OPINION: To point to an individual Māori person walking out of a hospital, cured, is to miss the abiding truth that collectively we die more, and earlier, and get sicker, than those non-Māori strolling in and out around him.
On average, Māori die seven years earlier than non-Māori. In 2015, the heart disease death rate for Māori per 100,000 people was double that for non-Māori. (Both excluding Pasifika people)
Cancer, infant mortality, suicide. I could go on. Believe me when I say the stats are appalling and longstanding.
On Wednesday, Health Minister Andrew Little will reveal the Government’s plans for its new Māori health authority.
The authority was part of a series of recommendations from the Health and Disability System Review released last year.
The toughest thing will be understanding what it all means. I digested the report myself and was struck by the thought that reading about health shouldn’t force you to self-medicate.
This maddening love of technical words, jargon, forms like a poisonous crust at the top of the health system. What is a ‘commissioning tool’, I wondered, reading the report? A pen? A baseball bat?
Politicians love this zone: a dark pocket where you can say anything, get away with anything, because nobody really understands you. It is the worst kind of code to decipher as a journalist: draining your will, and leaving you a passive vessel – much like navigating the health system itself.
What are Māori health inequities? The Ministry of Health lists them. First published June 2019.
Where am I going, you ask yourself? How do I get there? It would be nice to relax, but as an outsider you worry that once the dust settles from your vaporised kidney stone, you’ll limp out with a subtracted gall bladder as a bonus operation.
It is a maze where you are hemmed in by the expertise of others.
The review was completed in March 2020 and aimed to offer a clear path forward for the Government. One of its main jobs was to “ensure improvements in health outcomes of Māori”.
This problem was crystal clear, but the panel behind the report couldn’t even keep a lid on its own splits when it came to offering solutions.
Tucked away towards the back end of the report, a faction proposed an alternative model for the Māori authority.
These members said the Māori authority idea was good, but had a stingy budget and limited purchasing power. It needed to go further.
As far as I can tell, their authority as proposed would be Māori-owned, governed and operated. It would get a hefty budget so it could pay for services on its own, and work with iwi and Māori and district health boards at regional and local levels to support their purchasing as well.
It would start by beefing up kaupapa-Māori workforce numbers, facilities and services. Setting the infrastructure in place, I presume.
Over several years it would then start paying for the likes of screening and disease prevention services targeted at Māori, and a swathe of frontline health services, like GPs and maternity services, community pharmacies and radiology.
Cabinet minister Kiri Allan’s shock cancer diagnosis has highlighted the need for Māori women to get a cervical smear – that could save their life, and reverse the terrible statistics.
Like a game of reverse-Monopoly, where one person owns everything at the beginning then loses it, we might finally see the money (and thus, power) flow backwards from Rich Uncle Pennybags’ plump fingers to the people who need it.
In one of the worst-kept secrets of the last few months, it appears the Government has thumbed through to the back of the review and now leans towards the alternative proposal. It will hand over increased purchasing muscle to the authority.
I think this is good news. Let’s be clear, Māori are hyper-capable organisers (myself withstanding). There is nothing iwi and hapū and whānau cannot do – and do with the clear, big-hearted morality of our ancestors. Successive Governments have obstructed our development thanks to the complaints of a fearful Pākehā minority.
On Wednesday, what Health Minister Little owes us, everyone, but especially Māori, is a clear explanation of what the new health authority is, and what it will do.
He will face the task of boosting its credentials with Māori, while reassuring other parts of the community that it is anything but radical.
Don’t be fooled though, by jargon and complexities – if done correctly, it is something radically new. But that is a good thing and will make a bracing departure from decades of radical failure for Māori.