One of the most significant changes brought about by the Ardern government is redesigning of the Health system into two entities based on race. Let's take an early look at one of those entities, the new Maori Health Authority 'Te Aka Whai Ora'.
Its web site promises enhanced 'rangatiratanga' for Maori over their health and claims this is "central to Te Tiriti O Waitangi and will help ensure everyone has the same access to good health outcomes".
Wait, there is no mention, reference or allusion at all in Te Tiriti regarding health or any outcomes beyond Maori having the same rights as the British Queen's subjects. This does not and never did include a right to the same outcomes, probably not even opportunities and treatment by the state given that the British monarchy routinely favoured a few over the rest.
No, Maori were promised only the rights and opportunities allowed to the majority of British plebs. If we had a right to equal outcomes then the laziest drunkards should always be kept in the same wealth, Lamborghinis and private mansions as the hardest working high achievers earn.
The wording "same access to good health outcomes" is manipulative and misleading. The term 'access to' implies that people due to their race have not had the same right to health services but the term is instead applied to 'good health outcomes'. Maori have had as much access as anyone else to the best health outcomes possible for each individual through diet, exercise, sleep, avoiding alcohol and drugs, avoiding injurious sports such as rugby and boxing and so forth, and everyone has had the benefit of taxpayer funded information regarding those matters. Maori have also had the same right to use health services. Access to services has varied due to things like poverty and distance from main centres where many of the services are provided, not due to race per se. To address this, funding has long been available to assist people of low means to travel to distant services. Their circumstances, not their race, are the focus and rightly so. Looks like that's all going to change and race will determine what help and services people receive. Bad luck for those without the correct racial identity card; now where have we heard that before?
Claims that health services have discriminated against Maori are offensive to health service personnel and are based on very flimsy evidence such as research on specialist decisions regarding surgery. Small racial differences found regarding such decisions were likely due to predicted lifestyle, post-operative self-care and the like. Our specialists would be unethical if they provided an expensive and risky procedure knowing the patient was unlikely to maintain medication, overcome alcohol addiction or make other lifestyle changes required for that procedure to be successful. Specialist decisions will be based on the same considerations for Maori and non-Maori patients but Maori patients on average may well score a bit worse in those areas. Is personal or group responsibility at all relevant here or shall we just blame it all on colonization and racist flaws in our health services?
Here are some more excerpts from Te Aka Whai Ora's web site:
...We need to improve Māori health outcomes and embed the principles of Te Tiriti o Waitangi as central components of the reforms.
...Te Aka Whai Ora...is responsible for ensuring the health system works well for Maori by:
· leading change in the way the entire health system understands and responds to Māori health needs
· developing strategy and policy which will drive better health outcomes for Māori
· commissioning kaupapa Māori services and other services targeting Māori communities
· co-commissioning other services alongside Health NZ
· monitoring the overall performance of the system to reduce health inequities for Māori.
...Te Aka Whai Ora - Māori Health Authority is providing a more consistent, national leadership of health service delivery with a Te Ao Maori perspective.
...It then ensures this is reflected in the priorities and plans of the health system, and how services are designed and delivered to meet those needs, including through the use of kaupapa Māori models and the application of mātauranga Māori in the system.
...This will help build a stronger Māori workforce, support the growth in capability and capacity of hauora Māori healthcare providers, and encourage more innovation in services that deliver better outcomes for Māori.
Te Aka Whai Ora's aims are based on falsehoods. The falsehood that Titiri principles exist at all or that they could usefully guide health services. The falsehood that scientifically researched health interventions don't work for those with some Maori ancestry. The falsehood that using methods from a Maori knowledge base will achieve better health outcomes than through modern international healthcare treatments. The falsehood that disproportionate Maori failure to seek healthcare until they are very unwell, their disproportionate nonattendance rate to appointments, their comparatively unhealthier lifestyles (on average) and their lower likelihood (on average) of adhering to treatment recommendations are all the fault of health services and racism. The falsehood that health outcomes will improve through employing Maori health practitioners based on their kaupapa Maori competence rather than professional qualifications in established health disciplines.
Sure, it's likely to be helpful for health services to keep developing ways to be more welcoming and to seem more trustworthy for Maori. Maori art work on the walls, pamphlets in te reo, Maori support workers to greet and accompany patients through their health service journey, room for family to support a patient, and ongoing training for health workers to understand Maori protocols and sensitivities are already practised and could be extended. However, the changes brought about by the Ardern government go far beyond that. Like other initiatives, the changes to our Health system are a largely a pretext for getting us all used to tribal domination of our country. If it were a massive experiment then we might have expected outcome measures to be specified and a review date set but no, the repeated references to 'health outcomes' appear to be hollow bluster. It's really an ideological coup.
Here is a prediction: Under Te Aka Whai Ora we will soon be paying for superstitious practices to treat ill-health conditions. Casting out demons, lifting curses, communicating with dead ancestors, being guided by Maori star signs, using unproven herbal medicines and actively discouraging patients from using whitey's medications will become acceptable for a time until the same dreadful outcomes seen in past centuries are recognized and campaigned against.
If it's allowed to continue after the next election, it's important we hold Te Aka Whai Ora accountable for achievement or otherwise of its lofty aims from its rationally weak foundations.
A.E. Thompson is a working, tax-paying New Zealander who speaks up about threats to our hard-fought rights, liberties, egalitarian values, rational thinking and fair treatment by the state.