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6:00 am, June 19th, 2023 - 169 comments
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If this is correct – the policy is inexcusable.
It's badly considered implementation will also lead to further division along racial lines.
If the current government wanted to create a programme that provoked backlash against Māori, they couldn't have done better than what they have done with education, co-governance and this type of policy:
https://www.nzherald.co.nz/nz/auckland-surgeons-must-now-consider-ethnicity-in-prioritising-patients-for-operations-some-are-not-happy/ONGOC263IFCF3LADSRR6VTGQWE/
Inequality is not addressed by switching the players.
That just means it is a different demographic that is now experiencing it.
Yip great way to get unelected, I'll be considering swapping sides (top most likely)if labours finger prints are on this.
Chippie on te news gave a reasonable explanation, all is forgiven for now, but I'm watching!!!
Yes, this is unnecessary bullshit.
If Maori and PIs are amongst the most needy so far as medical care is concerned, then they will be more likely to receive priority on the basis of need without needing to reference race at all.
A system based on need is intrinsically fair, and easy for people to understand and accept.
tsmithfield, I am afraid you are wrong. I would genuinely like to say that you are right.
However, the evidence is otherwise. See my comment at 1.3.2.1 for why I contradict you.
The question of race is why there was inequality of treatment. Has it changed within 2 years?
it certainly needs to change for us to be able to say we live in an equal and fair society.
Thanks, I had a look at your post further down.
Several questions:
Firstly, how do you operationalise the term "Maori" because that can vary a lot depending on the percentage of Maori ancestory a person has. And, also is likely to be reflected in outcomes.
Secondly, does your research include multi-factorial analysis? Because, there will likely be a high overlap between Maori/PI and groups represented in poverty or low income. If that is the case, then targeting need should also target those at risk communities. Whereas, targeting groups on the basis of race will capture a lot of people who aren't disadvantgaged due to specific life circumstances.
Finally, don't you think the issue is really at a more fundamental level than surgical operations? Shouldn't we be targeting the root causes that lead to the outcomes you describe?
Indeed 'we' should, given those disgraceful outcomes. Your questions are intriguing, but imagine the shoe was on the other foot – wouldn't you want something done in a timely manner, until "targeting the root causes" took effect?
A quote from Mac1's comment @1.3.2.1 (copied below) sums it up for me.
Some Kiwis simply don't believe that long-standing (race-based) inequality of health outcomes justifies immediate positive discrimination – convenient eh?
Also, HT II @1.8
But, that still doesn't answer the question, really. I think it is important to know the criteria on which the group was divided into Maori and Non-Maori. For instance, would someone with 5% Maori blood be in the Maori or Non-Maori group?
And, how does that figure change once relevant variables such as income, education status, and similar factors are controlled for.
Quite often, when doing multi-variate analysis, the surface level effect will often disappear or become inconsequential when over-lapping factors are controlled for.
So, once those factors are controlled for, we might find that poorly educated people from low socio-economic backgrounds are more prone to poor health outcomes than those from better backgrounds, and that race has little to do with it.
Thus, interventions around health etc can be targetted much more accurately than on a broad, blunt dimension such as race, which includes both people who may need interventions, and those who don't.
We don't use blood quantum in NZ. Māori afaik primarily use whakapapa to understand who is Māori. Another reason why it's inappropriate in this context is that the issue is ethnicity not race. Think of ethnicity as something that arises out of ancestry and culture. The bodies that we inherit play into health outcomes, and so does the culture we come from. Arguing that there should be no ethnicity factor, is saying that we should ignore both those things.
(as an aside, I'm curious now if illnesses with a very strong genetic component that pass through families are affected by how many great grandparents were of a specific ethnicity. I'm guessing no much other than increasing chance).
And yes, it's not possible to design a policy that is good and fair for every individual. No health policy reaches that standard, which is why we have public health. It's based on assessing data about populations.
We already know it is both. When access to health care is shown to differ across ethnicities, we can understand the ethnicity side of it. Mac's prostate cancer example is a good one. One of the inequities is that the system enables Pākehā to get better access than Māori (beyond issues like poverty). I will see what research pops up in the debate over the next few days, but in my understanding this isn't controversial and has been known for a long time. I remember these issues being discussed in the 90s.
Weka, I guess the race/ethnicity side of the equation can really only relate to genetics. And, I assume those genetic effects would likely apply both to Maori and PI populations. For instance, the tendency for people from a Polynesian background to have higher BMIs, and the associated negative health outcomes that result.
But, while there may be a higher prevalence of individuals with high BMIs in Polynesian groups (including Maori), they also exist in other ethnicities.
Other factors that aren't genetic have to logically fit into the socio-economic basket which affects many people from a variety of ethnicities, though represented more highly by Maori and PI.
So, I think it is possible to set a specification of relevant factors, including genetic ones, that do not specify race or ethnicity at all, but still capture the target populations that are at most need.
If there is an issue of access, then that surely comes down to factors such as distance from health care, education etc. Surely, it is better to ensure those factors are correct in the first place. Because then a lot of problems can be solved before operations are even needed.
I just explained that ethnicity is also about culture, in addition to ancestry. Being treated differently in the health system arises in part because people treat Māori differently based on perception and belief. Māori trying to access a system that doesn't understand their needs is Māori would be another example.
While it's possible separate out genetics sometimes, in a healthcare setting like a surgical ward, both factors are at play and it's just not feasible to ask Māori to leave culture at the door (although that is often what is done).
Yes, which is why clinical relevance is one of the criteria.
nope. Socioeconomic class is considered in the deprivation consideration. It's distinct from ethnicity. You don't have to be poor to get worse healthcare, you just have to be Polynesian.
Meanwhile, the criteria were named in the article, and including ethnicity has good rationales that you haven't addressed. Your system would have bias against poor Māori conpared to poor Pākehā. Which is what we have now.
But I agree with you in terms of root causes.
The issues you have outlined aren't really to do with the final surgical outcomes, which is where the controversy is. It is more to do with accessing the health system in the first place. I think that is the first issue that needs to be solved.
We could prioritise Maori and PIs in terms of surgery as much as we like, and the actual health outcomes may not improve all that much. Simply because the access problem has not been solved, so many slip through the net. And, if the behavioural aspects related to various conditions persist, then people may well lose the benefit of any health interventions fairly quickly any way.
But, I still don't think we need to focus on ethnicity. I think we need to focus on ensuring there is adequate doctors, for instance, in poorer areas so symptoms can be quickly identified, and ensuring people get good education about symptoms to look out for etc. And good education about how to prevent risk factors. For instance, smoking cessation interventions in communities with high smoking rates etc.
Opportunity of access used to solely depend upon capacity (and need)…now opportunity of access first depends upon (declared) ethnicity…that is not equality.
