National’s very bad day

Written By: - Date published: 7:44 am, April 22nd, 2021 - 86 comments
Categories: Christopher Luxon, health, health and safety, Judith Collins, minimum wage, national, Parliament, religion, same old national, Simon Bridges, wages, workers' rights - Tags:

Yesterday was a very bad day for the National Party.  I hope it has many more bad days like this in the future.

First up it had to respond to Labour’s Health reform announcement.  The announcement of change has reverberated, particularly within the Health system.

The Spinoff reported on some of the responses.  Like this one from Dave Galler who is an intensive care specialist at Middlemore:

Never before have I been so moved, excited and inspired by an announcement from the government. It is as if all my dreams have come true.

I know that feeling will be shared by many of my colleagues and I hope the public at large.

Those of us who have been working on the frontlines know that these reforms are long overdue and we congratulate those in the Transition Unit for their work and our ministers of health for taking these bold and necessary steps. The word transformation is much overused but not here.

The intent here is clear – these changes are focused on an agreed outcome for all in a courageous approach to reconfigure our resources to better align and coordinate services to improve their reach to all New Zealanders and especially to those who are missing out now, Maori in particular.

These changes will begin immediately but the emphasis here is not on structure, it is on functions, those of a truly National Health Service based on equity and good outcomes and the promotion of health and well being.

These are changes I support wholeheartedly and I hope you will too.

And what is incredible is that the details were not leaked beforehand, even though hundreds if not thousands of individuals must have known about the general nature of the proposals.  Talk about discipline.

The announcement of a dedicated Maori Health Authority also received support.  Red necks will hate it, but the health outcomes and life expectancy of Maori are well below those of the general population.  Something is wrong with our system.

If you want the basic figures in 2013 Māori life expectancy was 77 for women and 73 for men.  The figure for non-Māori women was 84 and for non-Māori men was 80.  A seven year difference is really fucking significant.

The most recent figures I could find  suggest that the gap has not lessened.  From Stuff:

Life expectancy at birth was 73.4 years for Māori males in 2017–2019 (up 3.1 years from 2005–2007), and 77.1 years for Māori females (up 2 years from 2005–2007).

For the “European or other” ethnic group, life expectancy for males in 2017-19 was 81 and 84.5 for females.

This is a significant weakness in our health system and needs to be addressed.  Culturally appropriate treatment for Tangata Whenua, who could object to that especially given the statistics.

So how did National respond?

The bureaucracy claim is strange.  We are replacing 20 bureaucracies with one.  The examples where the 20 have found it difficult to cooperate are legendary, computer systems not properly communicating with each other being one example.  Our national population is the equivalent of a medium sized city overseas.  Having multiple organisations tasked with rolling out national campaigns to, for instance deal with a global pandemic, is not optimal.  As we have learned.  They have functioned quite well but the past 12 months shows how important it is to have a National Health system.

National managed to achieve something with a difficulty level of 10.5, oppose the significant reduction in the number of bureaucratic organisations and at the same time oppose the creation of a new bureaucratic organisation, albeit one favouring Tangata Whenua.

And Collins statement that National is committed to continuing the current DHB model but not in its current form as as kafkaesque a use of the English language as you can imagine.

In other National Party news Simon Bridges is hosting an event in Parliament involving what appears to be a rather extreme Christian sect.

This group expressed some rather way out views on Islam the week after the Christchurch Mosque killings.

And Christopher Luxon, who by all appearances is really rich, complained that his daily coffee was going to cost a few cents more.

So yesterday was a day where National focussed on dog whistle racism, supported religious extremists and moaned about workers receiving a modest increase in the minimum wage.

Keep it up National.  23% may not be your low point.

86 comments on “National’s very bad day ”

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  1. Foreign Waka 1
    22 April 2021 at 7:58 am

    Sorry, but I have to agree that health service is to be applied by need. This is the "contract" of paying tax and the middle income earners shoulder the biggest burden. I do not care what race, language or creed a person is, as long as it is an impartial service. Similar like applying the law. You don't have more than one set of standard laws floating around.

    What I really object to is that this hard earned money that is collected in taxes is being seen as something that is not mine to give but the governments to take. There is a big difference. The former is a social agreement with the proviso that I do have a voice, the later is feudalism.

    • mickysavage 1.1
      22 April 2021 at 8:05 am

      Don’t you think the life expectancy figures give a startling indication of need?

      • solkta 1.1.1
        22 April 2021 at 8:40 am

        It doesn't matter how many people die early as long as we do it the white way.

      • Jimmy 1.1.2
        22 April 2021 at 8:42 am

        Do the lower life expectancy figures have anything to do with their own personal choices like choosing to smoke, choosing KFC more often than home cooked food and less regular exercise?

        • Drowsy M. Kram 1.1.2.1
          22 April 2021 at 9:50 am

          Some lifestyle factors do influence average life expectancy, but 'poor choices' are only part of the puzzle.

          1. Do lifestyle 'choices' fully account for ~7 fewer years of life?
          2. Do different levels of 'advantage' require different approaches and resources to get equitable health outcomes?

          Ethnic differences in cardiovascular risk profiles among 475,241 adults in primary care in Aotearoa, New Zealand [NZMJ: Sept 2020]
          The reasons for CVD inequities by ethnicity are complex and multifactorial. The differences in socioeconomic status are stark and highlight the importance of the social determinants of health in the creation and perpetuation of inequities for Māori and Pacific. Opportunities and privileges provided by income, housing and education are not evenly distributed in New Zealand. Due to the effects of colonisation, both historical and contemporary, non-Māori non-Pacific groups have higher median incomes and educational achievement than Māori and Pacific people. Institutional or structural racism is now recognised as a ‘social determinant’ that can adversely impact on health-promoting activities including health literacy and access to and through excellent and timely healthcare. While health providers generally have limited ability to change the social determinants of health, it is well within our remit to ensure that people’s rights to receive high-quality, responsive and culturally safe healthcare services are being met.

