Poor results in Māori health
John Tamihere claims (NZ Herald, May 6) Māori are somehow "placed at the back of the queue" across the health system, implying systemic racism, which is specious.
In 40 years working in health, the only systemic discrimination I've seen has favoured Māori. Certain GP services and screenings are available free to Māori, but means-tested for other groups.
GP clinics are given incentives for higher rates of Māori screening. A South Auckland mammogram service sends drivers to fetch Māori and Pasifika women; provide them with morning tea; explain; get consent; and proceed with both mammography and cervical smear screens at the same visit; and drive them home - all for free.
Poor Māori health outcomes are due to a number of factors. High rates of smoking and obesity, combined with low rates of attendance at GP clinics and public hospital specialist appointments are some, and increasing efforts are being made to combat these problems.
The breakdown of Māori whānau encouraged by DPB systems, with solo mums struggling to care for multiple children, is another factor.
Greater efforts are being - and need to be - made to improve Māori health outcomes, but separating their health care from the mainstream health system would be counterproductive.
Dr Ron Baker, MD, Onehunga.
The frustration expressed by John Tamihere (NZ Herald, May 6) are shared by many working the healthcare system. We see the embarrassingly poor health outcomes of our Māori patients.
Old-fashioned healthcare relied on a reactive model; a person would present with a perceived health problem and the doctor would put together a plan to manage it.
Some of us have moved to a more proactive approach – early screening and active follow-up of those with established health problems.
Using the capitation funding, time is put aside to contact those who haven't had blood tests done or come for BP checks or requested more medication.
Having established this programme over the last 12 months, it amazes me how many either will not get their blood tests done, come in for a check-up, continue to take their medications or all three, despite the fact the service being virtually free.
I too am frustrated by the vastly different delivery of healthcare to Māori and non-Māori. Despite following up with these "poor attenders", we don't seem to make any appreciable progress.
Some insight into what we are doing wrong, or what we could do better, would be appreciated.
Dr John Clark, GP, Panmure.
In New Zealand, there's an assumption that handing Oranga Tamariki over to a "by Māori, for Māori" initiative (NZ Herald, May 1) will somehow improve outcomes for Māori children.
"Better" therapists, it turns out, form better therapeutic relationships with a broader range of clients. In fact, 97 per cent of the difference in outcome between therapists is accounted for by differences in forming therapeutic relationships.
Despite years of effort, including scores of randomised trials and meta-analyses, client outcome experts conclude, "current evidence does not offer a solution to the issue of which components of cultural adaptation are effective, for what population, and whether cultural adaptation works better than non-cultural adaption".
The logic is self-evident. The number of permutations and adaptations available would quickly become unmanageable for service providers, and too expensive to support for funders.
Such initiatives as cultural service-matching are simply an exercise in patronising virtue signalling, not evidence. If we are going to maximise the possibility of improving mental health outcomes for everyone, we need to side with the "what works" evidence, not corporate interest groups or ideological lobbyists holding out their hands for preference funding.
Dylan Tipene, Rānui.
Re: Emergency housing for youth in motels (NZ Herald, May 6) by Aaron Hendry. It's sad that so many youth are not able to feel safe at home and go out to live on the streets.
If the motels are not up to hygienic healthy standards as are required by the rental properties act, why isn't the MSD inspecting before paying out the ridiculously high rates?
I'm sure many homes aren't safe but maybe the age they can leave home should be raised to 18 instead of 16.
Surely more could be done to encourage two parents bringing up children and more importantly family planning to taught in high schools.
Instead, the welfare system has meant well but is abused and created dependency, solo parenting and a sense of entitlement instead of taking personal responsibility. I can't understand a solo mother's thinking that having up to seven children is going to have anything but a negative outcome and raise poverty in New Zealand.
Gary Leeming, Pāpāmoa.
Ratepayers covering the cost of the full-page advertisement (NZ Herald, May 10) outlining Auckland Council's improvement process for Queen St should be fascinated by the promise that adjustments can be made, based on people's feedback as work proceeds. This statement implies nothing is set in stone (or slippery wood boardwalks) and the plan is fluid enough to be made up as they go.
The word "vibrant" pops up twice in the blurb, as does the promise that improvements will be "well-functioning". Neither can be quantified at this stage and it's a "trust us, we know what we're doing" kind of attitude we are expected to buy into.
