Editorial: Māori health woes need a circuit-breaker

A mixed schools kapa haka group performs a rousing haka powhiri as the Waitangi Tribunal arrives at Te Rawhiti Marae in the eastern Bay of Islands in 2013. Photo / Peter de Graaf

EDITORIAL

Consider what you may do or achieve in the last seven years of your life - be it travel, writing letters to the newspaper or spending time with grandchildren. These years are likely to be denied your Māori neighbours.

Maori life expectancy is still seven years below non-Maori and Maori fared worse in nearly every area of healthcare from cancer rates to child hospital admissions and access to health services.

The latest call for action about this appalling inequity is the release this week from the Waitangi Tribunal of Hauora: Report on Stage One of the Health Services and Outcomes Kaupapa Inquiry 2019.

Some point out Māori often suffer from poor individual choices, and there is often evidence of this, but to so dismiss such levels of inequity is simple sophistry.

The tribunal says the Crown should consider establishing a Māori primary health authority to control and monitor Māori health-related spending and policy, and also consider compensation for underfunding of Māori health providers over the last 20 years.

PHOs have allowed community-led healthcare, with funding provided for clinics based on members rather than appointments and Māori groups have established their own PHOs as a means to take control of their healthcare.

However, claimants said the funding model was not adequate for Māori PHOs, where members were often in poorer health, making it more expensive to look after than those of an average practice. Māori PHOs also received less than 2 per cent of health funding overall.

There has been report after report. One report is simply the list of reports carried out by the Ministry of Health over 24 years - Ministry of Health reports on Māori health outcomes and disparity in outcomes between Māori and non-Māori from 1992 to 2016. Out of these reports have come innumerable recommendations and initiatives to tackle the issue.

New Zealand's current overarching Māori health strategy, He Korowai Oranga - literally, the cloak of wellness - was first established in 2002 and refreshed in 2014. The Wellbeing Budget in May committed $80 million over four years to expand the coverage and impact of Whānau Ora, under Te Puni Kokiri, a small agency with broad responsibilities. Five years on, the Waitangi Tribunal has reviewed the evidence and says not enough is being progressed.

Treaty settlements can be a matter of resentment, though more often from disappointment with the use of the funds, in some cases, than the principle of restitution. Some also point out Māori often suffer from poor individual choices, and there is often evidence of this, but to so dismiss such levels of inequity is simple sophistry.

The fact is, Māori are at the sharp and tragic end of a flagging health system, as painfully illustrated by the Herald's recent Fair Care series. Twenty health boards is probably too many for a country our size, draughting from our small bucket tax funds.

There simply isn't enough money to sustain the current unacceptable level of healthcare, let alone improve it. To quote Ernest Rutherford, "We've got no money, so we've got to think."

This current Labour-led Government, keen to kōrero about well-being, needs to take the bit between the teeth and address the whole healthcare crisis for everyone's sake.