          Our study is the largest and most recent review of CVD risk profiles in Aotearoa New Zealand, and we have demonstrated significant ethnic inequities. In our experience, generic interventions to reduce smoking and obesity or manage diabetes across the ‘whole of population’ are prioritised over ethnic-specific programs. A ‘one-size fits all’ approach will simply not work to achieve equity of CVD and its risk factors in New Zealand. In addition to current generic population health and risk-based approaches, there is a need for the continuing development of interventions from the perspective of those experiencing inequities. We believe that more support, including strong political commitment, is required to ensure such interventions are resourced appropriately so that they are implemented, evaluated and, if effective, scaled up in order to increase their reach, and achieve equity.

          https://www.nzma.org.nz/journal-articles/ethnic-differences-in-cardiovascular-risk-profiles-among-475-241-adults-in-primary-care-in-aotearoa-new-zealand

          • AJ 1.1.2.1.1
            23 April 2021 at 7:45 am

            What are some examples of either effects of contemporary colonisation or the contemporary effects of colonisation ( a bit ambiguous in the text above)?

            • Drowsy M. Kram 1.1.2.1.1.1
              23 April 2021 at 10:27 am

              Due to the effects of colonisation, both historical and contemporary,

              I read that as meaning that the effects of (historical) colonisation are both historical and (due to inter-generational flow-on effects) contempory.

              During the European colonization of Australia, New Zealand and other place in Oceania, explorers and colonists often regarded the landmasses as terra nullius, meaning "empty land" in Latin. Owing to the absence of Western farming techniques, Europeans deemed the land unaltered by mankind and therefore treated it as uninhabited, despite the presence of indigenous populations.

              It could be argued that colonisation of NZ is on-going due to surging migration. That doesn't fit with with widely accepted definitions of colonisation, although it would be wise to also seek minority views.

              New Zealand’s population passes 5 million
              About half of the population growth from 4 to 5 million (between 2003 and 2020) was due to natural increase (births minus deaths), and about half from net migration (migrant arrivals minus migrant departures).

        • Brigid 1.1.2.2
          22 April 2021 at 11:38 am

          Has there been research into the personal choices of those you are referring to regarding their consumption of KFC and their 'less regular' exercise?

          If so can you refer to it?

          Incidentally how do you define 'less regular'?

        • lprent 1.1.2.3
          22 April 2021 at 11:43 am

          Jimmy –

          …their own personal choices like choosing to smoke, choosing KFC more often than home cooked food and less regular exercise?

          Even if those were the causes, then these are still part of the health system – they are some of the targets of preventative healthcare. Which is part of the remit of the current health system in NZ. There is fact a pretty good list on the Ministry of Health. What are you trying to say? That the current district health boards aren't doing their job in this area? That I'd agree with.

          • Family violence
            This section provides resources for the health sector on implementing violence intervention programmes, and reports on their effectiveness. Read more
          • Fluoride and oral health
            Water fluoridation is a proven public health measure to reduce dental caries. This section provides information about fluoride and its importance for oral health. Read more
          • Healthy Families NZ
            Healthy Families NZ is a large scale initiative which aims to improve people’s health where they live, learn, work and play, for the prevention of chronic disease. Read more
          • Healthy Homes Initiative
            Healthy Homes Initiatives work with families, agencies and local partners to provide education and access to interventions which will create warm, dry and uncrowded homes. Read more
          • Immunisation
            Information about immunisation in New Zealand, including the National Immunisation Schedule and immunisation programme decisions. Read more
          • The Mobility Action Programme
            The Mobility Action Programme (MAP) is funding a range of programmes for people with musculoskeletal health conditions so that people have improved health outcomes. Read more
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            The Ministry ensures that nutrition recommendations have a sound evidence base. Find the Food and Nutrition Guidelines, recommended nutrient intakes and more. Read more
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            The Ministry of Health is the key agency for policy development in the tobacco control area and is involved in a large number of policy, service development and operational aspects of tobacco control. Read more

          Running programmes inside the health system as well as in other areas of our society drastically reduce the cost of the overall health system that we pay for.

          Like everything else, focusing on the preventable problems by targeting the areas of the most need against the bets return is the simplest, most economic, and most effective way to address need. In the case of the current demographics, that would be to focus resources into getting different messaging into the area of the population that has the greatest preventable need.

          The same way that we did with other preventable needs to reduce the overall costs of the health system – like diminishing smoking in the whole of the population – a measure front-footed by the health system.

        • mac1 1.1.2.4
          22 April 2021 at 12:46 pm

          Jimmy, my comment at #9 below addresses your issues by saying there are other factors than those you cite. Paragraphs 9-13 names some of the other factors which come into play.

          My scientist mate asked on our walk today, what part does genetics play in this? We know for example that redheadedness is a genetic trait linked to a higher incidence in skin cancer, higher pain sensitivity, Parkinson's disease and endometriosis.

          What part does poverty play? Rural isolation? Access to transport?

          Today a RNZ talk spoke of the unfriendliness of doctor's surgeries to Māori.

          What part does male culture play in being 'staunch' and not bothering a doctor?

          What part social culture? Fear, distress to family, condemnation even for being sinful enough to attract illness, condemnation for wrong diet, etc etc etc.

          My oncologist said our health system is racist. That is not a problem caused by Māori. That is a problem inflicted upon Māori. Simplistic answers such as those that blame Māori can be part of that racism.

          A similar process of blame can be seen in the excuse some Pakeha use to justify land grabs by saying the Māori dispossessed their own as well. Māori are fully responsible for their plight and therefore we shouldn't do anything. The same thinking can be applied to alcoholics, drug users, smokers, gluttons, couch potatoes, pie-eaters, white bread consumers, the sweet-toothed and chocolate freaks, the over-weight, the under-weight……. have I missed anybody out yet?

