13 Sep 2016

Accusations of racism in health funding

12:24 pm on 13 September 2016

Māori health providers are subjected to more rigourous criteria than DHBs according to Māori health advocates.

John Tamihere

John Tamihere Photo: Supplied

Māori health providers receive around 1.5 percent of the total health budget of DHBs, but some involved with those providers say they are treated differently.

Chief executive of Te Whanau o Waipareira Trust John Tamihere said his organisation was more closely scrutinised than DHBs and other health entities.

"There's different rules for different folks in this country and if you're a Māori provider you're never trusted. I have five full-time staff here working on audits from health, welfare, everybody running right across us. I keep a heap of regulators employed here to pore over whether our detail is correct or not. The same does not occur for non-Māori providers."

However, the Ministry of Health said in a written statement that Māori providers had the same standard contracts as other providers and the accountability and reporting requirements were the same.

Mr Tamihere said health organisations that were virtually identical could be treated differently based on the race of those running them.

"PHOs (Primary Health Organisations) can have massive reserves of $60 million sitting in their bank account. If a Māori organisation, privately owned and administered by doctors, Māori doctors, had that I'd guarantee the state would be screaming, 'spend it on the people at the front line.'"

Dr Stephen Child, chairman of the New Zealand Medical Association, said if there were discrepancies they could be explained by factors other than race. He said the size of different health providers could lead to different processes in how they get audited.

"If you're contracting with a big, well-known provider with a good provider track record, generally, sometimes can have less due diligence than with smaller or newer providers. It's just a general contracting rule. I personally doubt there would be institutional racism as such, but I have absolutely no facts to base those comments on."

Dr Child said there were also gaps in how the effectiveness of health contracts were measured.

"It's often very, very difficult to measure outcomes. Therefore, often contracts start measuring inputs. Take the smoking cessation target. We measure the brief advice people are being offered to quite smoking. We don't actually measure the number of people who have quit smoking."

Dr Heather Came

Dr Heather Came Photo: SUPPLIED

Dr Heather Came from Auckland University of Technology has researched institutional racism in the health sector and she said Māori health providers were held to a higher standard of accountability than DHBs.

"The DHBs and mainstream providers can lose millions of dollars and get bailed out. And yet Māori providers get into low-level funding blunders, it's huge news, their contract gets pulled and it's game over. It seems to be a different set of rules for other folk."

Dr Came said she has http://www.hauora.co.nz/assets/files/Hauora%20and%20KUTD/Keeping%20Up%20to%20Date%2038%20FINAL.pdf proof of differences in the way Māori health providers are treated when it comes to funding.]

"We've got empirical evidence of racism against Māori compared with other public health providers in relation to public health funding practices. The scrutiny on Māori providers is more intense, they're monitored more frequently, they're audited more frequently."