4 Nov 2019

Call for independent hauora authority to embed Māori-led solutions

6:26 pm on 4 November 2019

A parliamentary committee has been urged to recommend an independent hauora authority to tackle health disparities for Māori.

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Photo: 123rf

The Māori Affairs Select Committee heard submissions in Auckland today, in its inquiry into health inequities for Māori.

Among the submitters were the National Hauora Coalition, which is also a key claimant in the Waitangi Tribunal Health Services and Outcomes Inquiry.

The coalition's clinical director, Dr Rawiri Jansen, said the current health system was not set up to address causes of inequity for Māori, and the gap continues to widen.

"I think the important thing is we look at the health system and notice that it is organised deliberately in ways which deliver great outcomes for non-Māori - for Pākehā, and if we want to create equity then we have to deliberately organise the health system in order to achieve that." he said.

One of the examples he used was the bowel cancer screening programme, which he says is anti-equity and does not serve Māori adequately.

"So we have got a national bowel screening programme which is going to deliver more inequity and it beggars belief that we should be organising in that way, in this day and age when we have all these statements committing ourselves to equity so we need to change that we are organising that programme but we need to change lots of things in terms of government policies and programmes which are currently anti-equity."

The Waitangi Tribunal released its findings in its Hauora report from stage one of the Wai 2575 claim. In it it found the Crown has acted inconsistently with the principles of the Treaty of Waitangi in the health sector, including its failure to ensure equal Māori representation on District Health Boards.

Although at the time the Tribunal was asked to make recommendations on an independent Māori health authority, it instead made an interim recommendation the Crown commit to exploring the concept of a stand-alone Māori primary health authority.

Something the National Hauora Coalition has strongly advocated - and that Dr Rawiri said was echoed in the submissions given today.

He said it was clear there was strong support from other submitters for an independent hauora authority to embed Māori-led solutions.

"I remain hopeful that the committee will hear those voices from Māoridom and recommend that up, that's an important part of the future. I'm really confident that an independent health authority will be able to organise services which are directly contributing towards equity."

Talei Morrison's legacy: 'As a Māori woman, the health system failed her'

In a passionate and detailed submission, Eruera Keepa, the brother of Talei Morrison spoke of her story. She founded Smear your Mea, in late 2017, a movement to raise awareness and promote advocacy and support through early detection, treatment and prevention of cervical cancer, for kaihaka, their whānau and their communities.

Ms Morrison lost her battle with cancer in 2018 - today would had been her 44th birthday.

"We believe Talei was failed by the primary health care framework as it currently operates, we believe it failed her also by assuming that she could not afford the price of an ultrasound, we believe that the system failed her by a late response to her medical needs.

"We believe the system failed her by not responding to her needs as a Māori woman - given that she was in a high risk population and should have directed to have a smear well before she received her diagnosis."

Mr Keepa said overriding markers for his whānau and as the Smear your Mea trust, was that Talei Morrison's experience was absolutely preventable.

He spoke of the change in treatment when moving from her GP to a Māori health provider and that they only started to feel cared for once they moved to Te Kohao Health - that the staff listened with their soul and guided them with aroha, not just for his sister but the wider whānau. He urged the committee to ensure resources are bolstered for Māori health providers.

Mr Keepa urged the committee to help preserve whakapapa and offered them four key recommendations.

"That a cultural competency framework for all those that work in primary sector be introduced; All those who work in the health primary health sector must have some accountabilities that assess the way that they work with Māori; that a Treaty of Waitangi audit be put in place for the primary health sector; Initiatives for health promotion for Māori be resourced adequately, and that funding for community groups who have targeted campaigns be considered."

Other submitters today include Hapai te Hauora, Whanau Ora Commissioning Agency and Te Puna Ora o Mataatua.

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