          I have. The non-marathon runners, the genetically ill-disposed, the sleepless, the workers exposed to harm, drivers, people who live in sub-standard housing…. them. too.

      • Foreign Waka 1.1.3
        22 April 2021 at 8:46 am

        Yes, as I said: Need.

        But we should not mix two issues here. There is research done and still required as to why life expectancy differs. If it is lifestyle choices = personal responsibility and assistance in adjustments, if it is income related leading to poor housing etc. than it is not as such a health issue to remedy but the immediate issues are a need.

        But this would apply to everybody, no? I know of European who haven't had proper care and died in their 50's. Access to a professional is the issue and also how good that professional is. The quality of diagnostic is at the center. You have semi rural centers with maybe one general doctor looking after a wide area, maybe for a long time and no replacement is sight. Or no service at all as we see with maternity where women have children beside the road. All this is very much 3rd world standard.

        If a just principle is applied, it will see you through. That's all I am saying.

        The emotional outbursts such comments as mine receive is understandable but really in a debate unhelpful. If you want to find solutions don’t be afraid to look at all aspects from a base of reason. You don’t save a child drowning by crying foul, you need to jump into the cold water and swim.

        • ghostwhowalksnz 1.1.3.1
          22 April 2021 at 9:06 am

          Looking at specific 'avoidable' contributions to shorter life expectancy for Maori ( in the very broadest sense, as some can be preventable by the health system).

          NZMA research

          Within Māori females, trachea, bronchus and lung cancers accounted for 0.9 years of the life expectancy differential, followed by coronary disease (0.6 years), with diabetes and chronic obstructive pulmonary disease each contributing 0.4 years (Figure 2). Within Māori males, coronary disease, trachea, bronchus and lung cancers and diabetes accounted for 1.2 years, 0.8 years and 0.5 years respectively (Figure 3). In Māori males, avoidable injuries had a pronounced contribution to the differential. Injuries contributed 1.0 year to the differential, with suicide and land transport injuries contributing over half of the differential associated with avoidable injuries. A large proportion of the differential caused by injuries was a result of higher mortality rates in the 0–29 year-old age group.

          The higher suicide rate for young maori is so preventable and really cant be called a 'lifestyle choice'

          • Foreign Waka 1.1.3.1.1
            22 April 2021 at 9:27 am

            ghostwhowalksnz

            Suicide is an issue that is for many people in distress what they do, irrespective of race. This can have many reasons but I certainly did NOT list this as a lifestyle choice. How dare you.

            Brutally honest: diet, smoking, exercise would take car of a lot of illnesses. Driving on drink and drugs, too fast or "showing off" should absolutely be preventable.

            These are not health issues but choices that have health issues as a consequence.

            • ghostwhowalksnz 1.1.3.1.1.1
              22 April 2021 at 11:44 am

              It wasnt directed at what you said , just to expand the information about the wider definition of preventable deaths.

              Accidents at work would impact maori more as well as they are more likely in forestry, warehouses, construction or other outdoor work.

              • Foreign Waka …
                22 April 2021 at 12:29 pm

                Thank you.

                Accidents would fall under ACC technically, but in terms of treatment are emergencies. All manual work is inherently accident prone but a lot of work has gone into prevention, reporting, remedy of process etc.

                Interestingly, its manufacturing and construction leading in injuries whilst forestry is well below these numbers. But every injury is very regrettable.

                https://data.worksafe.govt.nz/graph/summary/injuries_week_away

            • McFlock 1.1.3.1.1.2
              22 April 2021 at 1:22 pm

              Ok. Let's go with that.

              Someone smoked 30 years ago. Gets heart disease today. Do you withold treatment on the grounds they did silly things in their youth?

              Young dude has a car crash. Does one not provide an ambulance or trauma surgery on the odds that speed was a factor?

              The "personal responsibility" trope is just an excuse to do nothing.

              • lprent …
                22 April 2021 at 2:36 pm

                Yep… Best way of describing it.

              • Foreign Waka …
                22 April 2021 at 3:41 pm

                No use of pulling the rug, attitudes were different 30 years ago. 50 years ago smoking was used as a hunger killer, especially in the war years. Movies portrait it as "sexy". Little did they know (or maybe they did?).

                Car crashes – any injured person has to be treated in the A&E.

                Personal responsibility: if you know that it does harm, assess and try to stay within manageable risk. This will always have to be seen within the timeframe knowledge was available.

                • McFlock …
                  22 April 2021 at 4:30 pm

                  So the crash dude turns out to have been speeding, or got distracted or fell asleep behind the wheel. Personal choice, immediate cause of the current healthcare need.

                  He goes to A&E, they patch him up, but he needs complex treatments for months after a short stay in intensive care. Head injury, broken bones, damaged liver, facial reconstruction, the works.

                  What does "personal responsibility" have to do with how or when he is treated for these problems?

                  • Foreign waka …
                    22 April 2021 at 8:29 pm

                    McFlock

                    Short answer to the last sentence as to how and when: nothing.

                    Because the debate is actually about access to healthcare and whether it would improve when all DHB's have been dissolve and the administration centralized.

                    But coming back to your question nonetheless, you wrote: So the crash dude turns out to have been speeding, or got distracted or fell asleep behind the wheel. Personal choice, immediate cause of the current healthcare need.

                    Answer: as you said, personal choice also means taking responsibility. No one "owes" the driver who made the choice to speed, fall asleep etc. anything. He will be treated in hospital like all other people involved in an accident, curtesy of the taxpayer.

                    • McFlock …
                      22 April 2021 at 9:16 pm

                      Well, we owe him treatment, for a start.

