The Northland District Health Board is confirming its commitment to equitable healthcare.
In a meeting yesterday, the NDHB board endorsed a position statement on equity which outlined its commitment to "ensuring equity of access, experience and outcomes for those populations who need our support the most".
The statement also highlighted a particular relevance for Māori in recognition of their status as tangata whenua. It concluded by linking the position on equity to the NDHB's overall approach to achieving optimal health and wellbeing for all Northlanders.
In the decision paper which was submitted to the board (which contained the proposed position statement), it detailed the Ministry of Health's definition of equity as having, "...differences in health that are not only avoidable but unfair and unjust. Equity recognises different people with different levels of advantage require different approaches and resources to get equitable health outcomes".
The paper then outlined the challenges Māori faced in the healthcare system and how the NDHB's actions must be informed by Te Tiriti o Waitangi (Treaty of Waitangi).
During the meeting, board member Vince Cocurullo was concerned by the position statement and said its focus on Māori devalued the needs of other communities.
"It states a position statement on equity. Race should not be a part of it," he said.
"When you turn around and focus on one race, you're creating racism and I prefer to say, 'let's talk about the issue', rather than talk about a race because to me, it's not right."
Board member and Equity in the Community committee chairwoman Ngaire Rae said it was the board's duty to highlight the disparity in quality of healthcare provided for Māori, as noted in the recent Health and Disability System Review commissioned by the Ministry of Health.
"[Māori] are not offered the same treatment as others and that is because of a range of factors including institutional and personal racism, so what we have to be clear about is equity absolutely is an issue for Māori and... therefore we need to develop a range of strategies to address that."
NDHB chief executive Nick Chamberlain said the position statement could have a beneficial effect for all communities if implemented appropriately.
"Believe me, if we get our system right for Māori, it will lift the whole system because it will actually improve access for all."
Chamberlain said discussion was needed regarding how the statement could be used through recruitment, training and the daily services provided.
Speaking after the meeting, acting general manager of Māori health Marty Rogers, who prepared the decision paper, echoed Chamberlain's comments and said the position statement was not exclusive for Māori.
"[The position statement] is not saying, 'forget everybody else'," she said.
"If we challenge the way the system is currently working in terms of how it either prioritises, interacts or engages with Māori... then the business itself will improve for others."
Rogers said acknowledgement of the variety of need within different communities was essential in delivering equitable healthcare.
"The health system needs to acknowledge that we are not homogenous... and we are at different stages of good health.
"If the system recognises that, that's a huge step towards acknowledging that there's a gap and what we can do about it."
In a paper concerning institutional racism, also prepared by Rogers for yesterday's meeting, it outlined how whānau had raised a number of complaints in relation to staff interactions, many directly relating to cultural incompetence.
In November last year, the NDHB board committed to a health system which eliminated all forms of institutional racism with purposeful investment in equitable health outcomes for Northland's Māori population.