When Shane Reti waved his health tokotoko (Māori ceremonial walking stick) at the Hawke’s Bay health organisation giving free GP visits to Māori and Pasifika youth aged 14-24, he had a golden platform to enforce the coalition Government’s blanket policy of need before ethnicity.
In a perfect world what Reti did was right, as we would like to believe everyone is born equal. But we know that’s a fallacy and, depending on your circumstances, your parents and the environment you are born into will probably determine what type of life you will live; and if you are Māori, how long you live it for.
We don’t live in a perfect world and Māori and Pasifika health inequities are etched in granite.
Māori and Pasifika make up slightly under half the Hawke’s Bay population of 130,000, so targeting a cohort who historically do not engage with primary healthcare was the right approach. Like crime prevention, get to them young and save money long term.
The reality is Māori health statistics are a national disgrace.
Māori adults, compared with the general population, have higher rates of cardiovascular disease, stroke, diabetes, cancer and respiratory diseases, with higher rates of complications generally reflecting an earlier onset. Health officials know if they can address major health issues earlier, then survival is a higher percentage option than the odds Māori face today.
Male Māori live an average age of 73.4 years compared with 80.9 for non-Māori, and wāhine Māori 77.1 compared with non-Māori females whose life expectancy is 84.4.
Green Party's Ricardo Menendez-March, Labour's Ayesha Verrall, Act's Brooke Van Velden, National's Shane Reti, and Māori Party candidate Lance Norman debate health during last year's election.
So, going after younger Māori and Pasifika in the 14-24 age group was and is the right thing to do.
But once the Act Party got a sniff of this ethnicity-not-need policy criteria, it jumped up and down and an immediate change followed.
Todd Stephenson, Act’s health spokesperson, claimed: “targeting services based on race is lazy and divisive”.
“The change in government should have sent a clear message to our bureaucracies that New Zealanders are sick and tired of race being put at the centre of everything,” he said.
Reti agreed and pointed to his policy statement on health that placed need as the highest priority influencing service delivery, with the practice of targeting population groups less important.
“[The health officials] got that round the wrong way and have now corrected it,” Reti said. “I truly believe they were well intentioned, but they hadn’t read the room.
“Read the room, read the statement, that is the direction of travel.”
What Reti must also read are the statistics and develop policies that put Māori and Pasifika first in some health instances.
He doesn’t have to have Māori and Pasifika with their own private queue, but he must ensure they can get access to the specialist services they do not get because of lack of primary healthcare engagement — that’s where the real health bottleneck is and where the work to fix that should be concentrated.