                      But the other thing is that we can look at the risky behaviours which caused the injuries needing treatment as an enforcement problem, or as a population health problem that leads to unnecessary suffering as well as the additional health resource problem.

                      Charging or ticketing the dude with "failing to stay in lane" or "careless use causing injury" might, if we are fortunate, change young dude's behaviour (doubtful if the crash didn't already do it).

                      Treating it as a health issue, investigating each instance with a research focus rather than a punitive and judgemental focus, can help guide effective approaches to improving road safety in the future.

                      Restricting what counts as a "health issue" to immediate effects would have stopped medical advances centuries ago.

                      Shit, these days we're beginning to not just look at the reasons for individual choices and risky behaviours, with the IDI we're beginning to look at things like how the parents personal choices years before giving birth correlate with health outcomes for the offspring (the IDI isn't as glossy as proponents plugged – the probabilistic linkage is a bit variable depending on datasources – but the potential for some really interesting work is there).

              • AJ …
                23 April 2021 at 7:52 am

                Foeriegn Waka wasn't talking about denying treatment; rather the point was to what extent lifestyle choices affect longeivity.

                • Incognito …
                  23 April 2021 at 10:06 am

                  Once you start talking about choices, decisions, and personal responsibility, you open a rabbit hole full of worms.

            • Lucy 1.1.3.1.1.3
              23 April 2021 at 8:45 am

              There is an amazing article that I can't currently find written by a woman in the US that states 1) she smokes as she has 2 jobs and goes to school and nicotine keeps her awake, dulls pain and stops her hunger pangs. 2) She buys fast food as with her schedule she is so time poor she can't cook 3) She would love job that gives her security, medical insurance and paid sick leave but her education ensures all she can get is low paid, insecure gig economy jobs. 4) She is not able to afford birth control so that is also an issue. If the reality of your life mean that choices about diet, smoking etc are not available then they are not choices at best they are suggestions. If you have your first baby at 16 then for most education is limited, your jobs for life will be minimum pay and likely temporary, and multiple jobs. If you understand cigarettes are an appetite suppressant the reason poor people smoke is sensible. When your body is in a state of hunger it becomes impossible to function.

      • Ed1 1.1.4
        22 April 2021 at 1:51 pm

        Men experience higher mortality by women at most ages, and different ethnic groups have different rates. The big question is whether genetics are to blame or environmental factors. My perception is that the gap between Maori and Pakeha mortality has widened – effectively through pakeha having improved life expectancy and this not being as evident for Maori. Since we have been through a period of increasing inequality of incomes, its seems obvious that there may be real cause and effect on that basis, rather than coincidental mere correlation. A lot of things are linked to poverty – disrupted family upbringing through parents working longer hours, poorer nutrition, poorer education opportunities through a difficult home situation / more infrequent moving of schools, hence lower job and income expectations. Then there is the possibility of slower intervention for medical problems, and less desirable medical outcomes. Does frustration at smokers result in discrimination by some medical personnel? Is there discrimination on other grounds? In some cases more resourced may be needed for a late presenter, and those resources may not always be available. So it is complex, but designing the system to cope with the needs of all groups instead of just the fortunate does make sense. The wealthy are able to avoid queuing through private provision, and this may mask total needs known to the public system – in hard times private hospitals may not be as busy as in times where money is more easily available – and those in most need can be squeezed out . . .

        • Foreign Waka 1.1.4.1
          22 April 2021 at 4:04 pm

          Private health insurance is not affordable for the majority of people here in NZ, that is certain.

          You describe a width and breath of life circumstances that may influence health outcomes but as you mentioned, genetics will also play a role. If you have cancer in your family, you will be prone to it. Many women with breast cancer in their family are very much aware of this. Circumstances of upbringing, poverty etc. need to be addressed and might ask at that point: how much has this government done to reduce these well known statistics? We are not even talking about it anymore. As for saying that pakeha have an advantage, this is not true. I had 2 friends of European descent dying of cancer and in both cases the diagnosis and treatment was too late. In one case access to treatment started six weeks before my friend succumbed. Despite having been diagnosed many weeks earlier. So no, I don't buy that line.

          I do think however, that the doctor fee needs to be allocated via that new central office in form of a reimbursement for services and that will have two outcomes: 1/ people will go to the doctor when they need to and 2/ hospitals are not swamped with people who should be going to their medical center. Take the money saved from disestablishing the 20 DHB's and fund this. The difference will be visible within a very short time as for the patient the visit to the medical center would be free.

    • Michael who failed Civics 1.2
      22 April 2021 at 4:05 pm

      You don't want Maori receiving health care then? Well, you'd be in good right-wing company. Article published in NZ Medical Journal last year found systemic racism within our health system contributed to Maori receiving less care, based on "need", than people with white skin received. Crusher Collins seems keen to perpetuate that racism too.

      • Foreign waka 1.2.1
        22 April 2021 at 8:34 pm

        OMG! Words fail me.

        • Dal Tarrent 1.2.1.1
          23 April 2021 at 4:53 am

          Dear me FW – buck up your ideas – you need to follow the party line here ! or else you'll get labelled as part of the a "nasty right wing interests" .

          • Foreign Waka 1.2.1.1.1
            23 April 2021 at 9:43 am

            Lol, reason seem to go out the window once indoctrination takes hold. No matter what kind. Sad really, as I am convinced that, no matter how contradictory some ideas might be, a good mix could get a great outcome. Closed minds are not the premise of a particular party.

  2. WeTheBleeple 2
    22 April 2021 at 8:14 am

    The worst kind of racists in social media today knocking the Maori aspect of the health reshuffle. Seems there's some organised groups this blog has never mentioned. I'll try make note next time I see them crop up.

    Regurgitated bile posing as talking points.

