People who work in Northland's healthcare system are committed to equity, staff from Kaitaia Hospital seen here. Photo / Tania Whyte
It's the million-dollar question - is the Northland DHB's goal to eliminate health inequity by 2040 possible?
Eliminating inequity has been a constant theme across our series on Northland's healthcare system which ran throughout the past week. There seems to be no Northland community inequity doesn't touch, indicating how debilitatingit is for the region.
As outlined extensively in the series, inequity can be broken down into many factors which inhibit people from getting appropriate healthcare. These include cost, access to services, and poorer health delivery and outcomes for Northland's Māori, Pasifika, rural and low socioeconomic populations.
Detailed in the series' second piece, Northland has an abundance of examples where these populations have worse health and receive worse healthcare than Pākehā, urban and rich communities.
The morbid result is that our disadvantaged populations die sooner. On the face of it, it might not seem shocking but when you look to your Māori whānau or friends and realise they will likely die seven years younger than you, purely because they are Māori, it is abhorrent.
Through the over 40 interviews done for this series, it's clear there is a want to eliminate inequity. In fact, there hasn't been one medical professional who featured in the Northern Advocate this week who I didn't feel wanted the best for their community.
However, what has also been made abundantly apparent is how restrictive our model of healthcare is in New Zealand.
At a primary-care level, health and social service providers are two sides of the same coin - doing invaluable work to address the harmful habits and conditions which degrade the health of Northlanders.
But for a range of absurd reasons, their traditional models of operations restrict them from true collaboration, something which would infinitely improve the overall healthcare of their people.
It is even worse in secondary care. The DHB/hospital structure appears to be so archaic, not even the will of its chief executive and board can effect swift progress.
If you peel back these models of care, you will find possibly the most committed group of people, but unfortunately there's is a daily battle against the sector they work in to provide the best healthcare possible.
While Heather Simpson's Health and Disability System Review is a real sign of hope, it is yet to be seen whether her recommendations will be acted upon.
At the end of the day, it's up to Northland's healthcare sector and the people in it to make change. So the question persists, will inequity vanish by 2040?
My gut instinct says no. My gut instinct says pervasive racism will continue to hold back our most vulnerable communities.
But one thing has been made clear to me by talking to our healthcare officials, there is hope. And hope is infectious.
Assuming racism will always exist, it's fair to assume inequity will exist alongside it.
However, if our health sector can become a more collaborative, responsive, accessible, culturally sensitive place, you might be able to look across at your Māori whānau or friend and rest easy, knowing you both will live to a grand old age together, equally.