As one who does bus into the city (when absolutely necessary to go there), I do want kerbside pickup and drop off to be part of the plan. The woman badly injured by a scooter rider as she alighted from a bus recently should have seen the word "safe" included as a must-have part of the environment promised.
Coralie van Camp, Remuera.
So Auckland Transport (AT) is to report pothole penis painter to police (NZ Herald, May 5).
What on earth is AT doing wasting both its own time and more importantly the time of the police reporting such a trivial matter?
Haven't they seen penis painting before?
It is quite harmless and makes the point very clearly.
Auckland Transport would do better to concentrate on their core business - maintaining roads. Not going off, half-cocked, on a silly complaint like this.
Russell O. Armitage, Hamilton.
Empty bus seats
Re: Simon Wilson's piece (NZ Herald, May 7) and further to my letter (NZ Herald, May 4), it is encouraging to have my guess (three to four passengers on each bus), confirmed by official statistics. Such figures are, on reflection, more criminal than "heartbreaking", the feeling expressed in my letter.
Hopefully, your contributing opinion writers, together with Andrew Krukziener, will maintain the pressure on AT for a change of direction.
Peter Cooper, Ellerslie.
In response to Jeff Hayward's letter (NZ Herald, May 7) regarding bringing vehicles into the CBD. Of course, his perspective is from someone who lives in Central Auckland. Not some one who has to visit it.
I challenge him to reverse positions and try visiting friends in Kumeū or Takanini for a couple of hours without a car. Good luck.
Quentin Miller, Te Atatū Sth.
I think one thing that everybody seems to be missing with regard to the Uighurs, is this situation is far from unique. Quite a number of similar incidents, from the close-fitting to the broadly similar, have occurred in recorded history.
The case that strikes me as being very similar is the Expulsion of the Sephardim and the Moors from Spain after the Reconquest. Spain had at the same time gained new prospects in the Americas and they got involved in some messy wars in Europe. The result, from cutting their Mediterranean trade routes off through these expulsions combined with the influx of precious metals from the Americas, was rampant inflation and a loss of status in Europe.
The time lost on religious wars can never be regained, whether they are wars between religious groups or wars on religious groups by outsiders.
I suspect the PRC leadership has not considered it in this light.
Wesley Parish, Tauranga.
"Uighur Muslims living in fear" (NZ Herald, May 6) is a catchy headline. But some historical context is required to fully appreciate it.
From 1997 to 2016, hundreds of terrorist attacks occurred throughout Xinjiang. These were indiscriminate in their targets, killing and injuring Han Chinese, Uighurs, people from other ethnic groups, men, women, and children. Very few were reported in the western media.
The terrorists were mainly Uighur youths trained by radical jihadist Muslim groups outside Xinjiang. Poverty of opportunity is a key driver for disaffected youth to train as terrorists.
Since 2016 measures adopted by Xinjiang authorities have prevented further attacks, but the situation remains volatile. Little tolerance has been shown to those who continue this threat.
Certainly the fear of terrorism affected Uighur Muslims, as it did all citizens. As a visitor to Xinjiang from 2012, and most lately in July 2019, it is comforting to see the majority of citizens are beginning to feel more secure. A Pakistani journalist, a practising Muslim and a regular visitor to Xinjiang, has credibility when he assures us Muslims are free to practice their religion, while terrorism has no place in Islam.
Dave Bromwich, Havelock North.
Short & sweet
How can the Prime Minister expect us to take her seriously when she expects the world to follow NZ on climate change and yet we import 1.1 million tons of coal a year? Chester Rendell, Paihia.
It is admirable to see New Zealand stand up against China about their abuses of human rights. Manh Bui-Van, Manukau
Simon Wilson's opinion piece (NZ Herald, May 6) referencing the AT "boffins" brings to mind the old definition of an expert: someone who knows more and more about less and less – until he/she knows everything about nothing. P.D. Patten, Albany.
Why can't AT trial smaller buses doing a constant shuttle up and down, and also on other routes where appropriate, such as Parnell and Ponsonby roads, leaving the through routers to do their job as well. Nick Nicholas, Greenlane.
Given the gnashing of teeth over the number plate NGR, I wonder what will transpire when/if a number plate is issued with the letters NWA. Clare Loudon, Waterview.
Does the wage freeze on many government departments also means MPs will not have their yearly pay rise, which is usually backdated? Wendy Galloway, Ōmokoroa.
There are no pay rises in the private sector either and we are getting milked, paying for others' motel accommodation and feeding children that others can't afford to. Nishi Fahmy, Avondale.