Is the Coalition Government Back Jabbing Māori?

Written By: - Date published: 4:10 pm, December 22nd, 2023 - 19 comments
Categories: health, inequality, Maori Issues, same old national, Shane Reti, vaccines - Tags: , , , ,

The Minister of Health, Dr Shane Reti, wants to lift child immunisation rates, particularly for Māori children. This health target may even result in improved health outcomes. It’s also an uncharacteristically forward-looking move by the coalition government to ensure there’ll be enough healthy smokers to help pay for future tax cuts for landlords.

As is the case so often with National, they’re quick to criticise alleged opponents and even quicker in claiming their ideas if not achievements as their own. And the recent announcement of “a two-year $50 million package to help Māori health providers lift immunisation rates” is true to form.

In July 2022, a report of the Māori Influenza and Measles Vaccination Programme (MIMVP) on Māori health equity was released, which made a number of recommendations.

The report makes a series of recommendations around how immunisation and vaccination rates could be further booster, some of which are being addressed by the establishment of the Maori Health Agency. [my bold]

One of its recommendations was:

identifying the need for the Ministry, HNZ and MHA to develop the capacity to engage, contract and fund Māori health providers directly. [my bold]

In April this year, another report came out from the independent Immunisation Taskforce entitled “Initial Priorities for the National Immunisation Programme in Aotearoa”. The Taskforce’s remit was, among other things, to provide advice to Te Aka Whai Ora – Māori Health Authority [MHA], which was the key (and equal!) partner that was crucial for implementing the recommendations. However, Dr Reti couldn’t wait to amputate the MHA.

Those recommendations again bare, of course, an uncanny resemblance to Reti’s announcement. The only difference, which is more optical than substantive, is that the Taskforce recommended a website for information on immunisations of tamariki and Reti launched an app.

This coalition government’s conduit for delivering healthcare to Māori appears to be Whānau Ora. This was the love brainchild of, mainly, Tariana Turia and John Key, with Winston Peters being the ever-grumpy and belligerent Godfather.

In 2018, the Whānau Ora Review Panel was appointed to assess how well Whānau Ora was doing. The findings were positive.

Affirmation of approach
The most compelling finding of the report is its affirmation of the Whānau Ora approach, as an approach that works.

This is a powerful finding which therefore creates the platform for other findings regarding greater investment from government and increased collaboration across agencies to expand its implementation. [my bold]

Besides the inevitable need for more funding it is highlighting the call for better coordination and collaboration, which is exactly what the Māori Health Authority was set up to do.

In 2022, the Labour government established the Māori Health Authority and in Budget-2023, it committed $168.1 million over four years to Whānau Ora. However, Whānau Ora did and does not fulfil the much broader function of the Māori Health Authority and the new coalition government has opted for a less efficient fragmented approach in which decisions are made on a case-by-case basis, without the coordination and collaboration provided by Māori Health Authority, and guided by meeting targets, not outcomes, that make for easy political point-scoring.

The coalition government was quick, and premature, to scrap the Māori Health Authority (covered here and here) but has as yet not allocated any funding to Whānau Ora, for example, except the aforementioned $50 million for jabs. This is another textbook example of right-wing parties robbing Pita to pay Paora and a cynical divide & conquer tactic purely for political advantage. The coalition government can arguably claim that it kept its election promises of abolishing the Māori Health Authority, better management of taxpayer money through targeted funding (i.e. pretend to be fiscally responsible), and lifting health ‘outcomes’ for all New Zealanders without preferential treatment based on race or ethnicity.

None of this will genuinely uplift and empower Māori who are treated as a proverbial piñata, stabbed in the back, and then offered a jab and an app (with te reo and in-person options?).

19 comments on “Is the Coalition Government Back Jabbing Māori? ”

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  1. Populuxe1 1
    22 December 2023 at 4:24 pm

    I am led to believe by the iwi grapevine that there is some debate as to whether Māori would really be better served by a centralised organisation in Wellington. I'm not convinced either way, but there is certainly something to be said for having Māori health tackled at the community level in conjunction with local iwi in the current system. Swings and roundabouts.

    • Incognito 1.1
      22 December 2023 at 7:56 pm

      This is the kind of comment one usually gets from someone who’s got no (firm) opinion, no (decent) argument, nothing (much) to say, and who’s not (really) interested in deliberation.

      In any case, I reject your premise, as it is a false dichotomy. However, it’s given me an idea for another Post, so I should thank you.

      • Louis 1.1.1
        23 December 2023 at 1:36 am

        yes Incognito

      • Populuxe1 1.1.2
        23 December 2023 at 12:40 pm

        Yeah, I know, I said I had no firm opinion. I was raising the fact that there were other opinions worthy of entertaining. It does not require I personally hold to either. The rest seems entirely projection – I am, in fact interested, particularly as I find some on the left seem to insist on projecting a left-right horseshoe on iwi politics.
        And you're going to have to explain to me how that's a false dichotomy when two valid options are presented? As an opening ambit, judging from the responses it seems to have generated some dialogue.

        • weka 1.1.2.1
          23 December 2023 at 1:11 pm

          You’re in premod. Letting these three comments through so I can point you to what you need to do to get out of premod. Go to the Replies tab and look at my recent replies to you, the mod notes are there. Please don’t comment elsewhere on site until this is resolved, as it clogs up the Pending list in the back end.

