Maori health remarks distorted, says author

Rhys Cullen says the book he co-wrote aims to get greater Maori involvement in determining their health needs. Picture / Martin Sykes

The doctor who co-authored a controversial book on Maori health has distanced himself from claims that Maori should smoke, gamble and eat excessively if they want.

Dr Rhys Cullen, who wrote Maori Health with his Papakura practice manager, Peter Caccioppoli, said critics had taken comments from the book out of context.

"Gambling to excess is never a good idea. I don't think anyone should smoke or eat to excess. What I am saying is if you want to stop Maori doing those things you can't do it from nagging from the outside. It must be driven from the inside, and they [Maori] will effect the changes."

Dr Cullen said he had very "traditional and mainstream" views when dealing with patients "one on one".

"We will advise individual patients not to smoke, we immunise our kids, all those things you would expect a mainstream general practice to do."

The book was designed to stimulate discussion and to get greater Maori involvement in determining their health needs.

"We don't endorse problem gambling. Gambling is a problem for some Maori. And those Maori need to do something about it.

"There is no denial that smoking is a huge problem, and obesity is a huge problem. We do not say Maori should smoke and Maori should eat all they want.

"Maori making a choice that somebody or another thinks is a responsible choice for them is just Maori being brainwashed, and we are very opposed to that."

Dr Cullen said the book was not targeted at Maori readers and provided little in the way of health advice, but was designed to stimulate thought among "first- and second-year under-graduate students".

The GP also acknowledged he was not qualified to speak as an authority on Maori issues as he had limited Maori ancestry.

"I'm not speaking on behalf of Maori. I certainly am a health professional and have very traditional doctor health views, on smoking, obesity and lung cancer. They are mainstream."

He accepted that he and Mr Caccioppoli had been outspoken on a number of issues, but denied he enjoyed being controversial.

"I think it is because most of our views aren't mainstream ... and we are both reasonably loud in promoting them."

He was unconcerned at the prospect of having health funding reviewed because of media reports and believed the views in the book were not reflected in his practice. "I think ... we are very conventional in the one-to-one advice we give to patients.

"The practice discourages smoking, eating excessively, gambling, with patients.

"A book is a good place to question the guidelines. You can't do that one-to-one with patients because ... whatever your own personal viewpoints, when people see a doctor they expect to see a doctor who has normal viewpoints."

The Royal New Zealand College of General Practitioners said the views in the book were not supported by established medical authorities.

The Medical Council said staff were sent a copy of the book but returned it "as it did not meet the standards of evidence-based medicine that we keep in our library".

- additional reporting: NZPA