    • Marcus Morris 2.1
      22 April 2021 at 11:03 am

      100%

      • Michael who failed Civics 2.1.1
        22 April 2021 at 4:19 pm

        Agreed. Lots of nasty right-wing interests lurking in the shdows here. Commercial as well as racist agendas in play too.

        • McFlock 2.1.1.1
          22 April 2021 at 4:46 pm

          Was reading on twitter that one of the ~adjacent (IDGAF whether they're technically "nazis", "fascists", or "white supremacists", they're in the same political locality of all three) groups was dismayed that the racists in NZ were so divided, so have decided to unite it… by forming yet another ~adjacent group.

          Trouble is, the chch fucker might have been an aussie, but the aftermath showed how many ~adjacent NZers were hiding in plain sight.

  3. Anker 3
    22 April 2021 at 8:26 am
    • The most important thing is that the Maori agency is effective. Give them or rather have them come up with their own targets and hold them accountable. This needs to happen across health generally.

    one health professional has been quoted as saying Smoking obesity and alcohol consumption need to be reduced for better health outcomes and I think this is correct. All three are linked to the poorest health outcomes as is lack of exercise.

    until we regulate the food and booze industry, I don’t know how this will be achieved.

    but I welcomed the health reforms.

    • gsays 3.1
      22 April 2021 at 12:11 pm

      My ten cents worth:

      We are putting a lot of expectations on one outfit to repair decades if damage.

      There are many drivers of anyone's poor health. Quality of their dwelling. All the money in the world doesn't overcome breathing in mould spores during your first years of life.

      As noted above, people's choices come into play. When you have little or no money, your options are severely limited. How does a Health Authority combat generational poverty?l

  4. Sanctuary 4
    22 April 2021 at 8:45 am

    If you want an insight into the mindset of the sort of people who seem to be giving National all its cues, I suggest you don't read Hosking's latest rant. Then imagine how grusome it might be. And then double it. It reads like Pennywise ranting from the neighbourhood sewer.

  5. Heather Tanguay 5
    22 April 2021 at 8:48 am

    The reforms are long overdue. The lobby from food, booze and tobacco has, and still is very strong. Collins will be interested in continuing her support for them, of course she will promise to change things when she is reelected!!

    The mighty church revival does seem strange however Simon is looking for support from all quarters.

  6. Pat 6
    22 April 2021 at 8:48 am

    Until the detail is announced any position (hard or otherwise) is foolish…..what has been announced so far could mean/lead to anything, better or worse.

  7. Stuart Munro 7
    22 April 2021 at 9:07 am

    I'm not sure if the relative life expectancies will lift terribly easily – they were down to about fifty in the eighties apparently, so I expect the easiest problems have been addressed to some extent. It might not be a purely health issue either, I imagine that workplace deaths, being concentrated among the working class, have historically been higher among Maori.

    As for a Maori Health Authority, if it concentrates on improving the reach and delivery of services that have often fallen short for their people, that will be excellent. Not so keen on what happened to Anna Penn, when the resources of a substantial institution were marshalled against a student in a complete failure of pastoral care.

    • lprent 7.1
      22 April 2021 at 12:15 pm

      Anna Penn – I had to look that up. 1993 is a bit of a far reach.

      I'd point out that was an issue about a woman being able to speak on a Marae.

      As a complete side issue, I don't go to Marae at all because it isn't my culture. In my culture, women speak frequently and usually first.

      I also don't attend Churches, Mosques or any religious institutions.

      Basically other people's cultures bore the crap out of me.

      But I'd give them the same room that I expect when people get offended by my personal culture of senior geekism. Don't screw with my culture – I may take offence and take actions that make it an unpleasant experience.

      Similarly if someone offensively tries to inflict the presumptions of their culture upon me (like right wing political types making unwarranted assertions), then I will take a great deal of pleasure in tearing into the fundamental flaws of their belief systems.

      But If people simply explain where they're coming from – I'll just listen, compare, and learn. Then make my own choices. I’d also make my views clear, but do it as part of the feedback and comparison.

      Professionally, I look closely at most situations that I move into to assess cultural risks and to decide what my responses would be. That is as much a part of my profession as a programmer as knowing git or c++.

      In effect that was what Anna Penn got copped by. She was being trained in a profession that required she dealt with people from a large number of cultures. Part of the training was to expose her to different cultures. In this case that of many of roughly 15% of the population. I suspect that she would have reacted the same if she'd run across Sikh's, geeks, or even military cultures.

      Basically she failed a basic test.

      • Stuart Munro 7.1.1
        22 April 2021 at 9:28 pm

        Friend of mind was the reporter who investigated the case, so I heard – at length – all about it. A much later informal conversation I had with a kaumatua of the same iwi was that the dispute was not mana enhancing for anybody – so bad handling.

        Chch Polytech very unwisely doubled down on poor conflict management, slating Penn by using mental health records (to which they had improper access) against her.

        Penn removed to Australia, graduated without issues, and went off the news radar.

  8. Sanctuary 8
    22 April 2021 at 9:08 am

    National's current plight is what happens when you play lip service to diversity by putting it all on the party list and then allow your party to be infiltrated by Evangelicals who proceed to stack your safe seats with happy-clappy wingnuts heavily influenced by American reactionary "conservatism." When you get thumped in an election,. you are left with the crazies, has beens and never-will-be who happen to inhabit the safe seats and lofty list places.

    They are now completely out of touch with contemporary NZ and so they continually engage in culture war posturing in the hope something might stick. National's current world view is predicated on denying the actual issues and problems of our time and instead seeking to construct imaginary threats and enemies that don't threaten their world view.

    • Morrissey 8.1
      22 April 2021 at 12:40 pm

      Indeed it seems that National is moribund. However, similar doom was predicted for the Republican Party after the 2012 U.S. presidential election.

