Flavell: Estimates Debate speech
Estimates Debate (Committee of the Whole House Stage of the Main Appropriation Bill 2006/07)
Te Ururoa Flavell, Member of Parliament for Waiariki; Thursday 20 July 2006
In the last month a number of ground-breaking reports have been released, which add to the depressing chronicle of evidence about the state of health in Aotearoa.
The Maori Party welcomes these reports. However, these reports become drained of any moral value if we fail to act.
The Estimates Debate is an opportunity for the Government to dare to act in the interests of the health of the nation. So let's set the scene.
The world's leading independent general medical journal, The Lancet. surveyed over 10,000 New Zealanders, asking them about any incidents of discrimination when approaching a health professional.
They described the health system of our country as 'racist and discriminating against Maori".
The study claims that 4.5 percent of Maori experienced unfair treatment by a health professional compared to just 1.5 percent of Pakeha. And I quote: "The findings of this study show that deprivation and experiences of perceived racial discrimination contribute to inequalities in health outcomes between Maori and Europeans. Indeed, the combination of deprivation and discrimination, as measured, seems to account for much of the disparity in the health outcomes assessed" Mr Chair, the impact of multiple factors of disadvantage in limiting health outcomes has always been well understand by tangata whenua. Ngati Hine leader, Moe Milne, for example, describes te oranga o te tangata whenua as being influenced by factors other than purely the absence of disease. She said: "I was told we lose our tangata whenua status when we don't have whenua to stand on. We lose our whenua status when we don't have tangata to stand on it". It is in this relationship of all the intersecting parts that the greatest damage lies.
Reference is often made to run down the most vulnerable - the so-called welfare cheats; dole-bludgers, welfare dependents; ripping off the system.
I have to ask - who are the greatest beneficiaries? Who feels good about the theft of Maori resources, our waterways, the land confiscations, the foreshore and seabed? And who feels bad?
The relationship between health and wealth and well-being is absolutely linked. The determinants of health are over-lapping and multiple.
Poverty. Inter-generational and lifestyle factors. Ethnicity. Racism. Ill-health. These factors are all related, and yet this Government persists in treating one factor in isolation.
These are systemic issues. We are always told that people must take "personal responsibility" and yes people must, but who in this House will take personal responsibility for the creation and support of systems and policies which will guarantee disadvantage and which will not change the lives of the most disadvantaged?
This House is frequently swamped with accusation, denial and with decision-makers who will not take responsibility for the decisions they have made in creating what, to many of our people, is an unjust system.
If we are really going to eliminate health disparities we need to address the institutionalised racism that reveals itself in the link between racism, morbidity and mortality. We need to treat the health of the whanau as intricately associated to the health of the individual. We need to make the associations. We need to act. Now, the National Party must also stand up and take responsibility for their role in planting the seeds of racism amongst the public mind.
I wonder how many in this House have had calls from Maori listeners, sitting in their homes - listening to the National Party talking about Maori in terms of 'privilege'- and wonder how this wounds the psyche of Maori people.
The focus on so-called Maori and Pacific privilege is in itself, creating disadvantage. That Party is allowing people to talk about us in a negative way. That Party is giving people permission to be racist. And that must stop.
Last week the Public Health Advisory Committee released their report, called Health is Everyone's Business. That report urged New Zealanders to rise to the challenge of reducing health disparities, particularly between Maori and non-Maori. The Committee advised Government of the widening social and economic inequalities, resulting in whole population groups being left behind. It described how it is in New Zealand, that ethnicity presents an independent and significant effect. The Committee concluded that 'being Maori or Pacific' further increases the risk of death or ill-health across all socio-economic categories. I repeat - Being Maori or Pacific further increases the risk of death or ill-health across all socio-economic categories. Now if we were to say "Being Pakeha" further increases the risk of death or ill-health, would that be ignored? If we were to say "Being an MP further increases the risk of death or ill-health" would attention be taken? So why is it that the association of 'being Maori or Pacifica' with the risk of ill-health and death is so casually described, almost taken for granted as an universal assumption of truth.
The Public Health Committee identified that there is no easy solution to health inequalities, no quick fix, no 'one size fits all'. Collaborative effort is required to address the social and economic determinants of health. Health can not be treated in isolation.
Mr Chair, the final report, released just a week ago, proves that while poor health can be expected to lower living standards; there is also evidence that poor living standards increase the risk of poor health. And who are the New Zealanders most at risk of poor living standards?
40% of Maori and 58% of Pacific people experienced some degree of hardship compared to 19% of European.
That's not a gap. That's an ocean.
Disparities emerge and grow from the overlapping disadvantage of racism and poor health and impoverished living standards and deprivation.
Add to those factors, the variable, 'being Maori or Pacific' and the result will be "severe and significant hardship".
And yet the Appropriations allocated a measly three million dollars, a measly three million dollars, to 'policy advice on reducing disparities in health status for Maori'. Worse yet, there is no specific funding at all for Pacifica health. I've heard all the excuses - like many others, that the priority of 'better health for all' perhaps means reducing inequalities for Maori, Pacifica, low income without having to actually spell it out. Well I'm a firm believer in spelling it out, in telling the truth, in facing the facts. Madam Chair, the reports I have spoken of today are not Maori Party documents. They are not the reports of Maori researchers, of Maori academics, of wananga graduates. They are not the reports of the United Nations Special Rapporteur. These are the reports of: * Professor Pete Davis of the University of Auckland, * The Public Health Advisory Committee * The Ministry of Social Development
We must act, decisively with courage and information, to make the connections explicit, to treat the whole rather than the separate parts.
Within Te Ao Maori, we know, we live, the reality of taking into account all aspects of our spiritual, physical, social, cultural, intellectual, and psychological selves when we consider the concept of health.
Kaore te taha wairua i te tu i tona kotahi.
You cannot divorce the water from the lake, and still call it a lake.
So we understand only too well, the impact of multiple disadvantage, that everything is connected, that nothing can be treated in isolation.
Solutions must be all embracing and inclusive.
We must all take responsibility for being a part of that solution.
I ask today, who in this House will address the living conditions that create poverty, that create misery, that create the underclass?
Who in this House is prepared to burst the septic boil of racism and stand up to protect the well-being of all?
When will you invest in raising the standards of living?
Only then, will the state of the health of Aotearoa be something that we can all be proud of.