Māori undercounted and under-resourced in health putea, new data report confirms

A Covid-19 vaccination drive in Manukau. Photo / NZME

A report released in the New Zealand Medical Journal confirms what Māori health providers and social services organisations have long been saying: Māori were undercounted by the Ministry of Health, thereby under-resourced in the health sector - and justifies their decision to take and beat the ministry in court.

The NZMJ report outlines that Māori who had not been to a GP were not included in vaccination targets.

“We need better leadership, co-ordination and accountability to improve ethnicity data in health. The recent health system reforms are an opportunity to achieve this,” the report says.

So proclaiming an 80 per cent Covid vaccination rate for Māori in any region was not strictly correct.

The report also showed Southland had a 106 per cent vaccination rate in September, even though many in the region are still to be vaccinated.

Whānau Ora Commissioning Agency CEO John Tamihere told the Herald he believes undercounting Māori numbers was a deliberate act by the Ministry of Health.

“The report is unsurprising to us, but it will be a big surprise to the general population because this is proof that the ministry cooked the books on vaccinations and the evidence is quite clear that the MoH undercounted so their vaccination numbers be deemed successful even if it wasn’t,” Tamihere said.

Tamihere said it seemed to him there were purposely a number of undercounts loaded into the system.

Tamihere said across Tamaki Makaurau, Māori providers knew there were at least 60,000 Māori not accounted for.

“We knew that 60,000 Māori had not gone to a GP in 2020,” he said.

John Tamihere, chief executive of the Whānau Ora Commissioning Agency. Photo / Brett Phibbs

“The Ministry chose to use only Māori with NHI numbers who had gone to a GP or pharmacy for support in 2020.

“Also in the report, if I use Southland as an example, they hit 106 per cent vaccinations in September. I don’t know where the other 6 per cent comes from?”

Whanau Ora last year took the Ministry of Health to court over its refusal to release details of all eligible Māori in the North Island who had not been vaccinated.

The government department was ordered to pay $264,284 in legal fees.

Tamihere said the NZMJ report also outlined the disparity and racism practised against Māori.

“If these numbers were extrapolated against two other ethnicities, you could say everyone was prejudiced equally,” he said.

Former director general of health Dr Ashley Bloomfield. Photo / Mark Mitchell

“But that’s not true because we know within our Māori and low socio-economic communities, is that for whānau to cut costs, they go without prescriptions or a visit to a GP.

“One third of all Māori are on $28K or less a year. Another third are on $50K or less - ‘the working poor,’ and so you have two-thirds of your people make their household decisions based on their poor incomes.

“They are not poor decisions but as a consequence, they are not counted in the system.”

Health Minister Andrew Little said he supported releasing the Māori data, but was worried about privacy issues.

“I was clear that information should be made available without putting privacy at risk,” Little told the Herald, and added the establishment of the Māori Health Authority would ensure data holes are now filled.

“One of the reasons for the establishment of Te Aka Whai Ora – Māori Health Authority, is to ensure the gathering and holding of health data, in particular about Maori, is placed under Māori stewardship so Te Aka Whai Ora can lead on Māori health in the way it needs to.

Health Minister Andrew Little. Photo / File

“There have been long-standing challenges with health data because of the disaggregated way our health system ran under the old DHB system.

“More than $500 million is being invested in health data and digital systems to ensure we have consistent and accurate data to make the best possible decisions in the future.”

The Ministry of Health was also not willing to get into another scrap with Tamihere as it looks at improving Māori data.

“Public sector health agencies recognise the importance of improving the accuracy of recording Māori ethnicity in health collections of data and the health system continues its long-term work to improve the quality of ethnicity reporting, with now Te Whatu Ora and Te Aka Whai Ora in place to help drive these efforts,“ the statement from the Ministry said.

“Government agencies are partnering with Māori data experts from the Data Iwi Leaders Group to oversee this work and ensure the datasets are used to benefit iwi, hapū, hapori and whānau.”

The 25-page New Zealand Medical Journal report said: “The ongoing systematic under-counting of Māori in health data is a reflection that Māori are not valued and that Māori health and the elimination of inequities are not the priorities they are claimed to be. The ongoing unjust and inequitable healthcare experiences and outcomes faced by Māori require the whole of the health and disability sector to commit to the collection of high-quality ethnicity data,” the report said.

“We found that one in every five Māori who have accessed healthcare, were not recorded as Māori.

“The undercounting of Māori in health data is a problem that has persisted for many years. It is the responsibility of the whole health sector to follow the clear rules that are in place for how ethnicity data should be collected, recorded and reported. However, there is evidence that these rules are not always being followed.

“Not enough attention is being paid to achieving good quality ethnicity data. Given its importance and wide-ranging use, this should be an urgent priority for the health sector,” the authors wrote.