The news early this month that a Pakeha patient asked not to be treated by Asian staff at Auckland’s North Shore Hospital and that the hospital complied was quickly and roundly condemned by the Association of Salaried Medical Specialists and health-worker unions. Many of the public, too, criticised the patient’s request as blatant racism.
While the code of consumers’ rights states, “Every consumer has the right to express a preference as to who will provide services and have that preference met where practicable”, the clause is presumably intended to resolve individual personality clashes between patients and the nurses and doctors looking after them, not a blanket refusal to be treated by a swathe of ethnic groups coming under the umbrella term of “Asian”.
What went unremarked in the furore, however, is that the idea that patients might want to have medical staff who look like them and whom they feel comfortable with is officially sanctioned at the highest levels of the health system. Both Auckland and Otago medical schools run extensive race-based, affirmative-action programmes to do exactly that.
Both consider such personal congruence to be so important they are willing to dramatically drop their academic entry standards to allow more Māori and Pasifika students to study medicine — thereby boosting the likelihood that a Māori or Pasifika patient might be attended to by someone who shares their ethnic background. In short, they happily give possible racial compatibility precedence over merit.
And it’s not a trivial programme. This year, of the 287 available places for domestic students, Auckland University’s Medical School set aside 115 places for MAPAS (Māori and Pacific Admission Scheme) students.
That is to say, a full 40 per cent of available places were earmarked for Māori and Pasifika students.
And the relaxed academic standards for Māori and Pasifika students are not trivial either. An OIA showed that while an academic grade of at least 93 was required in the general category to be granted an interview to study first-year health sciences at Otago Medical School in 2022, Māori students required only 69.14.
For graduates, the minimum GPA score to receive an offer in the general category was 8.59 while Māori required only 4.51 — or roughly half.
The mantra offered to justify this race-based discrepancy is that all students have to pass the same exams once they are admitted. However, a low B-grade student doesn’t become a strong A-grade student simply by virtue of studying at med school.
The most extraordinary justification offered for this racial discrimination is that Māori and Pasifika patients not only prefer to be treated by someone of their own ethnicity but that such a match leads to better clinical outcomes.
Last December, Professor Warwick Bagg, Dean of the University of Auckland’s faculty of Medical and Health Sciences, told RNZ, “There’s no question about it, that when you have cultural concordance between your provider and your patient, then you’re much more likely to get a better health outcome.”
The question immediately arises: is a Pakeha patient justified in mounting a similar argument for the good of their health, or is it one reserved solely for Māori and Pasifika?
Interviewed on TVNZ’s Breakfast alongside Professor Bagg, Auckland University’s Associate Professor of Public Health Sir Collin Tukuitonga similarly opined: “International research shows that when you have the health care provider — the doctor, or the nurse or the pharmacist — [from] the same ethnic language, social, cultural groups with the patient, you have better outcomes.”
It is a view shared by Dr Emma Wehipeihana (formerly Emma Espiner, wife of RNZ’s Guyon Espiner). A MAPAS graduate herself, she told Re: News: “It benefits our patients enormously in terms of the therapeutic relationship to be looked after by a doctor who looks like them, who understands what’s important to them and their whānau.”
Asked what she would say to those who claim race doesn’t matter when it comes to medical care, she replied: “I would love it if ethnicity didn’t matter when it comes to medical care. Unfortunately, the evidence — the mountains and mountains of scientific evidence — tells us that it does.”
It’s difficult then to argue that a Pakeha patient who doesn’t see any “concordance” between themselves and Asian hospital staff should be castigated for making their preference known. After all, if senior doctors and academics tell us that ethnic compatibility achieves the best health outcomes for Māori and Pasifika, why shouldn’t a Pakeha patient believe their prospects are best served by at least not having staff of totally different ethnicities caring for them?
The fact is that the arguments about the extensive benefits of having a doctor who looks like you are exceedingly weak — amply illustrated by Bagg’s example offered on Breakfast: “If you are a Māori woman with a breast lump and the only doctor in town is a Pakeha male, you might be reluctant to go and see that person. You might not, but you might be reluctant. Whereas if you have the option to see a Māori doctor, you may well present earlier and get the treatment you need.”
Of course, the hypothetical Māori woman might actually decide to go to the doctor who has a reputation for being the most competent rather than deciding that their race was the most important factor. And, unfortunately, she might assume that the Māori doctor is likely to be less competent given the lower academic standards required for entry to med school.
