A.E. Thompson: The Whatuing Of Our New Health Service

My contacts have provided an update on the 'reforms' of our health service. Not much has been sorted or admitted to yet though undoubtedly at great expense. Just providing new letterhead paper, envelopes, signage etc across all the previous DHBs and throwing away all the previous stuff will be very costly and wasteful. However, it's all worth it to bless us with the language of Manglish; the title of this piece joins in the fun. In a recent communication to employees of Health New Zealand (oh sorry, Te Whatu Ora; the English name isn't even mentioned in most communications), the following were noted:

• Instead of meetings or updates, they have 'hui'. 
• Instead of workforce, staff or employees they have 'whanau'; e.g. 'It's always disappointing to lose members of our Te Whatu Ora whanau' (regarding the unusually large number of clinicians who have been resigning). 
• Instead of work, they do 'mahi'.
• Instead of a change management team they have a 'Pae Ora Delivery Unit'. 
• Instead of a country, they have 'motu'. 

A couple of interesting things have come to light. Firstly, it seems that Health New Zealand (oh, wash my mouth out with soap, I mean Te Whatu Ora) is avoiding hiring permanent clinical staff because of (unspecified) changes planned, so appointments are being made on a temporary basis. It's incredible that at a time of crisis in health services due in large part to difficulty recruiting clinical practitioners, our health service would not offer permanent appointments. No wonder they can't fill positions, they're not genuine about doing so.

Secondly, there is talk of current employees perhaps being interested in the new roles that will come. This means that Health NZ plans to disestablish many current roles, make people redundant and require them to apply for new roles under new structures if they still want jobs. We can predict that people will be hired for the new roles on the basis of race and/or allegiance to prioritizing Maori and to ideology such as co-governance and unequal democracy based on race.

(Regarding democracy, one matter that mainstream media made little mention of and appear quickly to have forgotten is that the new health service will no longer involve local democratic accountability because the previous District Health Boards whose members we voted for are no more. Instead, we will have a massive Health politburo feigning interest in public consultation and feedback. The elected DHB members were quietly dismissed without compensation and, it seems with little or poor notification or thanks from the Ministry of Health and the Health Minister (see NZ Herald Article 'Health system reform: DHB board members gone by July without compensation', 10/03/22).

Thirdly, a 'Commissioning Team' exists. We can expect commissioning of health services to be race-based. Health NZ's web page on this (last updated 25/08/22) states:

The commissioning workstream is looking at how commissioning will operate under the new health system. This includes how services will be planned, designed, monitored and reviewed, and how commissioning will help improve health equity and uphold the principles of Te Tiriti o Waitangi.

(Ah yes, equity instead of equality, meaning that outcomes bearing little relevance to the services become the responsibility of those services while equality in service provision across the population doesn't matter any more. And what about those clever Te Tiriti principles, huh? Those principles that magically appeared in recent decades, are not mentioned at all in the wording of Te Tiriti, were not alluded to in speeches by Crown representatives or the chiefs at the time of signing or by anyone for more than a century following, have never been described in a definitive list, and that the Waitangi Tribunal and other Courts have made clear are ‘not set in stone’ but ‘will evolve from generation to generation as conditions change’!)

Although the Commissioning Team was due to provide a 'draft commissioning operating model' to the 'Te Whatu Ora Design Council' by the end of September 2022, no update has been provided on the web site concerning this. Those involved with this health 'reform' process keep their cards close to the chest and provide the public with only vague reports, self-congratulatory and full of ideological platitudes. And a Design Council? It seems clear that the 'reforms' are already involving a hugely expensive bureaucracy of planners and consultants. Surely the design of our health service should have been largely completed (and the public informed and in agreement) before the existing system was replaced? How precarious our situation now is.

Fourth, there are 'Regional Wayfinders' and those roles and positions, unlike clinical roles, are permanent. Health NZ's web information states:

The Regional Wayfinders will be responsible for providing rangatiratanga leadership to multiple locally based Commissioning teams to support local communities and whānau in the pursuit of Pae Ora.

A precise definition of 'Pae Ora' was unable to be gleaned from readily available translation resources and even a search on Health NZ didn't provide one. Regardless, the Regional Wayfinder roles appear to be for ensuring race-based ideological compliance. They are a further indication of how top heavy the new organisation will be.

Another interesting development is that people have started appearing in clinical teams with unspecified professional qualifications except that they are the correct race, with a role of keeping unwell Maori away from western health practitioners instead to be cared for by whanau and iwi under a ‘by Maori for Maori’ philosophy. Regarding mental health at least, one of the myriad problems with this is that it is usually whanau who either approach services desperate for help and treatment of mental illness for their family member or who have turned their back on that family member whose weird, trying, drug addled, manipulative, thieving and/or self-destructive behaviour has worn them out (no blame implied; such problems often stem from the condition). The idea that other Maori, on the basis of being Maori, will know better about managing and treating people with such conditions seems both arrogant and foolish.

Last week's drama concerning Rob Campbell, the now dismissed head of Health NZ, was telling. He indirectly but clearly defended the ideology of co-governance and race-based unequal services. He will have been appointed because of his ideological position and that ideology has shaped the health system changes now in process. The reasons the Labour ministers sacked him included but were not limited to his breach of his employment contract requiring him to be politically neutral. His intransigence was also intolerable to them. Possibly more importantly though, his statements provided a ready target for critics of the new racist health system who could call out his ideology as responsible for every new unwelcome detail that becomes evident. He showed his hand and drew attention to the broader race-based governance and privilege philosophy driving the health changes. Labour politicians don't like that. (As shown by their silence about their most significant policies prior to the last election.) Most of the public don't yet realize that we are not just getting a special Authority for Maori health but that our whole health service will be based on a new race-based class who will be provided for first, best and funded for various superstitious treatments as per their preference. There will be no sound scientific research into the outcomes of any of this though we can expect 'ra-ra' achievement claims regarding any improved Maori health demographics even when they had been improving anyway (e.g. lifespan). Evidence of deterioration in outcomes will be censored for both Maori and non-Maori health. Don't for a moment imagine that our current Labour government seeks any change in race-based management or direction; they just want the true picture of the new health system to be as surreptitious as possible until each new detail can no longer be obscured and appears as a fait accompli.

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.