Final submissions in the Health Services and Outcomes Inquiry are to be held before the Waitangi Tribunal in Wellington on 12 and 13 March. The Inquiry started in October 2018 on Tūrangawaewae Marae.
Given the alarming evidence placed before the Tribunal of Māori health disparities, the Wai 1315 claimants representing hundreds of thousands of North Island whānau are calling for significant changes to the NZ Health system for the Treaty of Waitangi to be consistent and lives saved.
The Crown’s evidence accepts that the state of Māori health is both inequitable and unacceptable. It also accepts that Māori health statistics are deplorable.
“The current Primary Healthcare Framework leaves little scope for Māori to determine and apply their own solutions to improve whānau health. We need the flexibility to do this and the funding so it’s not subject to whoever is in power,” says Lady Tureiti Moxon, Managing Director of Te Kōhao Health in Waikato, one of the claimants.
“The truth is Māori are often at the back of the line. We want our own mana motuhake over our own destinies and legislation that protects us because Maori health is a very political issue so depending on who is in Parliament and who is Minister will depend on whether Māori health is a priority and often we become part of the too hard basket.”
The group are calling for many competitive barriers to be reversed to allow Māori to actively participate in and contribute to Crown strategies for Māori health. Be appointed to decision making bodies and fairly consulted with regarding resourcing needs.
Inadequate funding based on assumptions is a significant issue. Compared to mainstream organisations, Māori Health Providers and Māori Primary Health Organisations suffer shortfalls in funding – nurse salaries are 25% less than those employed by the District Health Board.
“The Government ‘capitation formula’ simply does not work. It’s based on patient co-payments. Many of our patients simply cannot afford to pay so we are expected to run medical clinics with only half the funds necessary,” says Janice Kuka, Chief Executive Officer, Ngā Maatapuna Oranga, Tauranga.
Witnesses presenting evidence before the Tribunal in October included an overseas expert in primary health care redesign similar to the Whānau Ora approach, alongside many Māori leaders in the field involved health service delivery and management including former Cabinet Minister, John Tamihere.