Kaupapa Māori solutions key to better Māori cancer outcomes, hui told

7:11 pm on 18 March 2021

Māori health leaders want to see cancer health outcomes significantly improve to save lives of Māori.

Photo of woman supporting dying mother with cancer

Photo: Katarzyna Bialasiewicz photographee.eu / 123RF

These were concerns heard at the Māori Cancer community hui in Porirua this week hosted by Te Aho o te Kahu and Hapai te Hauora as apart of the WAI 2575 tribunal hearings.

Dr Myra Ruka, a clinical haematologist and member of Hei Āhuru Mōwai, the Māori Cancer Leadership Board, said cancer services needed to be Māori-led and -governed.

She said Hei Āhuru Mōwai had worked on key recommendations for the government last year to help improve cancer outcomes for Māori in the next few years.

The over-arching theme is that prevention of cancer and early detection of cancer through either screening or well designed kaupapa Māori cancer services will help safe lives and will actually move the dial of current inequities in cancer for Māori.

The Ministry of Health's New Zealand Cancer Action plan Te Mahere mō te Mate Pukupuku o Aotearoa 2019-2029 states that Māori are nearly twice as likely to die from cancer as non-Māori.

It showed Māori also suffer worse survival rates for breast cancer and lung cancer.

Dr Ruka said Māori needed to be at the decision making table to ensure a Māori voice within the cancer space was heard and health inequities within the mainstream system addressed.

"We've chosen those areas in terms of contributing to improving cancer outcomes for Māori by really focusing funding and focusing attention on the preventable and early detection stages of those cancers.

"It's about being really intentional about what we do with the information that's shared from whānau."

She said there had been plenty of time for kōrero but not enough action.

"The other important part of these hui that are going to be held around the motu ... is that there's actions that occur as a result of the kōrero ... from these hui there's an intention to ensure that the kōrero that comes out of the community hui actually translates into action when it comes to designing services, designing policy and implementing services from Te Aho o te Kahu but also Māori health providers," Dr Ruka said.

Health system has failed to meet Māori needs

The head of whānau-centred care at Te Aho o Te Kahu, Fletcher Beazley, said there were many issues that whānau were facing within the system - from cancer prevention, to diagnosis treatment, to palliative care - and feeling like the system did not meet their needs.

He said co-designing kaupapa Māori solutions with health providers, stakeholders and whānau, hapū and iwi was central to addressing issues.

"The health system hasn't really met the needs of Māori, it's failed us and the Waitangi Tribunal claim on health showed that, the government acknowledges that."

"We know that there's big inequities in cancer for Māori, we get cancer too much, we die from cancer too much and if we're going to address these issues, we need to listen to whānau not just one time but regularly," Beazley said.

Dr Ruka said a lot of the problems whānau Māori faced could be fixed, and the health system including hospitals needed to be culturally safe and culturally competent.

"There's inequities and issues that exacerbate inequities that occur at each step along the cancer care pathway, so that can be starting from the screening of cancer or the prevention of cancer, through to getting a referral through from the primary care setting into the secondary care setting.

"Communication is often brought up as a significant barrier that occurs for many whānau in their cancer journey," she said.

Associate Health Minister Peeni Henare said he wanted to attend the hui to hear the lived experiences of whānau which would beneficial towards creating equitable health outcomes for Māori.

He said accessibility for whānau, especially relating to travelling expenses and accessing the right medical care for families who live rurally, was a key issue raised.

"One of my focus points is on the development of a Māori health authority, as a government we've committed to that."

Henare said announcements on the Māori health authority could be expected over the next month in alignment with the Labour Party's election manifesto.

Dr Ruka said Hei Āhuru Mōwai hoped a Māori authority would be funded and granted commissioning mandate. She wanted to see the voice of Māori communities and whānau informing how cancer care is delivered.

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