrored by those existing in vulnerable communities and in this country, there are dozens.

Everyone is entitled to the same type of healthcare and this new system is going to make strong headway into making sure that happens.

Last year the lightbulb really went off when the Ministry of Health were presented with proof that a $5 billion-a-year investment is required to eliminate discrepancies on Māori health. This was through the Sapere report that the Ministry of Health itself commissioned.

Short term benefits for healthcare providers like Te Whānau o Waipareira is that our DHB contracts were very old and very messy.

With this new shift they can all go into one investment pool thus leaving us free to venture forward with mobile campaigns delivering services to our more impoverished areas with our pop-up clinics. These would provide regular, efficient frontline care dealing with patients needs and wants in their own neighbourhoods.

That is an immediate change that will bring services to the communities rather than having transactional meetings. We can customise the hours so that it suits māmā with pēpē in the mornings, and then again in the afternoon when parents are taking their tamariki home.

This is not a Māori-only approach, which is evident once you start to read more than a headline or clickbait.

At Waipareira, 45 per cent of our patients are non-Māori, but they are in the same vulnerable categories with problematic incomes. So, we advance their interests in areas like elective surgeries. This new system will provide better and clearer advocacy as the patient will be the focus.

For example, easier access to pharmaceuticals and waiving the $5 prescription fee, and even having medication delivered and making repeat prescriptions electronic. These factors alone will let some air out of the tyres for our overstretched health system.

The biggest challenges for the Māori Health Authority will be the embedded racist activity by certain folk. There is this thing called unconscious racism or unconscious bias and that's practised by racists when they are asleep - it's when they wake up that we start to have problems.

What we have to do is confront them, acknowledge it happens and tell them we collectively have to get over it. What is needed and overdue is simple, start treating everyone the same regardless of culture, colour or creed.

Looks easy, and it is.

And then our value for money needs to be addressed. We have to see the value of services we are getting for the amount of money.

Don't take my money, spend it on me, disservice me and then blame me for failing. That is the whole notion for the turnover of the health system and we look forward to the Māori Health Authority changing that thinking

John Tamihere is a former Labour Cabinet minister and chief executive of Whānau Ora and West Auckland Urban Māori organisation Te Whānau o Waipareira.