      • Sanctuary 8.1.1
        22 April 2021 at 1:55 pm

        National benefits from a right wing media that does a lot of projection in it's reckons and clings to the idea of political legitimacy by dint of a rosette. A settled two party system where a courtier MSM besotted with a horse race narrative pretends one side is not be radicalised into a far right insurgency has benefited the US Republican for example, which these days behaves far more like the illiberal authoritarianism of a Fidesz than a moderate party of a liberal democracy.

        So it is possible that an unreformed National with an evangelical core may win power on the back of media projection and time for a change – such a government though would be a disaster, and one advantage of three year terms is they'd be tossed out again rapidly.

  9. mac1 9
    22 April 2021 at 9:17 am

    I wrote the following a few months ago. I don't believe that Health Minister Andrew Little read it, but he would have seen the studies upon which it is based. Like me, Little is a prostate cancer survivor. Like me, as a Pakeha survivor, he would have seen the inequity of the survival rates for Māori. And he acted.

    "I attended an inaugural support gathering of men with prostate cancer recently. The guest speaker was an oncologist and surgeon.

    At the end of his talk, he dropped this elephantine statement into the room. "The NZ health system is racist."

    This was certainly challenging, especially with the recent Black Lives Matter debate here and in the US.

    Let's look at the statistics.

    Cancer impacts more heavily on Māori, with large inequalities in the experience and quality of care from diagnosis to treatment to outcomes.

    Māori have a higher incidence and higher mortality from for all cancers compared to non-Māori.

    Inequalities in cancer death rates are increasing, which is a major reason for the 8 year gap in life expectancy for Māori compared to non-Māori.

    Survival rates for Māori are poorer, with disparities in access to all cancer services.

    Māori are nearly twice as likely to die from cancer, even though they are only 18% more likely to have cancer. One reason may be that diagnosis comes when the cancer has reached a more advanced stage.

    Māori have the highest rate of lung cancer in the world with three times the mortality rate and a 7 year gap in life expectancy compared to non-Māori. This high mortality stems mostly from late presentation, delays in treatment and low surgical rates for early stage disease.

    The emergency department is the most common method of entry to secondary care. This suggests that access barriers (e.g. financial, cultural, geographic) may still exist in the primary care sector along with other factors influencing late presentation such as patient fear.

    Māori were more likely to have delays in receiving treatment, four times less likely than Europeans to receive curative treatment. Treatment for Māori was aimed at relieving symptoms.

    The differences in types of treatment received may reflect the stage of cancer at presentation and higher rates of comorbidity (e.g. renal disease, cardiovascular disease) for Māori, which would preclude the use of curative treatments.

    "The NZ health system is racist" said our oncologist speaker. The figures for cancer diagnosis, treatment and outcomes surely suggest this is so.

    Though these figures come from studies about 2003-5, more recent studies are published with similar findings and accusations of racism.

    Fifteen or more years ago researchers in New Zealand found a racist system. In 2020, the situation is substantially the same.

    Changes are evidently needed- in health provision from GPs, and primary health care, and from hospitals. The political will must be there to make the changes happen. The social awareness of the people must be there to call for changes."

  10. Deirdre Green 10
    22 April 2021 at 9:19 am

    It's always disappointing to read comments that blame the gap between Maori and non-Maori health outcomes on the 'life style choices' of Maori people. Smoking is one habit that people like to use to imply that as a race of people, Maori are weak and undisciplined and only have themselves to blame for their shorter life spans. This poorly considered attitude is boosted by the fact that statistically, Maori do smoke more than non-Maori. Health professionals know this, better than those who like judge from their couch, and so of course they will be targeting the high rates of smoking among Maori as part of the push to close the gap in health outcomes. Why argue against a plan to commit more resources to the problem? Yes, it may partly be about educating Maori to make better choices, but I guess the real problem is that some people, especially those who live on the right side of the equity gap, would prefer to leave things the way they are.

  11. Heather Grimwood 11
    22 April 2021 at 10:05 am

    Some decades ago in midst of our anti-nuclear testing days I was next patient for an oncologist in Grafton after he had dealt with what he described as a planeload of cancer sufferers of French Muturoa tests, held too long in Tahiti until a ‘planeful’.
    I will never forget that guy as he held back his tears at the inequity involved.

    Comments above have reminded me anew of racial discrimination albeit French enacted in that case, and I rejoice…..yes rejoice ….. this day to learn that equity is a major reason for Labour’s reorganising of the health system. May the proposals have every success.

  12. WeTheBleeple 12
    22 April 2021 at 10:17 am

    With regards to this 'Power of One' message they're pimping to the religious right:

    One Authority is an embedded christian trope. Translated to government it's an authoritarian model with one ringpiece to rule them all. The idea of Maori having a voice alongside of government, of an actual partnership, is anathema to these people.

    Hope authorities are keeping a keen eye on our right-wing racists, they're feeling very aggrieved after yesterdays events.

    • Yoza 12.1
      23 April 2021 at 10:47 am

      There are also Maori do not recognize the CROWN jurisdiction,see the constitution act 1986 as removing the sovereign and see this move from government as an attempt to further embed maori into what can be considered illegitimate.

      • WeTheBleeple 12.1.1
        24 April 2021 at 9:23 am

        I suggest you learn about whatever it is you're trying to repeat so you don't come across as another ignoramus acting in poor faith for the sake of having a go at Maori.

        • WeTheBleeple 12.1.1.1
          24 April 2021 at 9:29 am

          Actually, maybe I'm the one being ignorant – I do not get what you're trying to say.

          I'm no expert but I've studied a little. To my mind a Crown/Iwi partnership is the gold standard insofar as honoring the treaty. You?

      • solkta 12.1.2
        24 April 2021 at 9:46 am

        Most Maori i have spoken to can see that their ancestors signed the Treaty in good faith and feel a need to honour that agreement as part of the obligations they have as Maori.

