Wednesday, October 19, 2022

A.E. Thompson: Our New Race-Based Health System

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 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.


K said...

Herbal medicines? The stoners will be thrilled...

DeeM said...

Are you from a discriminated background, friend?
Are you a colonised, "indigenous" ethnic minority, too?
Have we got a deal for you!

One bottle of Te Aka Whai Ora snake-oil will cure all your ills from diabetes to obesity. It will even increase your life expectancy.

And the modest price for this elixir of life? To you, nothing!
Your poor fellow citizens will pay...through the nose, for the rest of their lives....and beyond.

RogerF said...

Could someone enlighten me as to how this race based system will integrate into our existing medical facilities?

Anonymous said...

Thank you for your intelligent analysis and effort to speak out to try to establish some sanity in this hitherto rational polity. We try hard to understand how it has come to this, and how we can move out of it towards a reasonable and fair way of living together - Maori - and all the rest. And it's 'all the rest' of us who, like you, are going to have to get it into our heads that there is no such thing as 'reverse racism'. There's racism!
Thing that has me gnashing my teeth in frustration is not how citizens of all stamps come to adopt the attitudes they do - I get that. It's how a government, in this day and age, individuals to the outside view normal, sane, average, man-in-the-street kind of chaps and chapesses - can be so STUPID!

Robert Arthur said...

It staggers me that much of the current racist legislation gets through the Labour caucus. They are not all maori. Some are moderately intelligent. Why are they so cowed? Do they know so much about maori offending that, faced with a culture steeped in utu, they are too afraid to differ?

oneblokesview said...

You start of with a statement from the website.

Its web site promises enhanced 'rangatiratanga' for Maori over their health and claims this is "central to Te Tiriti O Waitangi.

Like many European commentators. You use the English version of teh treaty to support your argument.

However it is the Maori version that takes precedence as confirmed by the UK Foreign office of the day.

The interpretation of Article two by the original Waitangi Tribunal is.

The Māori version of article 2 uses the word 'rangatiratanga' in promising to uphold the authority that tribes had always had over their lands and taonga. This choice of wording emphasizes status and authority.

I suggest this is where the Maori Health Authority gets its ""authority"" ie rangatiratanga.

It is a common mistake by non scholars of the treaty that the natives were effectively denied authority over their own future regarding their treasures.

So effectively the argument from the author fails due to his mis understanding of the treaty and its implications. Which were understood by the foreign office of the day.

Its common in todays racially divided society to pick a side rather than work on closing the gaps in the rhetoric.

MOMOTOM said...


Anonymous said...

Robert arthur I think.the lsbour caucus are cowed because unlike sharma who has a medical degree and other options, they want to keep their highly paid mp jobs for as long as possible., so keep quiet.
If only we had more wayne browns! What a champion!

Robert Arthur said...

Unfortunately, as with many maori words today whether manufactured or not, there was no positive definition laid down for the contrived word rangatiritanga as used. But clearly it was intended to cover chiefly influence of their tribe on matters not covered by the new British subject status. Chiefly influence extended to own local tribe or to a migrated or remaining sub tribe, not to all maori or to intermingled maori. The situation today with the tribal chiefs non existant or nominal only and subjects totally intermarried among tribes and with colonists and dispersed and not identifying with any rangatira, and generally integrated as British subjects was beyond imagination so not addressed or embraced. To avoid antagonising the natives with intrusive interference, and because of the sheer impracticality of enforcing the British subject laws newly applicable, a somewhat blind eye was turned to many maori practices initially (tribal warfare, polygamy, theft, slavery).The word rangatiritanga today should have application only to peculiarly local tribal internal matters.

Mudbayripper said...

Constantly trying to make sense of madness is actually counter productive and draining to us all.
The real issues facing us all in the democracies has been ongoing for many years. I believe its unstoppable. Those of us that have finally become aware are to old and wary to offer meaningful resistance.
The powerful forces behind the marathon of postmodern corruption are in the stadium celebrating the victory that will be theirs sooner rather than later.