As capacity continues to decline the preferred ethnicity will obviously access the diminished access…that is where your backlash will present, as it already is.
Equity my arse.
I've not seen anything that says access first depends on ethnicity. So please present compelling evidence for your statement or withdraw it.
https://www.immunise.health.nz/about-vaccines/nz-immunisations/flu-influenza-vaccine/#free
https://www.timetoscreen.nz/bowel-screening/50-74-screening-maori-and-pacific-people/
[you know better than that. Present your argument, use quotes, and back it up with the relevant link. I don’t have time to read whole webpages to try and parse your argument, the onus os on you – weka]
mod note.
Presumably there are agreed and reasonably robust criteria for identifying Māori Kiwis, otherwise it would be difficult to produce reliable statistics on the inequitous health and longevity outcomes for Māori and non-Māori.
It's just that whenever I read a list of questions that suggest improving something (anything) now might not be straightforward, I get the feeling that the authors of such lists are pretty comfortable with the status quo. Just a feeling, of course – perhaps there are Māori health experts who have raised questions similar to yours @1.2.1.1.
I keep telling you you need to vote Green.
As I have mentioned previously, I have signed a couple of Greenpeace petitions before. Voting Greens is probably a bit of a stretch lol.
But, as far as I am concerned, good ideas are good ideas. It doesn't matter which side of the fence they come from.
From personal experience of a friend being told to "Come back if it gets worse", and having to pay for "no service".. I insisted she got tests or a second opinion.
A silence then Marina Maori woman aged 56 was grudgingly given a blood tests script. Result….
Diabetes and after further tests thyroid cancer. The delays are not always caused by the patient.
Now if they are saying, because Maori die earlier, 56 may be 63/4 and therefore race should be considered….but it is so triggering to the treat everyone the same = equity group. That actually favours the longer lived Europeans and Asians. imo
Note Marina died 2 years later, a year after her husband. Neither lived to receive the pension, but that is another race based equity battle for another day.
Inequities exist right across government for Maori.
This was recognised in the 80's for welfare with John Rangihuna's report Puao-Te-Ata-Tu and continues today in health and justice well outlined in documents such as Pharmac's equity report.
https://pharmac.govt.nz/assets/achieving-medicine-access-equity-in-aotearoa-new-zealand-towards-a-theory-of-change.pdf
Any outrage that steps are being taken to address this in different organisations should be treated as the faux-outrage that it is and that it stems from either ignorance or racist dog-whistling.
The same bull-shit about about what makes a Maori, how do you prioritise, what if little white me misses out, etc has been trotted out for years and years while the actual practise has been well established.
Maori identity in NZ is is based upon direct whakapapa and self identification. Long may it stay that way. It is a cultural identification. It has nothing to do with race because as we all know, and as Darwin rightly said race is a non-sensical construct.
Darwin gently ribs them, pointing out that the range of races was anything between one and 63, depending on who’s counting.
Instead, he concludes, with typically voluminous evidence, that all races are indeed one species, and that proposed boundaries of physical or behavioural characteristics that separated the races were false, and the differences we see are graduated between different populations. He argues against racial essentialism – the idea that racial characteristics are fixed in populations.
The overseas experience of having to have a percentage of blood leads to silly situations esp for mixed race people where parents are deemed to be of one race and their children are not.
Prioritisation based on positive discrimination has always been on the basis of all things being equal and having a limited resource choice then you give precedence to the disadvantaged group.
That limited resource may be a job vacancy, a position on a course, an operation of which only so many are funded, the vaccine medication – which still didn't get it right by ignoring the broader issue of larger families, increased over crowding etc which meant you should have prioritised the whole family not just an age related occupant.
These things are not new and have been in place for years and years.
Employers do this sort of negative prioritisation all the time by flicking out the foreign name sounding CV's, or those over 50, or those who said something the employer doesn't like on facebook or blacklisting those who have taken personal grievances.
Where there are equity issues are in things like hospitals having people in them on staff who look like me and who can relate to me. Health has a long, long way to go with this. Once upon a time children of doctors were prioritised for medical school, children of chemists were next off the rank. As few doctors were Maori sufficient numbers could not get into medical school – regardless of ability as there simply were no spaces.
Maori were generous in giving land for hospitals and schools. Many of those rural hospitals and schools have been closed by successive governments meaning access is limited and more difficult. We talk about access as an individual problem but in reality it is us who chose not to fund rural health – and continue to make that choice.
It will take time to build up capacity for Maori to be more involved in health service provision to Maori. That we choose to try and do it seperately is also a failure – an inability to recruit, train and integrate into existing systems, and to once when in that system a preference to mould that person into a system image rather than have the system change.
I'd agree with you Molly, but I'd like to see the wording of the directive, as it might just be being misrepresented.
What we must acknowledge, and the medicos as well must recognise this, are the two decades of inequality that have elapsed since the first report (that I know of).
A good outcome will be that it is recognised that Māori did suffer for a long time with unequal treatment.
I am a prostate cancer survivor, and was treated quickly and well to achieve that status.
I am not happy to have been so well treated when I discovered later that my Māori brothers with prostate cancer for example were not afforded equal opportunities.
Here’s an example of academic studies/ https://www.otago.ac.nz/otago832492.pdf
The source of my original information, reports all available on the Web, was actually my surgeon who addressed a prostate survivor's group and mentioned this injustice.
He was aware but within the NZ context it continued.
To add some more information to the 'inequality' of health provision, I would add another learning gained from Tom Scott's book on Charles Upham, VC and bar.
Scott mentioned that Māori soldiers returning from WW2 were excluded from rehab loans. That has just been in the news recently also.
Upham himself would have been outraged as Scott mentioned his hatred of racism towards Māori.
Thanks for the pdf, Mac1. I agree with need to scrutinise the wording, but given there has been indications of ethnic preference in Covid response, it doesn't appear to be a policy that has no precedents.
IF – this is in any way enacted – then it is entirely the wrong response for addressing inequity, because the solution itself contains inequity. Having some kind of universal rating system that is transparent, would be a responsive and equitable solution.
I'll have a closer look at the pdf and the references contained within. But my criticism of the solution proposed remains the same.
Fair enough, Molly. My research, such as it is, brings me to the conclusion now that perhaps in order for Māori to achieve equality in a system adjudged racist by a Pakeha oncologist, there needs to be 'preferential' treatment to get to equality since the contributing factors I outline in my opinion below at 1.3.2.1 will still apply, I'm sure.
It's already being enacted. Doctors in Auckland have been instructed to take race into consideration in establishing medical priority for treatment since the beginning of the year.
From the original article
Belladonna, what factors were considered beside ethnicity in the three diagnoses and prioritising? The article doesn't say- BUT there are more factors.