Professor Bagg and Sir Collin Tukuitonga were being interviewed because the effectiveness of the MAPAS scheme and its Otago equivalent is due to be reviewed by the government this term as part of National’s coalition agreement with Act. David Seymour makes no secret of the fact that he believes “MAPAS is a scheme that openly practises racial discrimination, that treats people differently based on their ethnic background”. Act’s antipathy to any race-based policy is well known.
It’s a safe bet that the arguments predicting much better clinical outcomes will not stand up to close scrutiny in any review and that the true justification for the affirmative-action programmes will be revealed to be ideological. That is to say they are part of the relentless push to “indigenise” the university as a consequence of a particular interpretation of the Treaty of Waitangi as a “partnership”.
So far, that push has included inserting matauranga Māori with its vitalism and spiritual components into science courses and the introduction of a compulsory paper covering the Treaty of Waitangi and traditional Māori knowledge systems that all students in every faculty — including overseas students — will have to complete before being able to move on to second-year studies at Auckland University.
In an article in a BMJ journal last year, a team of researchers, led by Professor Bagg, made it clear they see training more Māori and Pasifika doctors not as an end in itself but as a stepping stone towards true indigenisation. “Although these equity-targeted policies [like MAPAS] have met with a degree of success through greater inclusion, more needs to be done. The work is part of the larger project of Indigenising academic institutions. While our institutions have sought to focus on Indigenous inclusion, this is not adequate as the goal, as on its own it is inadequate for achieving a properly productive relationship with Māori. Rather, the journey towards Indigenisation of the institutions, leading to the normalisation of Indigenous ways of being and knowing is required for medicine to truly mirror NZ society.
“In a broad sense, the reorientation of all government educational institutions (preschools, schools and universities) is required, focused on good relationships between Māori and non-Māori, to ultimately achieve health workforce and health outcomes, as envisaged in Te Tiriti o Waitangi.” The affirmative-action programmes are therefore most accurately viewed as just one aspect of the long and relentless march of progressive policies through the nation’s institutions that aim to effectively turn all our taxpayer-funded educational organisations — whether catering for children or medical students — into wānanga, imbued with Māori cultural values.
Graham Adams is an Auckland-based freelance editor, journalist and columnist. This article was originally published by ThePlatform.kiwi and is published here with kind permission.
What went unremarked in the furore, however, is that the idea that patients might want to have medical staff who look like them and whom they feel comfortable with is officially sanctioned at the highest levels of the health system. Both Auckland and Otago medical schools run extensive race-based, affirmative-action programmes to do exactly that.
Both consider such personal congruence to be so important they are willing to dramatically drop their academic entry standards to allow more Māori and Pasifika students to study medicine — thereby boosting the likelihood that a Māori or Pasifika patient might be attended to by someone who shares their ethnic background. In short, they happily give possible racial compatibility precedence over merit.
And it’s not a trivial programme. This year, of the 287 available places for domestic students, Auckland University’s Medical School set aside 115 places for MAPAS (Māori and Pacific Admission Scheme) students.
That is to say, a full 40 per cent of available places were earmarked for Māori and Pasifika students.
And the relaxed academic standards for Māori and Pasifika students are not trivial either. An OIA showed that while an academic grade of at least 93 was required in the general category to be granted an interview to study first-year health sciences at Otago Medical School in 2022, Māori students required only 69.14.
For graduates, the minimum GPA score to receive an offer in the general category was 8.59 while Māori required only 4.51 — or roughly half.
The mantra offered to justify this race-based discrepancy is that all students have to pass the same exams once they are admitted. However, a low B-grade student doesn’t become a strong A-grade student simply by virtue of studying at med school.
The most extraordinary justification offered for this racial discrimination is that Māori and Pasifika patients not only prefer to be treated by someone of their own ethnicity but that such a match leads to better clinical outcomes.
Last December, Professor Warwick Bagg, Dean of the University of Auckland’s faculty of Medical and Health Sciences, told RNZ, “There’s no question about it, that when you have cultural concordance between your provider and your patient, then you’re much more likely to get a better health outcome.”
The question immediately arises: is a Pakeha patient justified in mounting a similar argument for the good of their health, or is it one reserved solely for Māori and Pasifika?