    • SPC 1.2
      22 December 2023 at 8:36 pm

      It's certainly National Party policy to oppose centralisation and favour more decentralised delivery.

      In both health (there has always been the risk of PHO including hospitals – including private nationwide networks) and education (charter schools) and housing (selling off or transferring stock).

      • Incognito 1.2.1
        22 December 2023 at 8:47 pm

        And RW political parties also oppose a unionised labour force. The coalition government has already repealed the Fair Pay Agreements law.

      • Descendant Of Smith 1.2.2
        23 December 2023 at 7:00 am

        Depends how you define centralisation.

        Across several different government departments people I know are hearing about everyone has to be doing the same (just like McDonalds one was told), if you don't like it leave, all having the same KPI's and performance measures, aspirational targets, we decide what you do – you're just there to implement, etc. Apparently all the same messaging they got last time National were in – though my family in education said the talk about aspirational i.e. ridiculous targets is even stronger this time.

        They love centralisation – Ruatoria, Palmerston North, Wellington and Methven are all so alike you can do the same thing in each – it just comes in a different, more simplistic guise.

        • Populuxe1 1.2.2.1
          23 December 2023 at 12:46 pm

          It was my understanding of the argument being raised, that iwi understand their local needs more than a central organisation does. Admittedly that might just be fighting over territory, but I can see that there are benefits to both models, but some people do insist on histrionics if you point out there are political agendas in this country thet have nothing to do with the existing political parties. There is, of course, no guarantee that National would invest in local iwi providers however.

  2. bwaghorn 2
    22 December 2023 at 4:49 pm

    So is Whanau Ora a permitted name under the new regime?

    Shouldn't it be family health first??

    • Incognito 2.1
      22 December 2023 at 8:21 pm

      IIRC, the coalition government’s edict is that it should have its primary name in English unless it is related specifically to Māori, which Whānau Ora is, AFAIK.

  3. SPC 3
    22 December 2023 at 5:13 pm

    I'll note no plan to change the name of Te Puni Kokiri.

    https://www.tpk.govt.nz/en

    Probably more scared of the word Maori in Maori Affairs.

    The Crown makes no defence, it admits total fault and wants the case to go away anyway.

    https://www.nzherald.co.nz/kahu/crown-opposes-urgent-waitangi-tribunal-claim-to-halt-disestablishment-of-maori-health-authority/TRTJOKVJPBAFBFGTFYKH2COSX4/

    • mikesh 3.1
      23 December 2023 at 7:08 am

      Probably more scared of the word Maori in Maori Affairs.

      They could call it Indigenous Affairs, but apparently they don't believe that the Maori are indigenous.

      • Incognito 3.1.1
        23 December 2023 at 10:09 am

        … but apparently they don’t believe that the Maori are indigenous.

        That’s utter meaningless nonsense.

  4. Ad 4
    23 December 2023 at 8:09 am

    The Maori health providers contracted to do the Maori immunizations won't notice any difference.

    • Incognito 4.1
      23 December 2023 at 10:00 am

      Yes, they will notice the difference, which is in the instructions that come with the money. Anyways, thanks for missing the point.

      • Ad 4.1.1
        23 December 2023 at 10:44 am

        Is Te Whanau Waipereira getting new contractual terms for its immunization programmes? Or any other entity

        Surely it's a bit early for evidence on whether changes to delivery will be worse or better.

        Current Maori immunization rates are trending fast downwards.

        • Incognito 4.1.1.1
          23 December 2023 at 11:40 am

          I don’t know if the contracts as such will be amended or replaced. To answer your very specific question, I’d say that I’d hope so, and for the better.

          Māori organisations that were extremely successful in providing COVID-19 immunisations, such as Te Whanau o Waipereria and Ngāti Whātua, now have contracts to provide childhood immunisations but these are short term and funding is restricted, compared with general practice. These contracts do not specifically fund the infrastructure required for providing immunisations.

          https://www.tewhatuora.govt.nz/publications/initial-priorities-for-the-national-immunisation-programme-in-aotearoa/

          However, the [details of] general instructions (expectations) and incentives have changed.

          They [GP clinics] would have to either achieve 95 percent coverage for their childhood patients, and 75 percent for the flu shots, or achieve a five percentage point increase for each of those target groups, by 30 June 2024 to receive the payment.

          https://www.rnz.co.nz/news/election-2023/497705/national-announces-its-health-targets-and-an-immunisation-incentive-payment

          This is the old incentive scheme that was already in place replaced by something quite similar, technically speaking.

          Of course, if child immunisation rates go up across the board – they have been trending down since Covid-19 – and the widening gap for Māori narrows again, then this would be a small success albeit short-term, most likely. However, it’ll be a good result with the wrong ‘philosophy’ and it won’t address the much bigger and long-standing issues as mentioned in the Post. In other words, a reasonably easy health target for lazily scoring of political points and all it requires is throwing a bit of money at it.

          Surely it's a bit early for evidence on whether changes to delivery will be worse or better.

          Seriously??

        • Populuxe1 4.1.1.2
          23 December 2023 at 12:53 pm

          I can't see how an MHA would be any different. You can have a centralised organisation providing funding and telling the iwi health providers what to do, or you can have targeted funding from the Ministry of Health with the Ministry telling the iwi health providers what to do. At the end of the day it's still the iwi health providers at the coal face. There are a lot of benefits from an MHA in other areas, but this ain't it.