Justice delayed is justice denied

It is not surprising that creating an authority focused solely on improving Māori health outcomes might be seen as separatist

The idea that the fledgling Māori Health Authority is part of some slippy-slidey plan to create parallel health systems – one for Māori and one for Pākehā – is farcical.

While I’m not surprised that ACT leader David Seymour is resorting to the politics of race to garner votes, I find it hard to understand the advice that might lead National Party leader Christopher Luxon to promise to ditch the new agency should National win the next election.

Mr Luxon likes to point to National’s record of Treaty of Waitangi claim settlements to support his credentials to comment on Māori development issues. He has committed to memory a tranche of Māori health statistics to show he knows there is a problem.

But it all falls to pieces when he speaks, as he did on Discovery TV’s The Hui, like this: “Yes, we have really big improvements to get, a bunch of improvement on a range of social indicators for Māori and outcomes for Māori. But the way to do that is actually to still have a single system with innovation and components within it that can deliver those results.”

At this point I feel like the two of us are living in parallel universes.

In one there is a health system that just needs to try harder, “innovate”, do better and life will be sweet. That is where Mr Luxon lives.

In my universe, I have watched people with the best intentions work their arses off, believing if they just innovate and work harder, they can make a difference in the lives of Māori patients, their whānau and Māori colleagues.

Sure, there have been pockets of success, many enabled by Māori health providers, but still the stats paint a picture of large sums of money spent to little effect with regard to achieving health equity.

In my universe, the Waitangi Tribunal heard a far-reaching claim – Wai 2575 – into primary care, and the tribunal called on the Crown to commit to exploring the concept of a stand-alone Māori primary health authority. This fell short of meeting claimants’ call for a wider-reaching authority covering all healthcare, because the scope of the inquiry was limited to primary care.

In my universe, a panel led by health economist Heather Simpson travelled the country reviewing the health and disability system, and discovered it was not fit for purpose and its workforce was demoralised, with little sign that business as usual would produce anything other than business as usual.

The panel took heed of the Wai 2575 findings and recommended an independent Māori Health Authority, with not quite the extent of powers sought by claimants. In an unusual twist, in a dissenting view, most panel members and the review’s Māori advisory group called for an agency with full commissioning powers.

The dissenters’ alternative was pretty much in line with what the National Hauora Coalition argued for at the tribunal. Signatories to the coalition’s submission were Simon Royal, who graces the cover of this edition, and Mason Henare.

In my universe, health minister Andrew Little took the leap and followed the evidence: transformative change was needed in the system, and a Māori Health Authority with influence on policy and commissioning throughout the sector was born.

So, in my universe, far greater minds than mine have investigated how a health system might better perform for everyone, not just for the majority. And they have been doing this for years.

In real time, the vast majority of people in our communities and in the health system have been rightly focused on COVID, not on sector reform. And now, as eyeballs swivel, naturally questions are being raised about these new entities – the Māori Health Authority and Health New Zealand.