  13. Wayne Robert Andrewartha 13
    22 April 2021 at 12:12 pm

    Statistics are only a guide. They are not an absolute truth. There are many other factors which may have more of an effect on Maori as compared to other races. Such as drinking and smoking – is that statistically worse for Maori than non-Maori? Many Maori have lower paid jobs, which could mean outdoor work rather than inside. Is this statistically a reason for the longevity difference? I have a mate who is Maori and works on computers. He is indoors every day, and at 52, he looks and acts 42.

    With lower incomes, do Maori eat food which is cheap and perhaps not healthy. Does that shorten Maori ages? And of course, every man and woman on this planet is different. I have a father who died at 50: a brother who died at 60: yet my mother is now 91. Statistics don't work well enough for me, so this report means nothing. It is simply there for politicians to brag about and media to highlight to increase their sales (especially if they are bad statistics).

  14. Graeme 14
    22 April 2021 at 12:57 pm

    Also in the recent past Nania Mahuta’s Water Services Bill landed with a barely audible plop

    https://legislation.govt.nz/bill/government/2020/0314/latest/contents.html

  15. Chris 15
    22 April 2021 at 1:07 pm

    Judith Collins agreeing so vehemently with something Helen Clark introduced? I cannot believe it! What's the world coming to?!!

  16. Brendan 16
    22 April 2021 at 2:27 pm

    Nat voter here.

    The attacks of the health reforms by National appear to be trying to create noise for the sake of noise. When Kiwiblog approves in principal the basic thrust of the reforms, I don't see the point of making a big song and dance.

    So team red – get on with your reforms, but don't screw things up.

  17. tc 17
    22 April 2021 at 3:04 pm

    Dog whistling, chasing the christian vote and rich white man complains.

    Sounds like just any other day in the national party to me.

    • ghostwhowalksnz 17.1
      22 April 2021 at 3:09 pm

      Yes, Judith is happy to accommodate the 'separate group' that needs hip replacements.

  18. Enough is Enough 18
    22 April 2021 at 3:09 pm

    I hope it has many more bad days like this in the future.

    Really? You truly see politics as sport don't you, where it is simply blue v red and winner takes all.

    Good government requires good opposition, regardless of what side they are from. My hope is that we have a left leaning government that delivers on in its promises, and is challeneged on a daily basis by a strong opposition.

    Without a strong opposition we get a lazy and complacent government.

    So no, National having bad days is not a good thing.

    • ghostwhowalksnz 18.1
      22 April 2021 at 3:14 pm

      No. Doesnt follow. National are lazy and incompetent in opposition …you dont seem to know Judith spent some of the last 3 years studying for a diploma in Health and Safety….she wouldnt be the only one there having only an occasional eye on what the government is doing.

      Before parliament she was a Lambton Quay corporate tax lawyer…go figure

      • Enough is Enough 18.1.1
        22 April 2021 at 3:25 pm

        Yes National are lazy and incompetent in opposition. I want them to be the exact opposite

        • Michael who failed Civics 18.1.1.1
          22 April 2021 at 4:07 pm

          I do, as long as they remain racist and committed to religious fundamentalism.

        • Drowsy M. Kram 18.1.1.2
          22 April 2021 at 4:08 pm

          Yes National are lazy and incompetent in opposition. I want them to be the exact opposite

          National party MPs are certainly industrious, if not alway competent, when it comes to working for their rich mates.

          https://thestandard.org.nz/key-changed-the-law-to-turn-nz-into-a-tax-haven/
          New Zealand is a tax haven. We became a (much more attractive) tax haven in 2011 as a result of a law change directly instituted by John Key.

          Asset sales proceed in spite of referendum
          In the preliminary result, released last tonight, 67.2 per cent of those who voted said they did not support the Government selling up to 49 per cent of Meridian Energy, Mighty River Power, Genesis Power, Solid Energy and Air New Zealand.

          Eight years on and Canterbury's environment still has no democracy
          Almost eight years ago, on April Fool's day 2010, Nick Smith, then minister for the environment, sacked democracy.

          It was a move that outraged the Law Society Rule of Law Committee which denounced the ECan Act as repugnant to the Rule of Law. Almost everyone was appalled.

          Volatile but not abusive: National MP Jami-Lee Ross speaks out about affair with fellow MP
          It dawned on me, ‘I know this script, I helped write this script.’ At that point, I felt bad for what I did to Todd. But that’s the modus operandi of the National Party – when people become a liability you push them out the door.
          https://www.nzherald.co.nz/nz/volatile-but-not-abusive-national-mp-jami-lee-ross-speaks-out-about-affair-with-fellow-mp/V7OVWMGDJJIVMNELC5PLCN3PEE/

          • ghostwhowalksnz 18.1.1.2.1
            23 April 2021 at 12:27 pm

            "Ross, the MP for Botany, yesterday admitted affairs with two women, one an MP"

            The other was journo from press gallery – no names- but she was doing stories sourced from him as his breakup with national began. Then went quiet as Nats retaliated with spoon- fed stories to other journos about his shocking behavior

    • Chris 18.2
      22 April 2021 at 4:42 pm

      Sure, but challenged on a daily basis to do what? This national opposition is incapable of challenging the government to do anything good – nasty and hateful things, sure, but good things, no. This is because they are not a strong opposition. So national having bad days is a good thing. One would hope that the more bad days it has the greater the chance of it becoming a strong opposition. But until that happens surely it is a good thing they have bad days?

    • McFlock 18.3
      22 April 2021 at 4:43 pm

      Ideally, National having repeatedly bad days helps them move down as a realistic opposition, to be replaced by an actually competent opposition with the good of the nation at heart: the Greens.

      Tell me I'm dreaming? Maybe.

      But the nats are now closer to the Greens than they are to Labour, and the Greens are rising to meet them. ACT or other far right parties? Sure, they also benefit from Nat's bad days, but Greens have higher peaks so far. Maybe the gun-nuts are a bit like smokers: outraged, but a dwindling community.

