The Royal Australasian College of Physicians (RACP) welcomes the release of the Health and Disability System report, but says that the prioritisation of Hauora Māori is superficial, without a commitment to providing the funding, resourcing, and decision-making authority to support its success.
“It’s disappointing that the Report has rejected the alternative commissioning framework proposed and supported by the entirety of the Māori Expert Advisory Group, and a majority of the Review Panel’s members”, said Dr George Laking (Te Whakatohea), the RACP’s Aotearoa NZ President and a medical oncologist based in Tāmaki Makaurau Auckland.
“Creating a Māori Health Authority without empowering it to make decisions about where and how money is spent, risks more of the same – it may be partnership on the terms of the Crown, but it’s not partnership as stated under Te Tiriti o Waitangi”.
“Mana Motuhake is the critical change that is urgently needed. Mana Motuhake means Māori determination and funding of health services for whānau, hapū and iwi”.
Dr Laking noted the Report’s acknowledgement of Hauora, the report released as part of Stage One in the Waitangi Tribunal’s WAI2575 Inquiry, which made an interim recommendation for the Crown to commit to exploring the concept of an independent Māori primary health authority.
“The majority of the experts involved in the Health and Disability System Review support a structure which recognises tino rangatiratanga and mana motuhake in the design, funding and delivery of health services by Māori, and for Māori”.
“This is the time to be visionary. The change has to be transformative”.
Dr Laking said that there was also a risk that additional bureaucratic structures could mean a disconnection from what was happening on the ground for whānau, hapū and iwi.
“On average, Māori will die seven years earlier than Pākehā New Zealanders. Māori health inequity is writ large in every health outcome, and in every report”.
“If the Māori Health Authority is not established with the teeth to drive the systemic change that is needed, this is an admission by the Crown that this life expectancy gap is not only tolerated, it is accepted as an inevitability”.