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Te Ururoa Flavell: Estimates Vote Health

2008/09 Estimates Vote Health; 4.40pm

Te Ururoa Flavell, MP for Waiariki

The first sentence in the report of the Health Committee on 2008/09 Estimates for Vote Health should have made us feel pretty good. According to the Minister, health expenditure has doubled in the past nine years, and New Zealand is beginning to see results from this investment.

Well, that’s great and I’m all for results, but the funny thing was, the word Maori didn’t come up in the health committee report. And why should Maori be noted distinctly in this report? Because:

• Maori are 18% more likely to get cancer, twice as likely to die from it;

• heart disease kills nearly twice as many Maori but Maori are only one third as likely to have an angioplasty;

• avoidable death rates are almost double for Maori than other New Zealanders;

• Maori on average die eight to ten years earlier than non-Maori.

Team Whero, that’s team Labour is constantly crowing that the Government spends one in five tax dollars on health; so I ask why is it thatMaori obtain fewer referrals, fewer diagnostic tests and less effective treatment plans?

These Maori health stats paint a lousy picture so where’s the plans to address them?

The health committee report happily covered district health board deficits, inherited deficits, operational deficits but the biggest deficit of all appears to be missing.

That is the systematic deficit that we might call racism.

There was perhaps one vague suggestion of this in the transcript of the discussion that took place on the 25th June with the Minister, and his merry men of the Ministry. Well to be fair - there were a couple of women as well.

The Minister, when responding to questions about the aged residential care industry, raised the issue that wage rates are so low that turnover is very high – and concluded that there are and I quote,“some very valid concerns about working conditions for the workforce, many of whom tend to be Pasifika or Maori, and that is not a situation which is either sustainable or proper”.

Now we’ll give the Minister the benefit of doubt and presume that it was the working conditions that were neither sustainable nor proper – not the fact that the workforce is dominated by Pasifika and Maori.

Madam Speaker, it is indeed, neither sustainable nor proper, that such gaping inequalities, such levels of deprivation and deficit characterize Maori health within our national system.

So what can be done to urgently turn this situation around?

Well, first off, we have to get to grips with the reasons why the Maori population is overwhelmingly dominant not only in the low wage sector of the health workforce, but also in every negative statistic across the health system.

To help, Dr Matire Harwood, the Director of Maori Health for the Medical Research Institute, suggests that the basis for such inequalities is found in the fact that racism is thriving in the health system.

She describes three levels of racism that must be confronted.

There is a systematic racism which drives inequalities in health determinants.

There is the one-on-one racism, within the doctor-patient relationship.

And finally, there is the level of internalized racism which is observed in individuals – in this case Maori – feeling as if we don’t deserve to have certain procedures.

Madam Speaker, although the media profiled the revelations of racism by Dr Harwood talked about just this morning on Waatea radio; the faces of racism are not exactly unknown to the state. I am thinking back to a report some twenty years ago, called Puao-te-ata-tu; the Daybreak Report.

And it is fitting to refer to that pretty ground-breaking report today, on the day that Ngai Tuhoe have come to Parliament to sign an agreement with the Crown to settle their historical grievances.

Puao-te-ata-tuwas of course chaired by John Te Rangianiwaniwa Rangihau, of Ngai Tuhoe, who made a major contribution to the renaissance of tangata whenua, through his work with Government departments, as well as through the wananga he founded in culture and history for the people of the Tuhoe nation and wider.

Puao-te-ata-tu instructed Government that the most destructive form of racism is institutional racism – the outcome of mono-cultural institutions which simply ignore or freeze out the cultures of those who do not belong to the majority.

Madam Speaker, why is it, that twenty years after Parliament received this report, we are still witnessing the desperate statistics which constitute the crisis in Maori health care – and yet the health committee’s report neglects to even speak the name out loud – Maori.

We, in the party that are proud to bear the name Maori, do not intend to keep silent when there continues to be unacceptable health outcomes for tangata whenua.

We believe, as Dr Harwood has found, that health providers can learn much from Maori providers, who have developed patient-based approaches to care within te ao Maori.

We must invest in eliminating racism, in restoring health and wellbeing to all people who call Aotearoa home.


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