      Very early days in this electoral cycle, for sure. But a Greens opposition being a less plausible outcome than the nats getting their shit together in the next 18 months? Hmmm. these are interesting times, so who can tell.

      • Stuart Munro 18.3.1
        22 April 2021 at 10:21 pm

        I would love to see Brownlee's face, when the Greens take the opposition benches, and the Gnats are obliged to sit on the sidelines.

        • McFlock 18.3.1.1
          22 April 2021 at 10:52 pm

          Thing is, the last time they were this low they did a pivot to Brash and he took them explicitly racisty with the Orewa speech. So (being obviously highly creative and intelligent folks lol) they'll probably try that again – but we'll see how far the country has moved on. Might not be the magic bullet it was in 2004.

          • Stuart Munro 18.3.1.1.1
            22 April 2021 at 11:53 pm

            I'm less concerned by that kind of policy shift than by the crude sledging from Murdoch thralls – crap like this: Jacinda Ardern goes global, but Kiwis pay the price (theaustralian.com.au)

            There's no trick too dirty for a Murdoch writer, it seems – and the sample is not the worst I've seen lately from those spavined hacks.

            • McFlock 18.3.1.1.1.1
              23 April 2021 at 12:12 am

              Yeah, but the media are constrained by the right wing jocks getting fired when they go too far and lose advertisers.

              The Dirty Politics channel of far right shills keeping an incubator of extremists but the seeds are transferred to the (slightly) less extreme shill sites to be opined on by MSM opinionators and eventually the reactions to the rumours are "reported" in the main news report – that channel has been disrupted by the likes of Banks getting hiffed. Which means the tory msm engine is probably already working at near capacity.

              A Māori health authority just doesn't have the same leverage as the foreshore and seabed issue after the 2008 coalition with the nats, and the fear of the Greens that the nats used to work off (lols lightbulbs) actually works in favour of Labour at the moment.

              Either Labour have to really screw up an issue and piss a lot of people off, or the nats have to stick a finger up the butt of society and get attention that way.

  19. georgecom 19
    22 April 2021 at 9:04 pm

    National also waded in today moaning about how housing the homeless in motels was a gravy train for motel owners. If it was someone else stating such I would agree 100%. Motels are no substitute for a home. Problem for national is (1) they started the programme and (2) they reduced the state housing stock in their term of government by 2000 residence. The reality is National has nothing constructive to offer and has no standing to criticise others. Hence they should just keep their mouths shut.

    • ghostwhowalksnz 19.1
      23 April 2021 at 12:20 pm

      Yes. Around that time one of our clients was a builder doing pepperpot homes in value suburbs for Housing NZ- they were 'build to order to their spec'- extra bedrooms, single garage etc. Bypassed the middlemen such as real estate agents, experience meant he had the consenting down to a tee.

      Stopped overnight, once National was elected…. and this was during the GFC when unemployment was rising steeply.

  20. Jenny how to get there 20
    23 April 2021 at 7:12 am

    Victory was declared prematurely and that ebullient mood was communicated across the country, especially by politicians who wanted to get the economy going…….

    Sounds similar to the constant braying of National opposition MPs here. Thank goodness they were not in power when the pandemic struck.

    https://www.theguardian.com/world/2021/apr/21/system-has-collapsed-india-descent-into-covid-hell?CMP=fb_gu&utm_medium=Social&utm_source=Facebook&fbclid=IwAR3p9h4if_OgJdoHuj60wgbE5HmpheEXRk1ZWbZ1b9xI566z3G5ypJpYFZo#Echobox=1619005174

  21. peter sim 21
    23 April 2021 at 11:12 pm

    DHBS were set up to be privatised by the judith party coalition.

    Homeless people were created by english and keys ( a wall street trader, for heavens sakes..

    If the judith collins led national party is to survive it needs to recognise that it was not born to rule and will meet resist crusher tactics.

    The naz's have not grown or kept up. Difficult for them.

    It was the roger douglas, richard prebble, mike moore group that shafted us into the mess that we are in.

  22. JustMe 22
    24 April 2021 at 3:07 pm

    Looking at Judith Collins who is in reality a reflection of what truly exists in the NZ National Party and its current evolution one truly needs to ask those who support National as to what they are finding 'satisfying' about National and its batch of MPs.

    What they have are remnants of a stupid time in politics but is something National still holds dear to their very hearts to this day.

    And that is the pen-ultimate desire and goal to mis-spend taxpayers money on mostly Vanity Projects whether it be on a Has-been National MP who wasted $26million on a piece of cloth whilst he pulled a lowly paid NZ taxpayer's ponytail in a cafe or a double dipping MP of the afore-mentioned party who denigrated NZers whilst squandering OUR dollars on HIS accommodation costs.

    National need a new leader but what could they replace It with???!!!

    No-one like to admit failure and it takes a person with true intent, honesty and purpose to admit they make mistakes.

    What National are RIGHT NOW is a political party which has now well passed its USED BY date.

    It never possessed a Best Before date because to date and in all the existence of the NZ National Party I would probably not be so far wrong to say since 1975 to the last time it was in government it has become FIRMLY the ARROGANCE PARTY

    Something one doesn't want in government because it loses/lost touch with reality and humanity once the dollars entered into its various bank accounts and the bank accounts of its MPs between 1975 and to date.

    I am not inferring that bribery and corruption exists within say a NZ government like a previous National government. All I am saying is greed amongst politicians whether they be current or former and central or local has existed even here and overseas.

    Looking at the number of former National MPs having to go to court for one thing or another is rather puzzling and also a reflection back upon the political party they once were.

    And if they had no hesitation on doing things that were wrong then what is stopping the current batch of say National MPs doing the same thing?????!!!!!