I am surprized that your surgeon is politicizing treatment Mac 1 I.e talking to patients about Maori access to health care. This is inappropriate in my opinion. By all means let him lobby whoever to get better treatment, but talking to vulnerable patients who have just had a brush with cancer?? Frankly I think that is disgraceful.
About 15 years ago when there was a scheme for free counselling (six sessions could be accessed via Primary Health Care). Funding was cut and the service only became available to those under 25 years and Maori.
So prioritizing people by race has been going on for sometime. My friend who is a psychologist told me about this. She said suitability for therapy was based on so many factors (not everyone benefits). So the race criteria was arbitary and not helpful.
Of course as the health system continues to run down under Labour, it is likely that treatment will become less available to us all. My own example a case in point. I will need to have cataract surgery in the next year or two. I asked my optician how easy it was to access on the public health. Almost impossible was her reply. Relatively easy 5 years ago. I have many, many other stories like this re the public health system. Try not to need an MRI in Dunedin. The wait times go into the hundreds.
[“About 15 years ago when there was a scheme for free counselling (six sessions could be accessed via Primary Health Care). Funding was cut and the service only became available to those under 25 years and Maori”
Because this is a controversial political topic, please provide evidence for this. This needs to be reliable evidence, not ‘someone said’ evidence. Quote and links. If you cannot provide evidence, then please withdraw this claim of fact. In premod until either of these two things happen – weka]
Hi Anker, I have posted one citation above. Here's another. This is also in reply to your 1.4 below.
https://www.otago.ac.nz/wellington/departments/publichealth/research/cancercontrol/OTAGO660412
The studies I found went back to 2002-2005 btw and therefore encompass both National and Labour terms of government.
I recently wrote the following in a short newsletter article, inspired as I wrote above by my oncologist who said very plainly, "The New Zealand health system is racist'.
BTW, if stating the truth is 'politicising' then we should all be politicians!
"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."
Mac 1 I would agree that financial and geographical access plays a role in healthcare outcomes.
What do you think it means that there are cultural barriers to healthcare?
As for lung cancer. Maori have much higher rates of smoking than Pakeha. I will try and find the link, but this does account for the discrepancy.
Ayesha Verrall's Beehive press release, 17 Nov 2022, states that Maori daily smoking rates for 2021/22 were almost 20% for Maori, and a little more than 18% for Pacific people.
Europeans came in at 7.2% and Asian people 2.6%.
why do you think that is?
Comcare in Christchurch provides wrap-round support for mental health clients, including housing services. I was told the Maori population of Christchurch was ~7%, while around half of Comcare's clients were Maori.
Regarding cataracts, where you live has an impact. In the town I'm in, last year a 60 yo friend got their one eye cataract done within 4 months of diagnosis by the optician, through the public health system.
I live in a big city t Wiggle. I am lucky I will find a way to afford the operations and I won't go on a waiting list because there are people who won't have a hope in hell of getting the op done privately.
Good luck! My friend described their first few days post-surgery as hallucinogenically coloured!
Me too. I pay for health insurance because my eyes are rubbish.
I had cataract surgery last year and it took 6 months and about 4 visits to get all the measurements done so that the right sort of lens could be constructed. At one stage, my opthalmologist said to me "this machine is calibrated to measure from 0 to 20. You are minus 4".
It took 3 years to get the corneal graft right in my other eye about 20 years ago. I got very used to seeing someone advancing on my eye with a scalpel and a pair of tweezers.
If I was in the public system, I may end up under the knife in a demonstration class, but otherwise – I don't think it would cope. Fortunately, I can afford to pay for it at the moment.
mod note.
Hi anker, I put your last 4 comments into spam because you haven’t responded to the mod note above. Can you please respond now. I’d also like to know if you know how to use the Replies tab on TS so that you can see when a moderator has replied to you. thanks.
Ok I see this mod note.
I am not sure I can find a link for it. It is one of my inside information quotes. I know it to be true, but can't disclose the source. I accept this may not meet the standards for evidence on TS
I asked you to either provide evidence or withdraw the claim, and you have done neither. Instead you have doubled down by saying you know it is true.
The problem is that you made a serious claim you are not willing to back up and did so in a hot topic conversation. You are right that it doesn't meet the standards here for debate, but my concern is that you will do similar again instead of respect the ethos here and that this will create more work for the mods.
It's not about you accepting that your comment doesn't meet the standards, it's about what the moderators have to do to stop people from misleading debate in this way. It looks to me like you don't understand why this matters and think that your own view is the priority.
There is no obligation on you to make claims that can't be substantiated, there is however an obligation to provide back up when asked. In other words, if you cannot back up your claims of fact were you to be asked, then please don't make them!
This is an issue with a number of people and I will add it to the moderation post I am writing (and see if I can explain it more clearly).
Same with the 1914-18 war..
Returning maori were excluded from what returning pakeha soldiers received..
That was over 100 years ago…and I am not maori…
But that racist injustice to those who put their lives on the line..(what more could any individual do for their country..than put their life in jeopardy..in its defence?)
That really really pisses me off..
And for me the treatment of maori soldiers after both world wars.. (apart from land theft)..
is the most egregious racism/injustice inflicted upon maori…
You say that
"I am not happy to have been so well treated when I discovered later that my Māori brothers with prostate cancer for example were not afforded equal opportunities.".
Would you be equally willing to say that
"I would be happy to have had my urgently required cancer treatment delayed by six months in order that my Māori brothers with less serious requirements should be treated first".
If not, why not?
The fact that one group of people were badly treated in the past requires that other people who have some characteristics in common with them should now be treated more rapidly is not the same as saying that in the future treatment in the future should be colour blind.
See my 1.2.1.1. I have a feeling that NZ in parts needs to be seen to be doing, or aspire to be doing, more than it needs in order to achieve equality.
In terms of voice projection in a theatre I was told as an actor to project my voice to a spot beyond the last row in the audience.
That way, the inattentive, the hard of hearing, and the general audience would hear.
In terms of race and equality, we surely have our inattentive and hard of hearing……..
I'm afraid 1.2.1.1 was by tsmithfield.
1.3.1.1. Thanks, Alwyn.
I have spent some time wrestling with your last paragraph in 1.3.4
But I now see that you left out after 'more rapidly" the comparison "than others" which would have made perfect sense. I saw the other meaning of "more rapidly" as a simple comparative adverb.
There's a lesson in there about how what we write and read can be misinterpreted. That of course is the main topic of all this thread- namely, what did the Auckland surgeons get told exactly and have Barry Soper and the Herald represented the issue fairly? Weka brought us back to this point way down at 9.2.1
Yes. I wasn't happy with the convoluted sentence I wrote at the time. Adding "than others" would have been a distinct improvement. It is what I meant.
As far as what the surgeons were told I thought this email was pretty clear.
