Act has pledged to abolish MAPAS and it would have been fascinating if Guyon had explained why he fully supported someone gaining a place through a pathway that offers preferential treatment based on ancestry.
It is worth noting that Emma (now Dr Wehipeihana) has been a vocal defender of special entry programmes for medicine at both Auckland and Otago universities, including in her 2023 memoir There’s a Cure for This.
In a 2021 university newsletter, Emma Espiner opined that “[some] people want us specifically, as Māori and Pacific people, to feel guilty that we’re ‘taking’ someone else’s place”. She described that view as an “old red herring” and a “prejudice” motivated by “ignorance and envy”.
One of the justifications for the programme is that it is needed to overcome disadvantages that Māori and Pasifika students suffer when they are educated at lower-decile schools and are thus thwarted from reaching their potential.
However, when Emma Espiner applied she was already a graduate in art history and classics and had gone on to work at Parliament as a political staffer before a successful career in executive recruitment. She was highly educated and familiar with the demands of university study and high-pressure jobs.
Clearly such disadvantage didn’t apply in her case so what was the justification? In these scenarios, apologists are obliged to fall back on their next line of defence — that patients do better when they are treated by people who look like them in the health system.
When the review of both the MAPAS and Otago’s Mirror on Society schemes was proposed two years ago to fulfil ACT’s coalition agreement with National, 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.”
Auckland University Associate Professor of Public Health Sir Collin Tukuitonga similarly opined to TVNZ’s Breakfast: “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 was a view shared by Emma Espiner 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.”
Professor Bagg repeated that view this month in a university publication: “There is also growing evidence that health outcomes can improve when patients receive care from health professionals who understand and connect with their communities and cultural backgrounds.”
However, that argument can only be described as paper thin. It rests on the tenuous assumption that only someone with a Māori ancestor can care properly for a Māori patient. Or that their overall health statistics are poor because of a relative lack of Māori doctors to treat them.
If the advantages of a shared background were so significant, you’d have to say most New Zealanders are being denied optimal health care. As anyone who has spent time in hospitals knows, the chances of a patient being cared for by doctors or nurses who all share the same cultural or ethnic background as them are not high.
RNZ reported in May that a survey by the Association of Salaried Medical Specialists showed over 43 per cent of New Zealand doctors are trained overseas, the highest proportion in the developed world.
In the year to July 2024, more than 70 per cent of those registered came from 63 different countries.
And with around 25 per cent of GPs being Asian, an awful lot of New Zealanders will be treated by someone from an entirely different ethnicity and cultural background.
The idea that particular groups in society such as Māori and Pacific Islanders should have a Medical School policy designed to produce doctors who look like them is preposterous.
And because MAPAS applicants need only one Māori or Pasifika great-grandparent to qualify, some with such remote heritage don’t look even slightly Māori or Polynesian.
While it is clear that preferential entry confers a personal benefit on the Māori and Pasifika graduates who can move into a lucrative and high-status occupation, the benefits flowing to patients is moot. And if any such benefits do exist they have to be weighed against the serious damage race-based entry does to the professional standing of all Māori and Pasifika doctors no matter how they entered the profession or how capable they are.
That negative effect, both in the eyes of the public and among many doctors themselves, is regularly demonstrated on social media, where commenters often voice their belief that any Māori or Pasifika physician is probably second rate.
Such hostility has also been acknowledged in academic studies. A British Medical Journal article co-authored by Professor Bagg phrased it in careful terms:
“Providing ‘preferential treatment’ to one group or individual over another has not been universally welcomed by the public or the profession.”
Objections to race-based programmes of any kind are common but those reservations often turn to outrage when critics discover the gulf in academic standards between some MAPAS entrants and those enrolling via the General category.
A response to an OIA request for a breakdown of applicants for Auckland Med School’s 2024’s intake showed the median GPA for successful graduate students under General admission was 8.5; for MAPAS applicants it was 6.25.
The lowest GPA score for General admission was 7.25 while a score of 4 sufficed under MAPAS.
For this year’s intake at Otago, the minimum average marks to receive an offer of a place at Med School in the General category was 93.14 per cent. For Māori students, it was 65.29 per cent.
Backfooted by such criticism, advocates of the schemes frequently argue defensively that everyone who graduates has passed the same exams.
However, that is as disingenuous as saying all philosophy, politics or physics students in the same class pass the same exams and are therefore on an equal footing academically even though a gifted student might get an A+ and another a bare pass mark.
Anyone who thinks about the question even briefly will guess that most students who enter Med School with a low grade average are very unlikely to become A-grade students, despite the extra tuition and pastoral care they are offered.
What also outrages even those who are usually well disposed to giving minority groups easier access, however, is discovering the proportion of places available to Māori and Pasifika.
