Barrie Davis: MHA Disestablished! Yeah … Nah

Maori health authority has not been abolished. All the roles and functions of the disestablished MHA have been transferred to Health New Zealand except for a few going to the Ministry of Health. Although ‘co-governance’ has been reduced to ‘engaging’, the Iwi Māori Partnership Boards and the Hauora Maori Advisory Committee that were established with the MHA in 2022 will remain along with their funding. Of the Hauora Maori Advisory Committee, present Minister of Health, Dr Shane Reti said “I'll be powering them up to do even more.”

All the Maori Party need do is wait for the pendulum to swing in 3 to 9 years time and reinstate the co-governance provision. They could leave the transferred roles and functions within Health New Zealand, out of public perception, or maybe set up another MHA when it suits them.

The Money

The 2022 Budget included $579.9 million for Maori health initiatives over four years. At the time, Associate Minister of Health Peeni Henare said (here) the 2022 Budget included $168 million over four years for the Maori Health Authority to directly commission services and a further $20.1 million over four years to support the development of iwi-Māori partnership boards. He said, “We are also investing $39 million to provide the Māori health workforce with additional access to training and development to support them within the new health system.”

Tureiti Moxon of the Maori Party recently said (here), “We've already spent $50 million just before Christmas to work on the issues that we're talking about ...” The haste to spend the $50 million is a bit rich considering they are now complaining about the Coalition passing the Disestablishment bill under urgency before the Waitangi Tribunal got hold of it.

David Seymour said (here at 14:50) there will be fewer people in the new merged organization of what was the Maori Health Authority and Healthcare New Zealand: “That’s going to be a win, it may actually free up funds.” Minister Reti said (here), “It looks like there may be $10m to $20m to $30m that might otherwise be available for other projects.”

There are large chunks of tax-payer money up for grabs. You’d think the Government would have cancelled any redundant budgets to reduce the debt we have inherited from the previous Maori Party government. But not so: Dr Reti said (here) the funding for Maori health would remain the same, “and how that's distributed - through clinical or non-clinical frontline, backline, that's what's under discussion”. It seems it’s forbidden to reduce Maori budgets and he’s stuck for somewhere to splash the cash. Instead he could have disestablished the Advisory Committee and the Partnership Boards and saved those budgets as well, but he has kept them so they can be developed and be ready for deployment by the next régime.

This is at the same time that the Ministry of Health will propose job losses to meet the Government’s 6.5% cost saving targets. Additionally, many vacant roles were removed last year as well as a recruitment freeze (here). That is race-based replacement in the Government health sector along the lines claimed by Renaud Camus. It is an example of general roles being methodically replaced by Maori specific roles to diminish European influence in New Zealand.

Professor Linda Tuhiwai Smith explores replacement in her book Decolonizing Methodologies, which begins (p. xi), Western “research was one of the ‘dirtiest words’ in the vocabulary of Indigenous peoples. … and ‘research’ remains a dirty word for many of the world’s Indigenous peoples and communities.” Presumably they don’t want facts to stand in the way of a good story. Similarly in a book of essays, Imagining Decolonisation (p. 51), Ocean Ripeka Mercier agreeably quotes a definition for decolonization as “the removal of any Western ideas in a social, political or scientific issue. Logic is optional.”

That raises the question of what, if anything, is driving replacement in New Zealand? The Waitangi Tribunal, obviously; but what also is the influence of the United Nations?

After Shane Reti tabled the MHA Disestablishment bill under urgency on 27 February, Green Party MP Scott Willis asked in the House (here), “I want to understand why the Minister is so afraid of the Waitangi Tribunal … ?” That’s a good question. Who’s running this country? Our democratically recently elected fearful Government or a race-based, unaccountable, entitled Commission, the recommendations of which the United Nations called on the New Zealand Government to make legally binding in 2018. What exactly is this Waitangi Tribunal and why have we still got it? And since when was the UN able to demand our Government fundamentally change our constitution?

Little if any of the above Maori specific cost is necessary to Maori health, for which I will instead argue that logic is essential.

The Problem

The central complaint is that Maori life expectancy is about 7 years less than for non-Maoris. It is also 4 years less for Maori men than for Maori women (Ministry of Health's Māori health chart book 2015, here). Why then is the complaint about race differences rather than about sex inequities? An obvious reason is that Maori health is being used as leverage for Maori separatism when there is no guarantee that a separate Maori health system will increase Maori health.