"An email by Te Whatu Ora business support manager Daniel Hayes in April said: “Hi team, Heads up. This is going to be the new criteria for outsourcing your patients going forward. Just putting this on your radar now so that you can begin to line up patients accordingly. Over 200 days for Māori and Pacific patients. Over 250 days for all other patients.”
https://www.nzherald.co.nz/nz/auckland-surgeons-must-now-consider-ethnicity-in-prioritising-patients-for-operations-some-are-not-happy/ONGOC263IFCF3LADSRR6VTGQWE/
Once again, is this the complete email? Is this the only instruction given? Into what context is this 'heads up' to be inserted?
I'm not a corporate language speaker so don't know the answer to this question, but does a 'heads up' imply that more detailed instructions will follow? If so, what did they say?
The way the email is phrased seems like it is a response to an earlier query? If so, what was that query and what information and knowledge is assumed to be held by 'the team"?
The further detail in the press release does mention 5 factors to be considered. The article also acknowledges that timeliness is an issue, and if there is still an issue about much later times when a Māori presents for this kind of prioritising, then that is definitely a factor to be considered.
The reports I read related that reporting times for Māori with symptoms was generally later, due to factors such as fear, locality, distance, and culture.
Culture might include "don't make a fuss", "don't put yourself forward of the needs of others" or blokish "man up" or "don't wanna know" avoidance of possible difficulties especially with parts of the body that are barely mentioned, let alone examined. My uncle talked about "problems with the waterworks, boy".
Some men also do not help other men to get to a doctor by puerile behaviour in raising fears about DREs.
That example in the Herald article about two Māori men getting advancement above a Middle Eastern man only mentioned the time factor. None of the other four factors and their possible bearing on the priority decision was mentioned.
If men for example are reporting for prostate problems later through these factors then that time elapse needs to be factored in.
In my case as I went through the system with two separate diagnoses and treatments for both bladder and prostate cancer, four in all, I noticed that the official letter of diagnosis and outlining treatment stared with a paragraph describing me the patient, not in terms of these factors but more about my personality and value to the community.
It did make me wonder whether there is a different measure of triage that is not mentioned officially…….
Thanks for posting Molly.
What is the evidence that they have had historically had unequal access to healthcare?
Now when Seymour or Luxon call it out, wait for the "racist dog whistle" crowd to pile on.
We have ideologues in Te Whatu Ora. Expect more of this rubbish
Are you effing kidding anker..?
You are calling for evidence that maori have traditionally had unequal access to heathcare..?
Like I said..are you effing kidding..?
There are indications that Māori have accessed healthcare unequally. What hasn't been determined is exactly why.
Regardless, the goal that should be sought is to improve the access for all, and ensure equal treatment for all. Not provide a solution built on inequity due to ethnicity.
"Like I said..are you effing kidding..?"
This type of response is getting tiresome to read.
I had a similar response tbf. At this point in history, it's very strange to see politically commentary that doubts that Māori and Pasifica face additional barriers to health care that cannot be explained in other ways (eg poverty).
tbf yes Weka
thanks Molly. Saved me from having to respond.
For the record Phillip I guess my lens is coloured by being married to a Maori and seeing what happens to his family. And I also did provide evidence about Maori getting access to counselling that Pakeha weren't entitled to
There's no doubt that Māori have been less likely to receive early referral and effective healthcare. Even now, being Māori and poor is a double disadvantage in receiving healthcare. At an individual level though, why should anyone have delayed care just because of who they are?
If you want to see economic and ethnic inequality in action, spend a day watching who walks in and out of public hospitals and then spend the next day doing the same at a large private hospital.
Aside from dealing with structural and personal ethnic bias against Māori, the most effective way of addressing inequality in health without shuffling poor health and low life expectancy among the disadvantaged is to remove private healthcare.
Or, give free sign up to private healthcare providers to Māori and other people living in poverty.
I understand the inequities faced by those who have access to private healthcare options, and those that don't.
But the issue here is the provision of state funded healthcare and how it should be implemented.
I'm not disagreeing with you – transferring resorces from one group in need to another group in need has always bugged me, whatever the service.
I'm saying the priotitisation is fraught and uneven and will continue to be that way for as long as we have a 2-tiered system – and practitioner bias, wherever they work..
However, research also shows a level of bias in who gets to be seen in the first place but this policy is a blunt tool that will harm social cohesion. E.g. in a research project I was doing, I was going to interview an older Māori woman. A nurse in the department said "no point in putting her on your list, she wont's turn up, she's Māori." I put her on my list, she did turn up, I interviewed her, and yes, she's Māori and she had missed appts – because:
But yeah, she missed appts because she was Māori, not for any of the circumstances above, according to the nurse. Until we get that kind of bias out of the health system – and it's pretty common from what I can tell, maybe we have to make some rules around who is prioritised.
The problem with the ethnicity tool is it's blunt, and does nothing tom improve social cohesion, or inclusion (just like private hospitals, it will probably make it worse).
I'd be surprised if they're prioritising Māori and Pasifika on the basis of ethnicity. From what I can tell, the decision makers now have to take ethnicity into account alongside other factors. It's not like there is a stream for Polynesians and a stream for everyone else.
I suspect that you are right Weka.
There are some genuine cases where ethnicity affects purely clinical decision-making. The example of differences in how hypertension should be treated in African Americans versus Caucasians has been known about for ages.
Then there are second-order effects of ethnicity – where ethnicity is a marker for other things with a clinical effect – such as deprivation which might result in a more rapid decline of untreated patients or poorer recovery after treatment because of the affordability of follow up care.
Both of these things are valid considerations in my opinion. What would not be acceptable is having two clinically-equivalent patients (bearing in mind the factors just discussed) where one is prioritised over the other on the basis of ethnicity. Clinical equivalence of that type is probably only a theoretical possibility not a real one. But that doesn't stop it being the jumping off point for an anxiety about positive discrimination, especially in a febrile political environment where parties of the Right want to stoke the myth of Maori Privilege – not because they really believe it's happening, but because what they want the political power to reset the economy into a direction that favours them.
If actual positive discrimination is happening (which I doubt), it’s a silly mistake and a weak cop-out. The problem of historical injustice is not solved by creating an additional injustice within a process like healthcare. It is solved by removing all the causes of that historical injustice in the present – ending poverty would be a good start.
"What would not be acceptable is having two clinically-equivalent patients (bearing in mind the factors just discussed) where one is prioritised over the other on the basis of ethnicity."
and yet we are doing exactly that constantly
I expect that’s the situation too. However, just like 3 Waters and co-governance, it’s going to be reported as a Māori privilege.
Let’s not forget the 7-year gap in life expectancy of Māori vs. non-Māori. Only when this gap has been closed can we truly speak of ‘privilege’. Until then, anybody who ignores this vital fact [pun intended] is too lazy to think, too ignorant, or simply just disingenuous.