*** said...

It took 40 years, international sanctions and mass civil unrest to dismantle South Africa's apartheid, what will it take to dismantle New Zealand's apartheid?

Doug Longmire said...

An excellent article, and very relevant points raised.
From my own experience as a recently retired pharmacist with over 50 years in healthcare, I find the accusation of "discriminating against Maori" in the healthcare system to be both highly offensive and totally false.
I have never discriminated for or against any person based upon their race or culture !!
Fellow pharmacists and technicians that I have talked to agree with me, but are often reluctant to voice their opinion for fear of standing out.

Also - regarding the "Tiriti" health obligations - they simply do not exist ! The words of the Treaty are clear.
Unfortunately the Treaty has been re-written by a multitude of activists lawyers, judges and the like. The Waitangi Tribunal have actually stated that a modern application of the Treaty (signed in 1840) must ignore the actual words of the Treaty document !! They then go on to re write history. Need I say more ?

Empathic said...

OneBlokesView: No, the author did not refer to the English version of the Treaty. The author referred to Te Tiriti, the Maori version that was later translated into English for example by the esteemed Maori scholar Sir Apirana Ngata. The Maori version is the only Treaty as it was the one signed by the vast majority of the chiefs.

There is no argument that Te Tiriti did not contain the word 'rangatiratanga'. But Te Tiriti did not contain any reference to health outcomes or indeed any outcomes.

The author's predictions concerning our new racist health system were not arguments based on either version of the Treaty.

The contradiction between ceding government of New Zealand to Queen Victoria and maintaining rangatiratanga can be resolved as follows: Treaties are relevant to their particular time and are generally not seen as being forever. In 1840 it would have been realistic to envisage British law applying to the new settlers and to Maori interactions with those settlers while Maori continued to operate under chiefly authority within their own iwi and lands. That's what happened for a number of decades. As new immigrant settlement and co-existence with Maori increased that arrangement became increasingly unrealistic if New Zealand was to be a cohesive colony then country in which a government and a system of law were to apply.

Shall we divide New Zealand up into over 500 separate states because of a treaty signed in 1840, even though that would contravene Article One of that treaty?

The term 'taonga' was likely to mean 'valued possessions'. That has no relevance to a modern health care system based on international models and science. There is little stopping Maori from continuing to rely on traditional cures or whatever cures they prefer, but nothing in Te Tiriti obliges the government of all New Zealand (agreed to by those chiefs who signed Te Tiriti) to provide those cures.

Empathic said...

On Kim Hill's show this last Saturday 22/10 was an interview with historian Ned Fletcher who just wrote a book based on his research of Colonial Office material and all other written records he could find related to The Treaty before and after 1840. He found that the British Crown and NZ representatives were well-intentioned and the Treaty was intended to control the settlers and to protect Maori. He did not think there were any deliberate differences between the English and Maori versions. He found that the plan was for Maori to maintain chiefly authority in their own iwi and lands while British law would apply to the new settlers. He noted that the speed of growth in numbers of British and European settlers was unexpected and unprecedented (for example much faster than had been the case in Australia and other colonies) and this caused difficulties for the original plan.

While his historical research appeared excellent and very important for understanding the Treaty in its context, his views on the applicability of the Treaty to current times seemed unrealistic. He seemed to believe that co-governance was a solution to the inconsistency between 'kawanatanga' (ceding governance or sovereignty to Queen Victoria) and 'rangatiratanga' (maintaining chiefly authority), and that somehow iwi could now still operate under their own laws, justice system and so forth. However, he didn't appear to have thought much about this and I suspect his position was influenced by fear of flak from the race radicals and the indoctrinated masses given that his main thesis will already be controversial.

MikeV said...

The question I have regarding all of this Maorification is why is Ardern allowing it or indeed encouraging it? What has the Maori elite got "over her" to get her to allow this?