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Thursday, June 22, 2023

Peter Dunne: Closing the Gaps - Deja Vu


There are strong echoes of the Clark Labour government’s “Closing the Gaps” programme in the system now being used by Auckland surgeons to prioritise patients on ethnicity, geographic location and equity grounds.

“Closing the Gaps” sought to assist socio-economically disadvantaged Māori and Pasifika through specially targeted programmes. Labour had campaigned on this at the 1999 election and started to implement the policy in its first Budget in 2000. Labour’s aim was to combat the systemic racism it saw at the time by confronting socio-economic disparities directly and promoting greater opportunities for Māori and Pasifika.

Although “Closing the Gaps” was popular with Māori, it was dogged from the outset by strident political opposition, culminating in Don Brash’s infamous Orewa Rotary Club speech in early 2004, where he argued for one standard of citizenship for all. The government had stopped referring to “Closing the Gaps” from mid-2000, talking instead about “reducing inequalities”. Nevertheless, it was so stung by the Orewa speech, and the positive response it attracted, that it established an audit of all government programmes to ensure they were being administered on the basis of need, rather than ethnicity.

Between 1999 and 2004 Labour’s language deliberately changed from an overt, aggressive emphasis on “Closing the Gaps” with Māori and Pasifika to one of meeting needs and reducing inequalities. But the underlying emphasis on improving the socio-economic status of Māori and Pasifika was retained, as they remained the groups where need was the greatest.

Overall, there were material gains by Māori and Pasifika during the entire nine-year term of the Clark government. But Labour stopped acknowledging these after the Orewa speech. Ironically, this gave rise to a sense that Labour was actually neglecting the interests of Māori and Pasifika, reinforced by the foreshore and seabed controversy later in 2004, which was the catalyst for the formation of the original Māori Party.

The same focus on reducing inequality lies behind the ethnicity priority approach Auckland surgeons began following earlier this year to improve Māori and Pasifika access to surgical services. With statistics showing Māori currently have less access to specialist health services because of factors like geographic location, and seven years’ less life expectancy than non-Māori, there is a strong logic supporting the approach being taken in Auckland.

However, the political reaction has been no different from “Closing the Gaps” twenty years ago. The National and ACT Parties have decried the policy as separatist, saying that access to health services should not be determined by need not ethnicity, and that they will overturn it if they form the next government. Prime Minister Hipkins, reminiscent of Helen Clark after the Orewa speech, while defending the policy intent, has sought assurances from his Health Minister that “we are not replacing one form of discrimination with another”. Sounding more doctor than politician, as is her wont, her initial response has been that there are sound clinical reasons for the ethnicity focused approach. But in the meantime, plans to roll-out the initiative across the rest of the country have been put on indefinite hold.

Already, as with “Closing the Gaps”, the focus of the government’s narrative is shifting from the process, to its intended outcomes. Just as “reducing inequalities” over twenty years ago was promoted by the Clark government as more palatable than “Closing the Gaps”, the early signs are that this government will shift its focus to “reducing disparities”, rather than talking too much about the mechanism by which it intends to achieve this.

But rather than retreat into its shell, and pretend the policy is not happening any more, the way Labour did after 2004, the current government needs to be more activist in explaining why it considers the ethnicity factor to be so important. After all, the evidence that Māori and Pasifika have worse health outcomes than everyone else, is overwhelming. Labour should feel on solid ground in focusing its approach on expanding health access to Māori and Pasifika to improve their life expectancy and overall quality of life, but without implying that this will come at the expense of the needs of others.

But if it decides to ignore the current policy debate, in the hope the controversy surrounding it will evaporate over time, it will run the strong risk, as happened in 2004, of being seen to be doing nothing, handing Te Pati Māori once more a strong weapon to beat it around the head with, but this time only four months before the election.

Given the way things are going right now though, in the words of American baseball great and legendary Malapropist, Yogi Berra, “it looks like déjà vu all over again.”

Peter Dunne, a retired Member of Parliament and Cabinet Minister, who represented Labour and United Future for over 30 years, blogs here: honpfd.blogspot.com

4 comments:

Terry Morrissey said...

Doesn't really matter what sort of spin you want to put on it, Peter, it is bloody apartheid whichever way you look at it. The forerunner of He Puapua and tribal rule. The sooner that this labour/greens/maori cult are ejected the better for the country.

Erica said...

What contribution does Maori self -destruction contribute to their poorer health outcomes ? The 80% of Maori babies born to solo mothers along with other social factors well documented by Lindsay Mitchell that automatically places Maori into social welfare dependence with poor housing, nutrition and poor mental health. All those factors that automatically follow from being low SES.

Then how does our now shockingly poor education system contribute, with the longest tail of underachievement, in the developed world, in which Maori feature significantly?
These problems are difficult to solve because they require a major ideological shift in particularly education, but also social welfare and medicine. So much easier to blame it erroneously on so-called racism.

Robert Arthur said...

Is all that a for or against? The majority industrious responsible public will never wholehartedly accept race based favoured treatment to counter what most recognise as the result of cultural and poor lifestyle choices.

Erica said...

Both Robert, Maori have contributed to their situation by poor life style choices and we have also a thoroughly destructive education system that has contributed to Maori underachievement and in fact selectively all low SES children. Progressive education has callously ignored the failures of its methods for decades. Our social welfare system has encouraged welfare dependence and the medical system has failed to encourage prevention through healthy diet and lifestyle. ( My grandchildren are constantly being given sweets at school for rewards, against parents' wishes ).
Of course race based health care is wrong but consider the rottenness in our institutions as well.