There is also a three and a half year gap in life expectancy of men and women in New Zealand. Should we pay men their super earliar, or give them priority for medical care?
After all, wouldn't you think that "anybody who ignores this vital fact [pun intended] is too lazy to think, too ignorant, or simply just disingenuous."?
I’d definitely prioritise men over women with prostate cancer. Perhaps you prefer a mammogram and want to identify as a woman to get one instead of getting a digital rectal examination.
Question for you: have you surpassed the average life expectancy of a Māori male yet?
It looks like you and some others here aka the usual suspects are acting as disingenuous trolls again. I do feel like a good winter clean-out of trolls, until after the general election. Are you volunteering because you have already self-identified as a prime candidate?
Woman can’t get prostate cancer.
Transgender women can get prostate cancer. I don't think that was Incognito's point, though.
IMHO Trans women are not women.
And no, the point of Incognitos reply was to use their mod privilege to bully people they disagree with. They have form.
Incognito, having had a prostatectomy, I therefore no longer fear, if I ever did, a digital rectal examination.
But, I sometimes think there is some sort of correlation of fear between those who fear DREs and those who fear Te Tiriti, te reo rangatira and co-governance.
In the immortal words of Lance-corporal Jones in 'Dad's Army' ………..(and I don't mean "Don't panic Don't panic!")
They don't like it up em?
First prize a week in Warmington-on-Sea. 🙂
For old time's sake:
https://en.wikipedia.org/wiki/The_Royal_Train
My sides are aching just reading the story. Absolute classic series.
Mrs Mac1 and I have just watched the episode, series 6 episode 3 which we recorded recently. Very funny. The episode is actually 50 years old, being first broadcast in 1973. Lots of panic but not much up'em! Walmington-on-Sea btw. Jones in fine comedic form.
Both you and weka are completely fucking out of control as moderators. It is blatantly obvious and I am loosing count of how many good faith and acceptable contributors you have either burned off or intimidated. You have both had too much power for too long, immune to any criticism or accountability.
I have pondered this a week or so now and I will no longer falsify my words to please you.
I know exactly what you are going to do next – you are going to ban me for 'undermining your integrity as a moderator'. Except that you did that to yourself.
[If weka and I are out of control, as you claim, then we will cop it. Until then, your commenting privileges have been removed until further notice, because neither weka nor I should put up with this kind of shit from you or anybody else, no matter who you are.
I trust you know how to contact Lynn – plead your case with him, if you wish – Incognito]
Mod note
There is also a 5 year gap between Asian males and the male population as a whole. Perhaps non Asian males should get their super earlier, or get priority for medical care.
Some people just need a little more help than others, is all.
Who wouldn't choose a life of Maari privilege – alas, ethnicity is a lottery.
"A basic foundation of well-being and dignity for all, with people at the center, not money." – frightful !
“ethnicity is a lottery.”
Oh indeed it is. I am of an ethnic minority that suffers poorer health outcomes than others. The reasons are complex, and require more nuanced solutions than race based preference.
Privilege and it's effects are in our face(s) – we need only look.
What we know about inequality of outcomes suggests (to me) that timely solutions are needed. As for "more nuanced solutions", why not, just as long as that's not code for yet more ‘back to the drawing board‘ delay to change. We've known about these iniquitous outcomes longer than we’ve known about anthropogenic climate change, ffs.
“Current debates that seek to revive animosities between ‘iwi’ vs ‘Kiwi,’ for example, are classic Cartesian devices – anachronistic, divisive colonial throwbacks.”
Has poverty been taken into account in that equation?
A good number of Māori suffer from poverty compared to non-Māori.
https://www.imperial.ac.uk/news/189149/poorest-dying-nearly-years-younger-than/
Rob Campbell weighs in at the Herald
"No one I have seen, or heard has argued that clinical judgments must not dominate here. (Noting that differences in access and nature of facilities also play a role in different outcomes and need to be addressed in design and operational process as many are).
If there are persistent and widespread imbalances in waiting lists between different populations, then anything but the most narrow of clinical judgments would regard that as something to be taken into account in prioritising.
Remember that the private hospitals are not, shall we say to be generous, weighted in their services towards Māori and Pasifika patients."
A good piece. Thanks for linking
"No one I have seen, or heard has argued that clinical judgments must not dominate here."
If you dont look you wont find.
If you are deprioritised in a rationed system then you dont receive service until the need is acute (if at all).
Health is personal and rationing on the basis of arbitrary measures (in this instance, cultural identity) must therefore override clinical judgement.
Yes. I had a similar reaction.
Consideration for surgery should be based on the urgency or otherwise of the patients. Other factors might need to be taken into account but to give priority to the ethnicity of the patient is asking for trouble.
I find it hard to believe that public hospitals in NZ make surgery choices based on ethnicities. It may have happened in the past but those days have long gone. So what is the purpose of resurrecting a past grievance that has already been corrected.
It encourages racist comment in reverse.
There may be some factors such as actual access – ie. distance from healthcare, cost prohibitors, aversion to attendance – that play a part in inequities.
Determining factors that do play a part, and addressing those factors benefits both those who access healthcare and those who deliver it.
The different DHB's had different responses and timeframes for treatment for similar ailments. Depending on the diagnosis, someone living in Central Auckland might have had a noticeably different diagnositic and treatment experience, than someone living in the Manukau District Health Board. Due to ethnic demographics in both areas, differences could relate to address – rather than ethnicity itself.
The amalgamation of the DHBs may have addressed that in some way.
Thanks Molly
A good summing up of the differentials involved between urban and rural communities and the differing experiences related to certain DHBs at least in the past.
Chris Hipkins at his weekly press conference has now explained the full intention of the measure and what provision of services it covers. He has also asked the Health Ministry (I think it was the ministry) to look at the provisions announced to ensure they are the most appropriate available. [I have paraphrased so hope I am reporting what he said correctly.]
It looks to me like another example of a new policy announcement which has not been satisfactorily presented to the public. Who is to blame? Time will tell.
All sorts of things will be taken into account when making decisions about surgery.
Health status e.g smoking, weight, blood pressure are most likely important. These indicate that surgery increases risk for adverse events.
It is morally reprehensible, it is medically unethical, unjustifiable and utterly unacceptable.
The only people I've seen try to defend this policy and others like it are the most one eyed tribal labour supporters, criticizing doctors for speaking up. Oy vey.
Policies like these cause deep divisions, distrust and anger in our society.
Medical access is supposed to be based off need not box ticking and the admin for this is going to be extremely expensive.
TWO/Health NZ is about as popular with medical professionals and IT professionals as a bucket of cold sick.
Reforming the public health system during a pandemic was peak foolishness, and reforming it based off failed UK reforms was mind bogglingly stupid.