Professor Bagg told an obviously surprised Guyon Espiner last week that the target was to have 40 per cent of each year’s intake made up of Māori / Pasifika students because that mirrored their proportion of 16-24-year-olds in the North Island.
In practice, Bagg said, they make up only 25-28 per cent of the intake but the target remained 40 per cent.
However, behind the extremely dubious justification that medical schools should so closely mimic the demographic make-up of wider society lies a deeper ideological drive: indigenisation — aka “decolonisation”.
In an article published in a BMJ journal, a team of researchers led by Professor Bagg acknowledged that training more Māori and Pasifika doctors is not the end goal but only a station on a journey to 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.”
Indigenisation essentially means promoting a Māori worldview and ensuring it has at least equal status with that of the Pakeha “oppressors”.
That worldview includes traditional tribal knowledge — such as mātauranga Māori, with its core beliefs including an animating spirit (“mauri”) running through both the animate and inanimate spheres. It is a belief system rather than a body of knowledge produced by the scientific method.
This is yet another example of Auckland University’s extraordinary — if not suicidal — push to put mātauranga Māori on an equal footing with science as just another “knowledge system”.
In her memoir, Dr Wehipeihana recommended including oral history and stories as part of science:
“Indigenous academics are disestablishing colonial knowledge systems, which shut our knowledge out, by citing whakapapa, science through oral history, stories that form our evidence even as they master the tools of the coloniser and set about creating something better.”
Professor Bagg has also argued that “all government educational institutions (preschools, schools and universities)” should be indigenised to “ultimately achieve health workforce and health outcomes as envisaged in Te Tiriti o Waitangi”.
An Auckland University Associate Professor, Elana Curtis, who has been heavily involved in MAPAS, wrote in 2023:
“It was the MAPAS pathway which made it possible to get into medicine. I probably went in with some of the lowest marks in my year. But I also saw it as my right to be there. I didn’t want to apply for medicine any other way, because I knew MAPAS was about righting inequities and countering Pākehā privilege…
“For Māori, the MAPAS agenda is grounded in our rights as tangata whenua. We have the right to become doctors in our own land, even in Western medicine. We should be able to … have access to that pathway. It’s part of our Indigenous rights to outcomes, to sovereignty, to self-determination.”
For all the talk about mirroring demographics and countering disadvantage, race-based entry programmes to our medical schools rest on a highly contested political ideology of separatism that, for obvious reasons, is rarely presented to the general public as its underlying rationale.
Graham Adams is an Auckland-based freelance editor, journalist and columnist. This article was sourced HERE
In a 2021 university newsletter, Emma Espiner opined that “[some] people want us specifically, as Māori and Pacific people, to feel guilty that we’re ‘taking’ someone else’s place”. She described that view as an “old red herring” and a “prejudice” motivated by “ignorance and envy”.
One of the justifications for the programme is that it is needed to overcome disadvantages that Māori and Pasifika students suffer when they are educated at lower-decile schools and are thus thwarted from reaching their potential.
However, when Emma Espiner applied she was already a graduate in art history and classics and had gone on to work at Parliament as a political staffer before a successful career in executive recruitment. She was highly educated and familiar with the demands of university study and high-pressure jobs.
Clearly such disadvantage didn’t apply in her case so what was the justification? In these scenarios, apologists are obliged to fall back on their next line of defence — that patients do better when they are treated by people who look like them in the health system.
When the review of both the MAPAS and Otago’s Mirror on Society schemes was proposed two years ago to fulfil ACT’s coalition agreement with National, 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.”
Auckland University Associate Professor of Public Health Sir Collin Tukuitonga similarly opined to TVNZ’s Breakfast: “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 was a view shared by Emma Espiner 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.”
Professor Bagg repeated that view this month in a university publication: “There is also growing evidence that health outcomes can improve when patients receive care from health professionals who understand and connect with their communities and cultural backgrounds.”
However, that argument can only be described as paper thin. It rests on the tenuous assumption that only someone with a Māori ancestor can care properly for a Māori patient. Or that their overall health statistics are poor because of a relative lack of Māori doctors to treat them.
If the advantages of a shared background were so significant, you’d have to say most New Zealanders are being denied optimal health care. As anyone who has spent time in hospitals knows, the chances of a patient being cared for by doctors or nurses who all share the same cultural or ethnic background as them are not high.
RNZ reported in May that a survey by the Association of Salaried Medical Specialists showed over 43 per cent of New Zealand doctors are trained overseas, the highest proportion in the developed world.
In the year to July 2024, more than 70 per cent of those registered came from 63 different countries.
And with around 25 per cent of GPs being Asian, an awful lot of New Zealanders will be treated by someone from an entirely different ethnicity and cultural background.
