11.45am
Figures showing Maori are twice as likely to die of cancer than non-Maori show there is active discrimination in the health system, Associate health minister Tariana Turia said today.
While Maori contract cancer at about the same rate as other ethnic groups, their death rate is double that of non-Maori, the Decades of Disparity study found.
Those figures showed Maori and Pacific communities were having difficulty accessing appropriate treatment at the right time, Ms Turia told National Radio.
Asked if she felt that was due to active discrimination or oversight, the associate Maori affairs minister opted for the former.
"I'm certainly not going to say that it's oversight," she said.
"There are far too many people dying for me to sit here and say that it is just a mere oversight."
If active discrimination were "the words that need to be used, those are the words that need to be used", she said.
"I don't know why people discriminate against other people in any situation.
"I don't understand discrimination, I don't understand why it should exist in a society where there is plenty for everybody."
In the study, researchers from Otago University's Wellington School of Medicine and Health Sciences and the Health Ministry found European New Zealanders now have a life expectancy around 10 years longer than that for Maori.
The report was saying the idea that services were available to all people was "not true".
It was about poverty, systemic discrimination and a whole range of other issues, Ms Turia said.
"The Government needs to sit down and we need to look at how we can move the policy programme that we have already got in place... so we are making a difference."
Many Maori knew what was best for them, but were not getting the chance to say as services were provided to them by others over the top of what they wanted.
"We don't want our people to continually be reliant on help from others for all of their lives."
Health Minister Annette King said the study findings showed that the Government was on the right track with policies to target those with high health needs and low incomes.
The study found that cancer death rates had increased for Maori and Pacific people, while those for European New Zealanders had fallen.
Life expectancy for Maori females increased from 69.4 years between 1981 and 1984, to 71 years between 1996 and 1999.
For Maori males life expectancy increased from 64.6 to 65.8.
For non-Maori, non-Pacific Island females the increase was from 77.2 to 80.8 years, while for males in the same group the improvement was from 70.9 to 75.7 years.
Life expectancy for Pacific Island males increased from 66.7 to 67.9 years, while Pacific females slipped back from 74.8 to 73.9 years.
Those figures reinforced the Government's approach to improving the health of all New Zealanders through implementing the Primary Health Care Strategy, Ms King said.
District Health Boards are required by law and a Government directive to address inequalities.
That approach has come under constant attack from opposition parties, who argue ethnic groups should be treated even-handedly.
Opposition parties have also criticised the then-named Closing the Gaps committee of ministers, chaired by Prime Minister Helen Clark.
Ms King said she was "constantly astounded" by their attacks on Government primary health care expenditure.
"Particularly our decision to target high health need, low income parts of New Zealand first," she said.
"These areas often have a high proportion of Maori and Pacific people, and I am flabbergasted that some political parties persist in attacking our policies as race-based for that reason.
"I make no apology for wanting to improve the health of Maori and Pacific people."
Maori academic Ranginui Walker said there had been attempts to fix the problems, after a series of studies had pointed them out.
"The Government is trying to move on this thing, but obviously not fast enough," he told National Radio.
In 1990 it was suggested commissions be set up to address the issue, but the (National) Government of the time baulked.
"This was resisted by Cabinet as setting up something separate for Maori, if we'd had those commissions established and they had set achievable targets, then perhaps we could have seen some progress," Dr Walker said.
Then the opposition threw stones at Labour's "gaps" cabinet committee so "the idea was kind of shelved, though I understand they are still working on it".
"It would be simple enough to set up a commission to address the problem of health, and follow-up quality assurance," he said.
"As I understand it there is something like 156 or so Maori health providers and yet there has been no improvement in the rate of smoking among Maori women.
"The funds are being doled out but there is no quality assurance, no follow-up to see whether those health providers are meeting their targets."
Associate Maori Affairs Minister John Tamihere called for at risk Maori families to be more closely managed by non-Government caregivers.
Ms King said the Government had done a lot to reverse some of the social inequities caused by policies of the 1990s, such as market rents, harsh industrial laws, and user charges in health.
It would continue to build the sort of "just society" that removed inequalities covered in the report.
"I believe our best chance to make a difference to the health of New Zealanders is through a strong primary health care system."
National health spokeswoman Lynda Scott said yesterday more needed to be done to address the disparity in rates.
She called for increased resources in educating the Maori and Pacific Island communities about the diseases that affect them and a healthy lifestyle.
While the incidence of cancer was much the same between ethnic groups, Maori and Pacific people had about twice the mortality rate.
Maori bowel cancer death rates had nearly doubled in the past 20 years, while those for Pacific people had increased approximately tenfold.
Male Maori lung cancer rates were 3.5 times greater than European males by the late 1990s, and female Maori lung cancer rates were five times greater than female Europeans.
Maori and Pacific breast cancer mortality rates had increased, and by the late 1990s were 1.5 to two times higher than for Europeans, whose rates had decreased.
The report pointed to major economic and social changes starting in the early 1980s as a factor in the disparities.
Co-author Tony Blakely said the mortality rates for European men had fallen 30 per cent in the past 20 years. For European women it was 26 per cent.
"In contrast Maori and Pacific mortality rates have only decreased modestly, if at all," he said.
"It's a fairly important report. What we've done is collected 20 years of data... and the results are quite dramatic."
Maori had enjoyed large increases in life expectancy from the 1950s to the 1970s, but discrepancies between Maori, Pacific and European life expectancy emerged in the 1980s.
Other findings in the study included:
* Heart disease death rates had fallen across all ethnic groups in the past two decades but the decrease was greatest for European New Zealanders, and
* injury mortality rates had fallen in all ethnic groups, with Europeans having about half the rate of Maori.
Co-author Bridget Robson said Maori leaders in the 1980s had predicted government policies would make Maori the shock absorbers of the economy.
Public Health Association spokeswoman Marty Rogers said there had been debate about spending on services for Maori but the research clearly showed not enough was being done.
- NZPA
University of Otago:
Widening mortality gaps between Maori, Pacific and European New Zealanders
They allege the Crown ignored Treaty obligations by not engaging with them.