It's hated by everyone in the medical field. Again the only people who defend it are the most one eyed tribal labour supporters, orrr the bureaucracy hired to oversea it.
And this issue sums up just about everything wrong with public health and govt services in NZ ATM:
There's far too many bureaucrats, consultants, community outreach, managers, PR, Hr, advisors and business managers like Hayes, and not enough nurses or doctors.
The 6th Labour govt has been a horrible failure when it comes to delivery in our public services.
Labour has been obsessed with spending up large and going on in management and hr hiring sprees to reform the internal culture of our government agencies rather than hiring front line staff and improving delivery.
How the hell, are our state agencies work forces all bigger than they've ever been before, with larger budgets than they've ever had before, with more staff than ever before but have worse service than ever before.
No NZ govt department will ever answer a god damn phone and as someone who has been dealing with USA/Canadian Govt agencies lately, I nearly fainted when they actually answered the phone a couple minutes on hold….
Usually it's a couple hours (if at all here)
Tldr we need more front line staff, less backroom staff and need to focus on improving delivery above all else…. And this morally indefensible shit needs to be thrown out, it's election losing shit.
When you see how much more money we spend on corey state services and how much the delivery of those service has deteriorated, because govt isn't hiring front line it's hiring backroom, it's hard to disagree with nat/act that a massive purge of the civil service is needed, especially when you see the disgusting ideas some of these middle management types come up with… Like racial profiling in surgeries in NZ… In…2023…. Disgusting.
We haven't used that as sole criteria for a long time. Budget is a big factor (which is why we have waiting lists). But here's the list from the article,
Whoever is making the decision has to factor all of those in, not just clinical need alone. And they're working within the constraints of infrastructure, staff and budget.
What crap generalizations, I work for Te Whatu Ora, I don't hate it, it has huge benefits for NZ, the change has been seamless.
NZ health care has always been race based, whites first.
‘Seamless’? Are you joking?
Are you joking? what's your point?
The claim was ‘the change has been seamless’. This is easily refuted, as there have been numerous examples of transition problems with TWO, including inaccurate and out of date data (https://www.rnz.co.nz/news/national/491572/health-data-out-of-date-after-inaccurate-figures-pulled-from-te-whatu-ora-website), the sacking of the Chair of Health NZ (https://www.rnz.co.nz/news/political/485021/health-nz-chairperson-rob-campbell-fired-over-politicised-comments-health-minister-says), a CV lack of transparency (https://businessdesk.co.nz/article/health/delayed-and-forgotten-oias-what-we-did-not-learn-from-te-whatu-ora), and overt political bias (https://www.newshub.co.nz/home/politics/2023/03/revealed-health-minister-dr-ayesha-verrall-s-inappropriate-puff-profile-publication-cost-14k.html).
This op piece casts more light on the situation:
https://businessdesk.co.nz/article/opinion/healthcare-the-next-policy-mess-that-needs-to-go-on-hipkins-bonfire-1
Without increased specialist capacity I would expect it is going up. We have an aging population with the first baby boomers turning 80 in a couple of years.
I'm expecting it to rapidly accelerate.
Should have been training and bonding more people twenty years ago. Health already has one of the oldest workforce in NZ which will be exacerbating the problem.
No doubt if National gets in they will do their usual trick of kicking people off the waiting lists.
Were people upset when Bill English prioritised children? Did old white people go full Moving Pictures on him.
Health Minister Bill English announced today that children would be given priority on hospital waiting lists for assessments and surgery with the new money the Government was planning to allocate to elective surgery.
"Children deserve the best possible start in life and this Government is committed to improving child health. Making children a priority on waiting lists is only one area we need to work on, but it shows the Government is determined to make a difference for children."
https://www.beehive.govt.nz/release/children-get-priority-waiting-lists
An aging population doesn’t explain a near 17 fold increase in people waiting for first specialist assessments.
Without knowing how many have had them it isn't possible to tell that.
You need to know demand, actualisation and supply.
You then need to understand the increase in demand – it may be health, it might be greater expectation from a labour government, it might be that National's strategy of telling people we won't put you on the waiting list if you are going to get one within six months is a better strategy that understates demand but better matches to realistic likelihood, it might be playing catch-up after not being able to go during COVID-19 lock downs etc.
Going by the change in A&E residents I'd strongly suggest some is an aging population.
“Without knowing how many have had them it isn't possible to tell that.”
Had what?? This is about the number of people waiting for first assessments. An aging population cannot account for a 16 fold increase in 2.5 years.
Have you got proof this is labours directive, Corey
Lots of racists come out of the woodwork today.
Sadly for them this approach is supported by actual surgeons. Maybe not by the ex-South African one locally who is also a racist snot I guess.
The Royal Australasian College of Surgeons has spoken out about the new surgery wait-list rank system, explaining this isn’t about putting Māori and Pacific health above the health of other people, rather it’s about reducing existing health institutional bias.
Although the college did not have a hand in developing the scale, it supports its use as a means to provide “fairer access and treatment to surgical patients”.
https://www.nzherald.co.nz/nz/surgeon-organisation-backs-surgical-ranking-policy-says-it-reduces-institutional-biases/EOV33GU5XJCKDGNIVVQRKIRYLY/
And as for Alwyn little bit of racist ranting.
Right. I am going to identify as being Maori and insist on getting priority medical treatment.
It isn't my father that is missing from a birth certificate but there is one of my ancestors who was in this situation. No father given.
Like those men who self-identify as female I am going, from now on, to identify as Maori. Let them prove otherwise if they don't want to prioritise my operation.
Look forward to you heading off to the marae you claim to whakapapa from and helping out. Yours is the argument racists fall back on after the quantum one has failed. Apparently white people can only think in binary – either there aren't any full blooded Maori any more or we are all Maori if we want to be. It isn't like you give a shit about better outcomes for Maori in any way shape or form.
Treatment under our health system must be colour blind, like our justice system is meant to be.
lol. Quite. The whole point is that it isn't (health or justice). Māori do badly in both systems, because of the systems.
So black people now have a lower priority for surgery?
I'm loving how many of you have jump on the race aspect – makes me wonder did you actually read how it's being implemented?
But at least those fixated on not giving people a hand up are outing themselves on this site. Week in and week out.
National's gun control policy supports ACT's position, and will pass firearms licencing to COLFO, the gun users organisation for which ACT's McKee was previously spokesperson.
After 'the Government's gun laws reforms following the Christchurch terror attacks. COLFO at the time "suggested that members hold on to banned firearms." '
Nick@Stray dog, 9.20 AM 27th April, 2021
Guns for Gangs!
I live close to the local Deerstalkers Assn Hall, and think one of them, who hires the hall for social gatherings, is a (discrete) gang member and a Deerstalkers member, both.
