Wednesday, April 13, 2022

Don Brash: Absolutely no logic in a separate Maori Health Authority

Not many months after the 2020 election freed the Labour Party from the constraints which New Zealand First had placed on them between 2017 and 2020, the Government admitted to commissioning the most radical plan for over-turning New Zealand’s constitution since the Treaty of Waitangi was signed in 1840.

It was called He Puapua, and I have written about its quite extraordinary implications previously. In short, it envisages New Zealand’s moving away from being a Parliamentary democracy in which all adult citizens have an equal vote to one in which those who chance to have some Maori ancestry – always now with some non-Maori ancestry – have a much larger say in how things are run. The ultimate aim was to put the small minority with some Maori ancestry on a par, politically, with those without such ancestry.

“Not Government policy”, the Prime Minister declared, but continued with policies designed to achieve exactly that goal.

The most blatant example of He Puapua in practice currently is of course the Government’s Three Waters proposal, the ministerial responsibility of Local Government Minister Nanaia Mahuta. Under that proposal, all of the three waters assets – those involved in providing drinking water, disposing of sewerage and controlling storm water, paid for by generations of ratepayers of all ethnicities – would be confiscated by central government and moved into four enormous regional bodies drawn along tribal boundaries in which tribes would have half of all board appointments. With key decisions requiring majority support, tribes would have effective control of all of these assets.

Initially, the Government pretended that this scheme was to be voluntary, and local governments spent time providing feedback on the proposal – most of it negative. Then the Government admitted that the scheme was always going to be compulsory, and the “consultation” was just window-dressing. Even the former Leader of the Labour Party and now mayor of Auckland, Phil Goff, declared the proposal totally inconsistent with any concept of democracy.

Flying under the radar to some degree – perhaps because of the noise being created by the Three Waters proposal – is an equally obnoxious proposal to break up the taxpayer-funded health system into two, one serving those who are Maori (though to my knowledge there has been no clear definition of who will be regarded as Maori for this purpose) and those serving the rest of us, with both parties having to agree on the allocation of resources and other major decisions. The Maori Health Authority will be headed by the sister of Nanaia Mahuta, though we are assured that her appointment has nothing to do with that family relationship and that she is the best person for the job.

The Government referred the legislation which will establish this segregated health system not to the Health Select Committee but to a specially selected Select Committee with a heavy weighting of Maori Members of Parliament. And then that Committee paid not the slightest heed to any submissions which were even slightly critical of creating such a racially segregated system.

One of the most powerful submissions was a lengthy one made by former All Black Lawrie Knight. In that submission, he noted that there are five claims presented by Maori when demanding a separate health authority:

1. That Maori die seven years earlier than other New Zealanders.

2. That Maori have poorer health services than non-Maori.

3. That decolonizing the health system will improve Maori health and longevity.

4. That a primary contributing factor for Maori ill health is “systemic racism”, “white privilege”, and “unconscious bias” in the New Zealand health system.

5. That non-Maori are not affected by inequitable health provision and services.

In his submission to the Committee he demonstrated that all five of those contentions are incorrect, or caused by other factors.

For example, he noted that while on average Maori New Zealanders do have a life expectancy some seven years less than the life expectancy of European New Zealanders, the life expectancy of Maori New Zealanders is closely similar to the life expectancy of Maori living in the Cook Islands; and while the Cook Islands were colonized many years ago, that colonization ended more than half a century ago. He noted that Chinese New Zealanders had a life expectancy some five years longer than that of European New Zealanders, again strongly suggesting that there is a major genetic component in life expectancy.

He quoted interesting figures for the life expectancy of Samoans in Samoa and compared that with the life expectancy of Samoans living in New Zealand – those living in New Zealand using the supposedly racist New Zealand health system of course – and found that on average Samoans living in New Zealand have a life expectancy 6.4 years longer for males and 6.9 years longer for females.

The reality is that there is absolutely no evidence that the New Zealand health system discriminates against Maori and plenty of evidence that the health system works hard to treat all New Zealanders equally, regardless of race.