Interviewed on TVNZ’s Breakfast alongside Professor Bagg, Auckland University’s Associate Professor of Public Health Sir Collin Tukuitonga similarly opined: “International research shows that when you have the health care provider — the doctor, or the nurse or the pharmacist — [from] the same ethnic language, social, cultural groups with the patient, you have better outcomes.”
It is a view shared by Dr Emma Wehipeihana (formerly Emma Espiner, wife of RNZ’s Guyon Espiner). A MAPAS graduate herself, she told Re: News: “It benefits our patients enormously in terms of the therapeutic relationship to be looked after by a doctor who looks like them, who understands what’s important to them and their whānau.”
Asked what she would say to those who claim race doesn’t matter when it comes to medical care, she replied: “I would love it if ethnicity didn’t matter when it comes to medical care. Unfortunately, the evidence — the mountains and mountains of scientific evidence — tells us that it does.”
It’s difficult then to argue that a Pakeha patient who doesn’t see any “concordance” between themselves and Asian hospital staff should be castigated for making their preference known. After all, if senior doctors and academics tell us that ethnic compatibility achieves the best health outcomes for Māori and Pasifika, why shouldn’t a Pakeha patient believe their prospects are best served by at least not having staff of totally different ethnicities caring for them?
The fact is that the arguments about the extensive benefits of having a doctor who looks like you are exceedingly weak — amply illustrated by Bagg’s example offered on Breakfast: “If you are a Māori woman with a breast lump and the only doctor in town is a Pakeha male, you might be reluctant to go and see that person. You might not, but you might be reluctant. Whereas if you have the option to see a Māori doctor, you may well present earlier and get the treatment you need.”
Of course, the hypothetical Māori woman might actually decide to go to the doctor who has a reputation for being the most competent rather than deciding that their race was the most important factor. And, unfortunately, she might assume that the Māori doctor is likely to be less competent given the lower academic standards required for entry to med school.
Professor Bagg and Sir Collin Tukuitonga were being interviewed because the effectiveness of the MAPAS scheme and its Otago equivalent is due to be reviewed by the government this term as part of National’s coalition agreement with Act. David Seymour makes no secret of the fact that he believes “MAPAS is a scheme that openly practises racial discrimination, that treats people differently based on their ethnic background”. Act’s antipathy to any race-based policy is well known.
It’s a safe bet that the arguments predicting much better clinical outcomes will not stand up to close scrutiny in any review and that the true justification for the affirmative-action programmes will be revealed to be ideological. That is to say they are part of the relentless push to “indigenise” the university as a consequence of a particular interpretation of the Treaty of Waitangi as a “partnership”.
So far, that push has included inserting matauranga Māori with its vitalism and spiritual components into science courses and the introduction of a compulsory paper covering the Treaty of Waitangi and traditional Māori knowledge systems that all students in every faculty — including overseas students — will have to complete before being able to move on to second-year studies at Auckland University.
In an article in a BMJ journal last year, a team of researchers, led by Professor Bagg, made it clear they see training more Māori and Pasifika doctors not as an end in itself but as a stepping stone towards true indigenisation. “Although these equity-targeted policies [like MAPAS] have met with a degree of success through greater inclusion, more needs to be done. The work is part of the larger project of Indigenising academic institutions. While our institutions have sought to focus on Indigenous inclusion, this is not adequate as the goal, as on its own it is inadequate for achieving a properly productive relationship with Māori. Rather, the journey towards Indigenisation of the institutions, leading to the normalisation of Indigenous ways of being and knowing is required for medicine to truly mirror NZ society.
“In a broad sense, the reorientation of all government educational institutions (preschools, schools and universities) is required, focused on good relationships between Māori and non-Māori, to ultimately achieve health workforce and health outcomes, as envisaged in Te Tiriti o Waitangi.” The affirmative-action programmes are therefore most accurately viewed as just one aspect of the long and relentless march of progressive policies through the nation’s institutions that aim to effectively turn all our taxpayer-funded educational organisations — whether catering for children or medical students — into wānanga, imbued with Māori cultural values.
Graham Adams is an Auckland-based freelance editor, journalist and columnist. This article was originally published by ThePlatform.kiwi and is published here with kind permission.
14 comments:
The arguement that better outcomes are achieved when treated by someone who looks like you is such a strawmanly spurious bit of outright garbage.