China’s Xi Jinping backs ‘just cause’ of Palestinian statehood
"A solution to the Israeli-Palestinian conflict lies in the establishment of an “independent Palestinian state based on the 1967 borders with East Jerusalem as its capital”, Xi was quoted as saying by Chinese state media"
https://www.aljazeera.com/news/2023/6/14/chinas-xi-jinping-backs-just-cause-of-palestinian-statehood
Well at least one or two of the major powers are ready to go in and bat for the poor Palestinians….it is just a plain fact that the West has failed them totally, in fact the West has failed in The Middle East full stop…and failed in Africa and in Latin America, and of course who can forget our many unjust and destructive actions in East Asia… little wonder they are all open to alternative diplomacy and partnerships.
Brics is looking like it will be the back bone of this new World trade alliance..who knows, maybe this will bring in something less ultra aggressive than the USA and her allies have been on to the world stage for the past century…lets hope so, because it is happening whether we in the West like it or not.
"In the next five years, Bloomberg predicts that the Brics countries (acronym for Brazil, Russia, India, China and South Africa) will increase their share of the global economy to nearly 35%, beating the world’s strongest economic conglomerate —the G7 countries (US, Canada, France, Germany, Italy, Japan, UK)."
https://www.funds-europe.com/insights/a-new-brics-currency
https://elements.visualcapitalist.com/de-dollarization-more-countries-seek-alternatives-to-the-u-s-dollar/
This is a good backgrounder to a n international shift from $US as the international trade currency. It has implications for the US economy, and for US debt. "Currently, central banks still hold about 60% of their foreign exchange reserves in dollars."
"Concerned about America’s dominance over the global financial system and the country’s ability to ‘weaponize’ it, other nations have been testing alternatives to reduce the dollar’s hegemony.
As the United States and other Western nations imposed economic sanctions against Russia in response to its invasion of Ukraine, Moscow and the Chinese government have been teaming up to reduce reliance on the dollar and to establish cooperation between their financial systems."
Thanks, will check that link out..
..yeah it is kind of ironic that the massive sanctions piled onto Russia by the West, is looking like it could well be in the future, be historically regarded as the tipping point that ended Western hegemony…a real self goal of epic proportions.
Yup.
Confusion reigns over whether Meng Foon has or has not resigned as Race Relations Conciliator. He claims he has not, yet (and it seems clear that he doesn't want to), Russell says he has (or she'll fire him)
…
https://www.nzherald.co.nz/nz/race-relations-commissioner-meng-foon-reveals-he-hasnt-formally-resigned-and-makes-call-for-explanation-of-potential-removal/SIPXQVFEJRE7DBNEKXYGE5YXMY/
This is amusing. An official normally resigns via a formal letter, right? Such conventions are part of the process of our democracy.
https://www.rnz.co.nz/news/national/492119/meng-foon-resigns-as-race-relations-commissioner
So RNZ published this anonymous report that he'd resigned. Anon due to the author seeking refuge from accountability??
Perhaps RNZ has another disinformation agent lurking in the woodwork. Perhaps an entire infestation ecosystem?
Was she being naughty & telling a fib? Will someone demand she produce evidence she was telling the truth? Will the news media actually do their job??
And here's the latest:
So Hipkins has a leaker in his office. Will he do something about that?? And while it's encouraging that the govt apparently didn't make an idiot into the Race Relations Commissioner, they may have appointed a Don Quixote:
Oughta make a good reality tv show.
Well, she has to get someone to write it, eh? Then it will have to be run past govt lawyers to see if it's fit for purpose. Could land on some manager's desk & get shuffled under a pile of other letters. Best not to hold our breath waiting.
You can see why he's bewildered, if he's being expected to conform to some official document that doesn't actually exist…
If this did indeed leak from Hipkins office – he should be justifiably furious.
Really, really poor behaviour and lack of loyalty.
He's protected them from the Nash fallout, and from the Wood one (in both cases, staffers made politically poor decisions and/or failed to refer issues to him in a timely manner).
Third time (that we know of). Gloves should be off, and dismissals (or transfers to filing in the basement) should be happening.
Whoever the leaker is – they've created a political storm which could have been entirely unnecessary. Hipkins should have had the time to call Russell and Foon into his office – and get them to sort it out – without political bloodshed (if possible). And for his government to form a coherent political policy on conflicts of interest (why is Foon's worse than Wood's, for example).
Instead, he's got a potential duel on the front pages of the media.
I cannot believe that there are right-wing moles in the leader's office. So this can only be internal white-anting.
Happening right now, transforming potential into actuality:
Whether it will lead the news tonight on both channels depends if some other shit hits the fan or not…
The Platform has been given a document dump by Foon, and he’s on with Sean Plunkett at 9.00 tomorrow morning.
Sounds like he is an entitled attention seeker to me.
How hard is it to write a resignation letter?
How on earth can this be an issue with the government when this idiot has a genuine COI (unlike Wood's) which he failed to declare, agreed to resign because of this, and then is incapable of writing a 5 minute resignation letter?
entitled
I get the impression he feels entitled to know the legal basis of his prospective resignation. He isn't aware of doing something wrong.
https://www.rnz.co.nz/news/political/492264/meng-foon-says-government-handling-of-resignation-absolute-shambles
Reading the tea-leaves here, it looks like he was seeking advice on due process. His courtesy note to the PM Friday morn apparently remains un-answered. Perhaps the PM sought legal advice & the lawyers are in a huddle trying to figure it out??
I'd say his problem seems to stem from oddly thinking that a declaration of a conflict of interest is a one-off role related duty – rather than individual event related duty.
Someone attending or chairing a particular event (meeting, policy discussion, etc) isn't gong to know about the general declaration he might have made a year ago.
He should know better being mayor previously.
I do wonder these things are occurring because landlording has been so normalised amongst the landlord ruling class that is isn't seen as anything like a conflict cause everyone is doing it – at lease everyone they mix with. Doesn't even enter their little landlording heads that it might be.
Oh dear Denis Frank……what particular piece of policy or legislation has Meng Foon upset the Govt or Hon Russell over?
And as far as the offending conflict of interest notification is concerned, I worked years with statutory boards, as company or board secretary and with staff who might have potential conflicts. The conflicts of interest register we operated, to best legal precedent and advice from the PM's dept had a requirement to enter the conflict once.
Once it was entered it stood for all time and often/usually the Chair noted the idea that XXX & yyyy may have a conflict. Most people stood themselves out, as I feel Meng Foon would have, had there been a day to day requirement to that was not covered by his existing declaration.
The Chair had the CoI register with him at every meeting and at every meeting when controversial subjects came up would ask for advice of CoI. There was usually a convo saying you will note my earlier declaration etc etc. These were always written up in the minutes.
