Government’s Covid-19 response is a breach of Te Tiriti o Waitangi, Māori health experts say

Monday, 11 October 2021

Māori health providers are considering whether to lodge a Waitangi Tribunal claim, as the Māori vax gap grows.

Māori health experts say the Government’s Covid-19 response could constitute a breach of Te Tiriti o Waitangi because it breaches the principles of equity and active protection.

While no-one has lodged a Waitangi Tribunal claim so far, there have been discussions among Māori health providers about whether the vaccine roll-out, and move away from the elimination strategy, are consistent with the principles of Te Tiriti.

This comes as Covid-19 spreads across the North Island, and the gap in the vaccination rates between the general population and the Māori population continues to widen.

Last week, people of Asian backgrounds closed in on 100 per cent for first doses, but less than 60 per cent of Māori have been reached. This trend was reinforced with the Ministry of Health’s release of suburb-by-suburb vaccination data.

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Dr Heather Came, head of the Department of Public Health at Auckland University of Technology, said inequitable roll-out was a clear breach of Te Tiriti.

The vaccination rates showed Māori did not have the same rights, privileges and protections as the general population, Came said. “I think we’ve prioritised everybody instead of prioritising Māori.”

Head of the country’s largest Māori primary health organisation, Simon Royal, says those working in this space have been discussing whether the Government’s approach is a breach of Treaty principles.

In an open letter to Covid-19 Response Minister Chris Hipkins, Came said that in stepping away from the elimination strategy, despite low Māori vaccination rates, it “confirmed the worst fears of many tangata whenua and tangata Tiriti people that the Crown still regards the Māori population as disposable”.

The letter called for the Crown to engage with Māori health leaders and communities on a strategy that put Māori health needs first.

The current approach was a failure by the Crown to uphold its obligations to be in an honourable relationship with whānau, hapū, iwi and all Māori organisations, Came said.

Came told Stuff the inequitable outcomes Māori were currently experiencing was an indication of the treaty breach.

“The challenge is how do you share power and resources? This is the perpetual challenge of Te Tiriti o Waitangi,” she said, adding that there was a leadership void while the country waited on the Māori Health Authority.

Lady Tureiti Moxon says no-one should be left behind, regardless of who they are, where they live, and their standing in the community.

While it was clear to Came that Te Tiriti had been breached, it was unlikely those Māori health providers, working on the frontline, would have the capacity to call for an urgent Waitangi Tribunal hearing.

“Most folk are busy at the moment, fighting the pandemic, so there’s not a lot of time or capacity to log a claim, such as that.”

National Hauora Coalition chief executive Simon Royal said only the Waitangi Tribunal could determine whether the Treaty had been breached.

So far, the coalition was not aware of any others who had sought to bring a claim under urgency, nor was it currently planning to bring a claim, he said.

“NHC, however, is aware of conversations occurring in this space and these matters will no doubt be discussed by ngā kaitiaki o te NHC [the guardians of NHC],” he said.

National Hauora Coalition is the largest Māori primary health organisation in the country, and Royal is one of the lead claimants of the recent Waitangi Tribunal kaupapa inquiry into health services and outcomes (Wai 2575), which sets a precedent for this type of claim.

The inquiry stage one report – looking at primary care – found multiple Treaty breaches and serious failings by the Crown to fix Māori health inequities. The tribunal recommended the establishment of a Māori Health Authority.

“One need only look to the 2019 report which followed stage one… to understand the Crown’s obligations under te Tiriti and the breaches that have occurred through improper partnership,” Royal said.

Right now, NHC was working hard to combat inequities in the vaccine rollout and lift rates for whānau Māori.

This has included working with the Ministry of Health to access live Covid Immunisation Register data to identify those who remained unvaccinated and support their access to vaccination.

NHC was working alongside other Māori providers under the umbrella of the WERO Hauora Immunisation Alliance and other Auckland public health organisations.

Tureiti Moxon, managing director of Waikato Māori health provider Te Kōhao Health, said the Māori response and vaccine roll-out so far had been “spasmodic”.

There were delays in Māori health providers accessing funding, and there was no cohesive Māori communications strategy. “A lot of us are really under siege right now. We’re going full boil,” she said.

Moxon, who is also a claimant of Wai 2575, said Te Tiriti o Waitangi was about shared decision-making, to make sure nobody was left behind.

“While we all say everyone's got the opportunity, what we know, in terms of equity and equity, is that’s not always the case. And it's not actually true for a lot of people in our country,” she said.

“We’re all in this together. It doesn’t matter who we are, or where we are, or what our standing is in our country or our community.”

Ministry of Health group manager of equity Tamati Sheppard -Wipiiti said the ministry was committed to fulfilling its obligations under Te Tiriti o Waitangi as part of the Covid-19 Māori health response, including through the delivery of the vaccination programme.

This approach included governance and partnership; a targeted vaccination approach; Māori health and disability provider support; workforce development; and tailored communications.

Sheppard-Wipiiti said the ministry was also delivering vaccinations in targeted settings such as, marae-based clinics, community centres, mobile units, workplace programmes, and through mobile clinics.

He pointed to partnerships with Māori health providers and other Māori organisations, and equity-focused vaccination sites. And in some DHBs, like Northland, Māori health providers were priorities ahead of other community vaccination sites.

Covid-19 Response Minister Chris Hipkins’ office did not respond by deadline.