That a person of one ethnicity may have a better outcome if their brain surgeon is the same ethnicity is mindlessly inane.
I'd bet the house on the one fact that is true.
If you are of an ethnicity that sees colour as more important than merit you'd still insist the surgeon who got straight A's and has massive experience does your surgery over any other surgeon no matter his colour, period!
RE Indigenization:
Note that " obtaining taxpayer approval" is never mentioned as a criterion. "Pay - but no say " is therefore the plan.
A referendum would sort this out for sure.
The hypocrisy is hardly new. The insistence on nursing students learning to be "culturally safe" must go back decades. And the funding of explicitly Maori Health Providers is an established feature of the health system. Presumably the doctors and nurses emerging as a result of these equity targeted policies gravitate towards those Maori Health Providers, so we might reasonably expect see see an improvement in the health outcomes for their indigenous patients. Hopefully the proposed review of the MAPAS scheme and its Otago equivalent will go looking for evidence of this sort. Because that's the only metric that could possibly matter in determining whether the schemes are justified.
When will we find an adult to talk some sense into these people?
And the outcome if a doctor stated he would only see patients of his ethnicity.? The doctor would be called racist. Thank goodness most health professionals are above University garbage
i would have reservations of a maori treatng me. In part due the reduced qualifications accepted. And so extreme is their anti colonist attitude I would be fearful of any disciple of Motu, Moxhan, Sykes, Waitaiti, and co, especially if they recognised Robert Arthur.
How do these fudged qualifications stack up internationally ?
Does a medical degree with NZ (or more probably Aotearoa ) on it have any standing anywhere in the First World ?
Were there Maori doctors who treated war wounds inflicted by sharp sticks and blunt stones in pre- European times ?
Matauranga medicine is patently just another made up crock of crap being foisted on the general population by Baggs and Tukiatonga.
I am sick of people like this telling us what we have to do to satisfy their ethics and newly created culture.
It's a matter of qualification equivalences. As a very general rule, graduates of medical training systems that follow the classic British model (as the NZ one does) are recognised here and can practise in NZ, unless there are clear quality discrepancies with respect to standards involved.
My GP qualified in India and he is fine. Not so fine for me personally would be a NZ citizen of a favoured race who had got into medical school as part of a race quota and whose competence may not be questioned because that would be 'racist'. The irony here of course is that people with inferior competencies get let loose on patients not because they trained overseas but because they trained here as members of favoured races. And that is when all this PC bullshit starts costing patient lives.
The missing info here is the relative performance of Maori and Pasifika students, and other students, in the actual degree programme. Equity programmes are built partly on the assumption that the recipients of equity places have academic potential that may not have been evident in their school results because of disadvantages they suffer. You may not agree that these disadvantages are real, - and I imagine most of the audience that this NZCPR site targets doesn't believe they are. But what you'd need to know is whether the equity students' results improved during their medical studies, and how competently they performed in a practical sense as well.
I want to see the A word removed from our passports and cash! I feel that it diminishes my standing in the World and offends my culture.
Can ms Espiner direct us to the mountains of evidence ?
Joanne W, There is no requirement that Maori/PI students should come from disadvantaged backgrounds. Emma Espiner, whom I mentioned as a MAPAS grad, has admitted her life has been "privileged". Years ago, Hinemoa Elder, who was the wife of another broadcaster, the wealthy Paul Holmes, was admitted under the programme (which caused a furore).
The only requirement regarding ethnicity for MAPAS is that the candidate has at least one great-grandparent who is Maori.
I have spoken to senior doctors who say most of the candidates are not really up to medical studies and require a lot of special pastoral and academic coaching to pass their exams. Once accepted into med school, very few are failed.
Yes, obviously not all Maori /PI students come from disadvantaged backgrounds, but in comparison with the overall population, a higher proportion would. As regards the views of the senior doctors, I guess the question would be whether they thought the coaching for MAPAS students turns out to be worth it, or they'd have preferred to have academically better students of other ethnicities? Or that the medical work-force would be better with fewer MAPAS students in it?
I have not been able to find the "mountains of evidence" Emma Espiner (or Sir Collin) referred to. I suspect at best it would amount to people saying they would prefer to be treated by someone of their own ethnicity, but that, of course, has no necessary bearing on health outcomes. Espiner perhaps needs to believe that to justify taking a place that might have gone to a better-qualified candidate.
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