The idea that particular groups in society such as Māori and Pacific Islanders should have a Medical School policy designed to produce doctors who look like them is preposterous.
And because MAPAS applicants need only one Māori or Pasifika great-grandparent to qualify, some with such remote heritage don’t look even slightly Māori or Polynesian.
While it is clear that preferential entry confers a personal benefit on the Māori and Pasifika graduates who can move into a lucrative and high-status occupation, the benefits flowing to patients is moot. And if any such benefits do exist they have to be weighed against the serious damage race-based entry does to the professional standing of all Māori and Pasifika doctors no matter how they entered the profession or how capable they are.
That negative effect, both in the eyes of the public and among many doctors themselves, is regularly demonstrated on social media, where commenters often voice their belief that any Māori or Pasifika physician is probably second rate.
Such hostility has also been acknowledged in academic studies. A British Medical Journal article co-authored by Professor Bagg phrased it in careful terms:
“Providing ‘preferential treatment’ to one group or individual over another has not been universally welcomed by the public or the profession.”
Objections to race-based programmes of any kind are common but those reservations often turn to outrage when critics discover the gulf in academic standards between some MAPAS entrants and those enrolling via the General category.
A response to an OIA request for a breakdown of applicants for Auckland Med School’s 2024’s intake showed the median GPA for successful graduate students under General admission was 8.5; for MAPAS applicants it was 6.25.
The lowest GPA score for General admission was 7.25 while a score of 4 sufficed under MAPAS.
For this year’s intake at Otago, the minimum average marks to receive an offer of a place at Med School in the General category was 93.14 per cent. For Māori students, it was 65.29 per cent.
Backfooted by such criticism, advocates of the schemes frequently argue defensively that everyone who graduates has passed the same exams.
However, that is as disingenuous as saying all philosophy, politics or physics students in the same class pass the same exams and are therefore on an equal footing academically even though a gifted student might get an A+ and another a bare pass mark.
Anyone who thinks about the question even briefly will guess that most students who enter Med School with a low grade average are very unlikely to become A-grade students, despite the extra tuition and pastoral care they are offered.
What also outrages even those who are usually well disposed to giving minority groups easier access, however, is discovering the proportion of places available to Māori and Pasifika.
Professor Bagg told an obviously surprised Guyon Espiner last week that the target was to have 40 per cent of each year’s intake made up of Māori / Pasifika students because that mirrored their proportion of 16-24-year-olds in the North Island.
In practice, Bagg said, they make up only 25-28 per cent of the intake but the target remained 40 per cent.
However, behind the extremely dubious justification that medical schools should so closely mimic the demographic make-up of wider society lies a deeper ideological drive: indigenisation — aka “decolonisation”.
In an article published in a BMJ journal, a team of researchers led by Professor Bagg acknowledged that training more Māori and Pasifika doctors is not the end goal but only a station on a journey to 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.”
Indigenisation essentially means promoting a Māori worldview and ensuring it has at least equal status with that of the Pakeha “oppressors”.
That worldview includes traditional tribal knowledge — such as mātauranga Māori, with its core beliefs including an animating spirit (“mauri”) running through both the animate and inanimate spheres. It is a belief system rather than a body of knowledge produced by the scientific method.
This is yet another example of Auckland University’s extraordinary — if not suicidal — push to put mātauranga Māori on an equal footing with science as just another “knowledge system”.
In her memoir, Dr Wehipeihana recommended including oral history and stories as part of science:
“Indigenous academics are disestablishing colonial knowledge systems, which shut our knowledge out, by citing whakapapa, science through oral history, stories that form our evidence even as they master the tools of the coloniser and set about creating something better.”
Professor Bagg has also argued that “all government educational institutions (preschools, schools and universities)” should be indigenised to “ultimately achieve health workforce and health outcomes as envisaged in Te Tiriti o Waitangi”.
An Auckland University Associate Professor, Elana Curtis, who has been heavily involved in MAPAS, wrote in 2023:
“It was the MAPAS pathway which made it possible to get into medicine. I probably went in with some of the lowest marks in my year. But I also saw it as my right to be there. I didn’t want to apply for medicine any other way, because I knew MAPAS was about righting inequities and countering Pākehā privilege…
“For Māori, the MAPAS agenda is grounded in our rights as tangata whenua. We have the right to become doctors in our own land, even in Western medicine. We should be able to … have access to that pathway. It’s part of our Indigenous rights to outcomes, to sovereignty, to self-determination.”
For all the talk about mirroring demographics and countering disadvantage, race-based entry programmes to our medical schools rest on a highly contested political ideology of separatism that, for obvious reasons, is rarely presented to the general public as its underlying rationale.
Graham Adams is an Auckland-based freelance editor, journalist and columnist. This article was sourced HERE
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