Communications to Māori are still determined by the heirarchy. Photo / NZME
Communications to Māori are still determined by the heirarchy. Photo / NZME
Opinion: Speech delivered to Iwi Communications Collective Communicating For Health Equity at 10.30am today
It is significant that you are open to a tangata tiriti perspective on your issues as tangata whenua communications specialists. It would be useful if reciprocal attention was part of the daily practice on the part of health officialdom.
This highlights two things in my mind:
That there are genuine significant differences in what, how, when and why information and views require communication within and between the different cultures making up the population of Aotearoa
That there is a vital primacy for communication about health issues in the Te Ao Maori context given the outcome inequities, which are almost universally recognised, finally receiving some policy and practice attention, but remain persistent and damaging.
Thank you also for your individual and collective contribution to more effective communication among and from tangata whenua to the health services system. It is still common within that system to refer to poorly served people as “hard to reach” when in fact it is the system that is hard to reach for the people. Your work can help to bridge this divide.
Communication in the health services system is - which is not uncommon in large organisations on a “western” model - largely hierarchical. Its function is to make information and views that the controlling management and governance people consider important available to those working for or with or seeking service from the system.
Rob Campbell on health. Photo / Michael Craig
Much less, if any, attention is paid within the communications function to lateral exchange within the system or with other significant government and private services. Still less attention is paid to communications back to the controlling management and governance people of what the concerns are of those working for or with or seeking service from the system.
It is simply not possible to effect substantive and positive change in health services from within and using this structure. It is one of the key things that itself must change.
One of the really effective roles for Maori communications people in the system or interacting with it is to reverse this flow. What the people want and need is the spring from which communications should flow, not back upriver. Find the ways to cut through the hierarchy to communicate this in ways that cannot be avoided.
Often that will mean using public media and taking risks. Please do so. The system will not provide for you the means to undermine its power.
One part of your role, which is part of the hierarchical flow of information is in making information about services available known to whānau.
There are too many barriers to whānau getting equitable service even when they know of its availability and how to access it. So anything you can do to communicate more effectively on availability and access is important.
This should be funded by the system, and they do make efforts to improve their skill at it but a quick glance at those doing the communication will suggest that they might struggle as they do.
By Maori, for Maori applies to communication too.
Often this will be in the form of knowing your rights. Telling them like it is, not sugar-coated. As The Clash in Know Your Rights many years ago put it “You have the right to food money/Providing of course/You don’t mind a little/Investigation, humiliation/And if you cross your fingers/Rehabilitation”.
But clear advice that is practical and non-judgmental will help. Putting the hierarchy’s view of rights in te reo is not the same thing as effective communication with whanau, as you will all know better than I.
To go back to my opening thoughts:
You have a vital role in identifying each stage for your own organisation and for the hierarchy.
You are close enough to be whānau driven on this. Ignore communication that is not “what” is relevant. Sift it and bin it as it comes from above. Define what whānau want to know and to say and be steadfast in communicating that.
Be innovative in “how” you communicate.
I write stuff in mainstream media and places like LinkedIn or maybe Twitter. I have no doubt I am locked in an echo chamber of the Pākehā elite. You can join if you like for entertainment but largely your best channels will not intersect with mine.
It is more important to work in the media of whānau, kanohi ki te kanohi or whatever written or online media works for them.
I think most of what is produced by the formal communications channels of the health services bypasses its audiences from clinical professionals to users. It is not likely to be very useful to you.
Any effective communications have to be made when people are in a position and mode to receive it. That is not just time of day, though mid-shift is not ideal! I more have in mind communicating when the issue is relevant to whanau.
Available when and in contexts that make it more likely a message will be heard and interacted with. Your skill will be finding those times and places. It will differ for all sorts of reasons, for example between rangatahi and koroua and kuia or between urban and rural environments.
The “why” is also important.
Much communication from the hierarchy is about things that are important to the hierarchy. Let that be, no use to fight it, though you might as well ignore it.
For communications you create or pass on, apply the test “why are we doing this?” “Does it serve a purpose for whanau?” I think you will find you are often filling in spaces left between the communications of the hierarchy.
Our mind space and attention are not endless, so make every message you create or pass on have a real purpose.
You may share the view, which I have, that much of the wording of the Pae Ora legislation and Te Pae Tata (the health plan), is a considerable advance on previous health service recognition of Maori issues.
We may also share a wish that all actions matched the words. There is a great deal more to do to have a health service consistent with Te Tiriti. But can I warn you that there is a greater danger than this aspirational gap right now.
The next few months are likely to see some intense debate - and noise, which falls well short of being debate - about Te Aka Whai Ora and absurd paranoia about Māori “privilege” in health.
I cannot think of anything more important in the work you have over this next period individually and collectively than the work of engaging with and combating this noise. Of promoting the huge worth of kaupapa Māori health services and of strong independent tangata whenua voice and practice across the health system to whanau and to the wider voting public.
On some specific matters I was asked to address:
I think you are better not to get tangled up in debates over co-governance. For tangata Tiriti there is an obligation to establish governance structures that enable us to act in appropriate Tiriti ways. That is largely our problem. For Māori, I think that asserting mana motuhake is more important. In my governance career I have never encountered a Maori group who was not ready, willing and able to contribute where they are welcome. I have met plenty of Pākehā who are distinctly unwilling to share power. The “co” part is our problem;
Don’t be afraid of “disruptive” or “assertive” change. Equity is not something which can be given by those with power. It can only be claimed and asserted and it will by definition be disruptive for those forced to share. Again, it is a Pākehā problem;
Culture change is typically a long-term exercise. It took some decades for colonial rule to be imposed in Aotearoa after all. The German physicist Max Planck once said that “science advances one funeral at a time”. Let’s be kind and make that “one retirement” at a time for system culture change. Decolonisation is driven by the colonised calling “time’s up”. I think it is.
Thank you for hearing these thoughts. I am honoured by the opportunity. I look forward to your reactions and advice.
Rob Campbell is a professional director and investor. He is Chancellor at AUT, chairman of Ara Ake, chairman of NZ Rural Land, an adviser to Dave Letele’s BBM Charity and former chairman of Te Whatu Ora.
