Morgan Godfery: The Māori Health Authority isn't separatist. It's necessary.

Wednesday, 13 July 2022

Northland has one of the lowest Covid-19 vaccination rates in the country, but Māori health providers are pulling out all the stops to encourage people to get the jab. (Video first published November 10, 2021.)

Morgan Godfery is a senior lecturer in the department of marketing at the University of Otago. He has a background in journalism and public policy, including as a parliamentary staffer with the Labour Party. He is a regular opinion contributor to Stuff.

OPINION: I’m not sure if many people know that Māori health providers, the iwi or community-run healthcare agencies that exist in most major towns and cities, were the champion vaccinators in last year’s drive to vaccinate more than 90% of eligible New Zealanders.

In West Auckland the Waipareira Trust, a longstanding Māori health and social service provider, was responsible for administering more than 120,000 vaccines for eligible Aucklanders. In cities and towns as different as Dunedin and Whakatāne it was Māori health providers – Te Kāika and Te Puna Ora o Mātaatua respectively – who were their community’s chief vaccinators.

West Auckland residents await vaccinations from the vaccination bus with the Te Whanau O Waipareira Trust in September, 2021. “At the beginning of the Delta outbreak ... only 3% of the people the Waipareira Trust was vaccinating were Māori,” Morgan Godfery writes.

Each provider did this without much resource, and often without gratitude. When the Waipareira Trust, fresh from its success out west, made a request to the Ministry of Health to share contact details for Māori clients, Dr Ashley Bloomfield, the Director-General of Health, declined. That left the trust without the resource it needed to extend the 90% drive to Māori.

And yet, the trust and its vaccinators pushed on, self-funding a mobile vaccine clinic to reach isolated people in rural communities north of Auckland.

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Associate Health Minister (Māori Health) Peeni Henare, centre, at the launch of Health New Zealand and the Māori Health Authority in Auckland.

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This is the innovation and success that the incoming Māori Health Authority is tasked with supporting. On paper, the authority would fund initiatives like the Waipareira Trust’s mobile vaccine clinic.

Or, indeed, Te Kāika “green prescription” service (the agency runs a “health hub” that includes access to a free gym for people who need it) or Te Puna Ora o Mātaatua’s dementia support service.

Morgan Godfery: The “parallel health system” argument “only acts as a fantasy for poorly-polling politicians who want to import US-style culture wars to New Zealand”.

In government language the incoming authority is responsible for “procurement”. Each year the Government allocates the authority a budget and then the public servants, evaluating the needs of each community, fund health providers to meet those needs.

But in political language the authority is, at least according to former National Party leader Judith Collins, “segregation”. If ACT makes it into government, its leader, David Seymour, is promising to remove the authority within the first 100 days. “We need more effective and efficient services”, Seymour told his party’s annual conference, “but creating two parallel healthcare systems means the exact opposite”.

This is dangerously dishonest. The reforms abolishing district health boards, replacing the old model with a centralised Health New Zealand, maintain a single healthcare system. When a Māori patient presents at the emergency room, no-one is going to point him to the door to the left, an exclusive entrance for people of his ethnicity.

Likewise, no-one is going to point a Pākehā person presenting at the emergency room to the door to the right. The country will maintain only one healthcare system.

The Māori Health Authority will not run its own hospitals. Instead, it is a procurement agency, resourcing health providers like the Waipareira Trust, Te Kāika, and Te Puna Ora o Mātaatua to provide services to their communities. And that includes non-Māori too. At the beginning of the Delta outbreak in 2021, only 3% of the people the Waipareira Trust was vaccinating were Māori. That means the vast majority of people it was servicing were non-Māori – and rightly so. No-one would argue that providers should reserve resources like vaccines exclusively for Māori.

That scenario – “segregation” - only happens in the imagination of people like David Seymour.

Knowing that the authority will resource health providers that treat their entire community, how can the “parallel health system” argument stand? It can’t, and it only acts as a fantasy for poorly polling politicians who want to import US-style culture wars to New Zealand.

But if we accept that argument – that Māori health providers treat their entire community – what is the point of a Māori focus in the first place? It’s useful to think, if you’re a Pākehā person, about a Māori person born at the exact same time, date, and place as you.

If you were a Pākehā person born in 1991, the same year as I was, statistically you’re likely to live longer than me. You’re less likely to die from chronic disease, and you’re likely to earn more than me. This has nothing to do with our intrinsic worth as people, but instead is a product of the system. Māori presenting with chronic pain are less likely to receive specialist referrals, as one recent example shows.

This adds to a terrifying body of evidence, especially in cancer care, indicating that the system treats Māori poorly compared to non-Māori. And so the Māori Health Authority is one modest answer to that disparity in care.

The authority’s mandate is to fund solutions that work best for Māori. Usually, that means resourcing Māori health providers like the Waipareira Trust to deliver services.

What politicians like Collins, Seymour, and Christopher Luxon (who also opposes the authority) miss is that what is good for Māori is almost universally good for New Zealanders overall. No-one loses out of the Māori Health Authority. And it deserves better than the false opposition of Seymour and National .