Tureiti Moxon (here) claimed that if Maori health were to come back under Health New Zealand, Maori health inequities would continue to grow. But advice provided with the MHA Disestablishment bill identified there has been a gradual increase in Maori life expectancy in recent years, more than for other ethnicities (here). That may be placed in the context of Maori life expectancy more than doubling since the time of the Treaty. If the decreasing health inequity continues after the Hauora Maori Advisory Committee becomes operative, I would not be surprised if Tureiti Moxon then claimed it is due to the Committee.

The Maoris also claim institutional racism (here). So, if there are problems for Maoris, are there similar problems for Islanders? If not, then identify how it is that Islanders succeed when Maoris do not and apply that to Maoris. If yes, then whatever Maoris get should also apply to Islanders and there should be no Maori-specific health authority. I wonder if this is more about political power and self-determination for Maori elites than it is about health. When the MHA bill was passed in June 2022, ACT Party deputy leader Brooke van Velden said (here) the legislation was “all to do with co-governance”; the bill “won't go any way to addressing better outcomes for New Zealanders.”

The Solution

In a previous Breaking Views post (here), I considered the view of Anne Salmond who says that Maoris think differently to Europeans. She says relational thinking is ubiquitous in te reo, whereas Europeans are more inclined to logical reasoning. I pointed to some cognitive science which claims we share relational thinking with other animals, whereas logical reasoning is evolutionarily recent and uniquely developed in humans.

Logical reasoning is a function of the conscious rational faculty we call ‘I’ and it is perceived as the constant string of language that passes through our consciousness. Logical reasoning and relational thinking interact; in particular, there are circumstances in which logical thinking takes over, overruling the automatic impulses and associations of relational thinking.

Examples are carrying out a rational decision to stop smoking, to drink less, or to eat less. Where, for example, relational thinking associates having a coffee with having a smoke, logical reasoning intervenes to prevent having the smoke. Health agencies claim up to 75% of deaths from lung cancer could be reduced, mainly by cutting smoking (here). The present trend for Maoris to regress to traditional archaic behaviours, such as relational thinking, is therefore a negative factor to Maori health. Maoris (17.1%) have the highest rates of smoking followed by Islanders (6.4%), Europeans/Other (6.4%) and Asians (3.3%). (Source Health NZ) So an appropriate remedy is to strengthen the Maori rational faculty and encourage its use; that is, for Maoris to think as Europeans do, or perhaps as Islanders or Asians.

I therefore propose the following solution to Maori health. It will increase Maori life expectancy, save Maoris a significant amount of money and will not incur cost to the taxpayer. It comprises the following three practices which may also be applied to non-Maoris:

1. Stop smoking tobacco which will avoid various diseases, such as lung cancer.
2. Drink less alcohol (and smoke less pot, etc.)
3. Eat less and eat healthy, which will reduce the incidence of obesity and associated disorders such diabetes.

I select these three for illustrative purposes of a general lifting of healthy lifestyle practices. Others could include doing appropriate exercise and appropriate visits to health professionals. We can all do the homework to identify what we individually need to do for a healthy lifestyle. But Maoris can’t know what is best for themselves by using traditional relational thinking. We need to tap into the available science on the subject. The thing is, everyone knows this.

Conclusion

The point of the proposed practices and healthy lifestyle choices generally, is that Maori health lies in the hands of Maori individuals, as it does for all of us. The idea of attempting to shift responsibility for these behaviours onto the state is mistaken. We learn from the outcome of our behaviour, so to the extent that Maoris are absolved of the responsibility for their behaviour, they will learn less than they would have otherwise.

Maoris claim to want self-determination, but when they can determine their behaviour for themselves they do not accept responsibility for the outcomes. I suspect that the ‘by Maori, for Maori’ claim is a means to obtain power for the elite minority and get ‘resources’ from the public purse. If it was really ‘by Maori’, it would be funded by the rich powerful iwis.

The three activities I mentioned – smoking, drinking and eating – are expensive and curtailing them will save Maoris money. The only cost to the taxpayer is the reduction in tax from sales of the associated products – tobacco, alcohol and food; there is no cost to implement them. As a taxpayer, I do not accept responsibility for providing health services to those people – Maoris and non-Maoris – who do not enact these already well-known practices. I am not the cause and it is not my problem; so it is only fair and reasonable that I should not pay for it.

We are being taken for a ride.

Barrie Davis is a retired telecommunications engineer, holds a PhD in the psychology of Christian beliefs, and can often be found gnashing his teeth reading The Post outside Floyd’s cafe at Island Bay.