So without any robust evidence that there is a problem to be fixed, the Government is on track to create a racially segregated health system where the tribal elite will be given power and influence over the health system of the whole country. It has to be one of life’s great ironies that a country which was the first in history to guarantee equal rights to all its citizens is now succumbing to pressure from people who have some Maori ancestry to create a society where ethnicity is the most important determinant of political power.

The Labour Government is pushing this agenda aggressively. The Maori Party has explicitly stated that it will only go into coalition with a party which affirms the primacy of tribal rule – because that is what the Maori Party’s interpretation of the Treaty means. So far, the ACT Party has made it clear that if that is the Maori Party’s “bottom line”, then there is no way that ACT could be part of any Government of which the Maori Party was also a part.

The challenge for the National Party is to state clearly whether they believe in “equal citizenship”, as the Party’s constitution proudly asserts, or whether they would be willing to concede the field to those who want to change our constitution so that tribal power-brokers have power equal to the rest of the country.

Dr Don Brash, Former Governor of the Reserve Bank and Leader of the New Zealand National Party from 2003 to 2006 and ACT in 2011. This article was first published at e-local magazine


Jim Rose said...

The spirit level had a point in that most health inequalities arise before you have any contact with doctors. The spirit level authors looked in the wrong place and got the wrong answers but still was right about one thing. The issue is why do people fall sick in the first place rather than what treatment doctors can provide once sick.

The great and the good have argued for decades over whether the main driver of improving health and longevity is better nutrition or better public health interventions.

Nobel Prize winners in economics go mono on mono to argue that nutrition and particularly prenatal nutrition casts a long shadow over our life chances. The counter case is that public health interventions such as pure water, vaccines and safe food did no end of good.

The public health interventions crowd have perhaps decisive evidence because of the rapid increases in longevity in poor countries with chaotic and corrupt governments. Life expectancies even in poor countries is not that much different from rich countries now. They have access to vaccines, better neonatal care and bottled water.

The most interesting data comes from military healthcare. When the standard of health care is pretty uniform such as in the US military, there are no ethnic gaps in health.

Recently, the US Veterans Administration opened a few hundred outpatient clinics. It found that the ethnic gap in health incomes could be explained by week's delay in the picking up prescriptions at the clinic pharmacy.

There are also vast differences in health spending per capita between US states for no great difference in health outcomes. People who migrate between states with high health spending to a lower health spending suffer little.

Most disturbingly, when Robert Hanson proposed cutting expenditure in half on health, his critics in that Cato debate argued he had gone a bit far. they thought health spending could be cut by 1/4 for no declining health outcomes.

Ewan McGregor said...

Agree entirely. Co-governance is undemocratic and will exacerbate race relations in this country for years, perhaps permanently. Our race relations, with its imperfections, we can regard with much satisfaction. This process is fixing a problem that doesn’t exist.
What, in fact, is the definition of a Māori, given, as I understand it, there are no full-blooded Māori today? It is a person with Māori blood and who identifies as such. Fair enough. European men arrived here in the 1830s and 40s, and with which Māori women were quite willing to co-habitat. They were sealers and whalers, seamen and even missionaries, William Colenso being one. Babies were born. Fair enough to that, too. A descendant today could be the sixth generation. He/she would be of one sixty fourth of Māori blood if all subsequent parentage was non-Māori. At what point does one such person become a Pakeha? Indeed, can one with no Māori blood claim to be one merely through identification? You might as well, given the previous hypothetical example. This whole thing seems to me to be unnecessary and socially damaging. Where’s National on this?
Ewan McGregor

Unknown said...

This legislation if passed will backfire on present Maori. They will be selected against as were the Irish in the Presbyterian settlement in Dunedin.
"The Little Enemy "They were called and " No Irish need apply" on their knitting circles
Most Irish fortunately came from a subsistence peasant background and survived often with help from local maori (there was no Maori politics in 1850). so we owe them even if it is Robbie Burn to whom we doff our bonnets!