Sounds very much like the old forced resignations of yore when staff found that they were managed/magiced out of a job with the twinkling or waving of a letter they had been forced to sign. For staff, constructive dismissal has a lengthy Tribunal precedential history against this practice.
I know Ministerial appointments are subject to complete Ministerial whim, more's the pity, often based on rumour that such & such a statutory chair is a Nat or Labour supporter…..depending on who is in power…
The Race Relations Commissioner is appointed by the GG on the recommendation of the Minister of Justice so one would have thought any resignation process would have been carried out with care and attention and extending goodwill to the incumbent. I have seen a postion description but I cannot see the date of this. This says the usual term is 5 years. He has time from 2019 (4 years) but surely if a person is doing a good job then an extension for another term from 2024 could be useful.
I know also in days of yore when there were Ministerial appointments coming up, it was done in a caring, compassionate way with letters of thanks and thanks meetings taking place with the appointing Minister.
This failed in spectacular fashion when I was working close to a Board Chair. His term came up & he received nothing (no thanks or reappointment) except to note a couple of his board members had been reappointed. (only because they came to his office to let him know.)
His was not a political appointment, he was a lay person with highly specialised qualifications that were needed. He had been appointed by a National Minister & received no thanks from a National Minister.
To say I found a guy close to tears would not have been far wrong. I tried to tell him that the process may have got away on the Minister/staff/department and he would be formally advised. Right up to the time of his death, eight years later, this former chair person had not received any thanks from the people/person who appointed him.
As with anything if people are treated badly one looks for the 'grown -up' in the process. The grown up there was the Minister and if he had not known better then some of his staff should have.
The grown-ups seem to have gone to ground and left those who may not have good manners and knowledge of good admin procedures holding the fort. To my mind this is arrogance and can catch out longer serving Governments, as it clearly did in my example above. People just become expendable.
And talking of Conflicts of Interest I note that the possible conflict of interest by Paul Hunt, who has been a signatory to a pro trans declaration, did not seem to stop him from coming out most strongly against the ability of women to meet a la Posy Parker, and pro the lovey dovey festival once the pesky women wanting to talk women's issues were out of the way…..in Wellington.
https://en.wikipedia.org/wiki/Yogyakarta_Principles
https://tikatangata.org.nz/news/no-human-right-eclipses-another-is-lesson-from-parker
And a bit of an acid view from Karl du Fresne
http://karldufresne.blogspot.com/2023/03/new-zealands-most-useless-public-servant.html
I was puzzled over the issue of what actually happened – did he resign or not. The murk around conflicts of interest is too subjective to opine on, for me. Situation now clarified…
So while Foon thought he was entering the process of resigning, and seeking legal clarification of the basis for doing so, lawyers told the PM his language in the email meant he had (inadvertently) resigned – by saying he was resigning.
There must be established case law indicating that declaring intent to resign trumps actually doing so?? Lawyers being wackydoodle…
Sounds a bit mocking/spoofy to me or he the first person ever to receive anything substantial from MSD that needs declaring? Or does MSD not stand for Ministry of Social Development?
Surely an intention to resign or thought he may resign not followed up by the actual formal resignation is not a resignation.
Sounds a bit like a storm/teacup but once people have got the bit between their teeth they see CoIs etc everywhere? Sarc/:
Surely an intention to resign or thought he may resign not followed up by the actual formal resignation is not a resignation.
That's my view too, and seemingly his until the PM clarified the govt position today, which Foon now seems to accept.
My take is that formality is now too old-fashioned to believe in. Govt & lawyers are making it up as they go along, 21st-century style. Sir Geoffrey will not be amused by this. He may harumph quite loudly…
"If this did indeed leak from Hipkins' office".
It may have been directly from Hipkins himself. He may have been told that Foon had said he would resign, rather than that he would resign in preference to being sacked and he repeated it.
In that case it wouldn't have been a leak. After all he is PM and in the immortal words of one of his illustrious predecessors, By definition I cannot leak
The ginger Elvis is back.
Queens of the Stone Age release their new album "In Times New Roman…" on the 16th June.
Here is a live concert from a few days ago. Very tight performance and a happy looking band.
Imo little as it means, Chris Isaak (his tv show The Chris Isaak Show was another to go virtually unnoticed)and Josh Homme should have made greater cut thru in the misic business, not sure if it was their decisions or others as to why their quintin tarantino coolness isn’t matched
https://en.m.wikipedia.org/wiki/The_Chris_Isaak_Show
So Ginny (our Police Minister) has had a go at our justice system. See link below.
https://www.newshub.co.nz/home/politics/2023/06/police-minister-ginny-andersen-attacks-new-zealand-s-prison-system-says-it-s-no-place-for-m-ori-offenders.html
As poverty is a driver of crime, will she also have a go at our welfare system and Finance Minister for not better funding it?
Anybody know what the Justice Minister has to say about it? Moreover, what she plans to do to make improvements?
Additionally, is this a move towards a race based justice system?
What is Labour's justice policy regarding Maori? Easy enough to find out…
https://www.labour.org.nz/justice
"One key part of the strategy is the Māori Pathways programme – a ground-breaking series of initiatives underway around the country that are designed in partnership with Māori to reduce reoffending and improve outcomes for whānau. We have launched Māori Pathways in Christchurch Women’s Prison, Northland Regional Corrections Facility and Hawke’s Bay Regional Prison. We’re also replacing Upper Waikeria prison with a modern design, including a 100-bed mental health and addiction facility."
That last bit’s really important, due to the heavy penetration of meth into Maori rural communities.
That wasn't one of my questions but thanks for your input.
Can you tell me what the success rate is for the Māori Pathways programme?
Indeed. And not only due to the heavy penetration but also its related impact on crime. Therefore, I take it you'd also be disappointed with this failure to deliver – see link below.
https://www.newshub.co.nz/home/politics/2023/06/government-set-to-break-methamphetamine-programme-rollout-promise.html
I doubt that she can speak publicly about another Minister's portfolio.
What is a race based justice system?
The Minister said:
Then went on to say:
https://www.newshub.co.nz/home/politics/2023/06/police-minister-ginny-andersen-attacks-new-zealand-s-prison-system-says-it-s-no-place-for-m-ori-offenders.html
So she seems to be having a go at the justice system and corrections.
The Corrections Minister, the Police Minister, the Justice Minister and the Health Minister should all be putting pressure on the Welfare Minister and the Finance Minister to sort out poverty. As poverty has a negative impact on their portfolios.
A race based justice system is where one is openly treated differently based on race.
As opposed to being treated differently in a closed way? It's already a race based system, we just aren't honest about it.
One doesn't justify the other.
actually it does, that's the point. If there is bias in a system against a particular ethnic group, then one way of solving that is to redress that systemic bias. To some people this looks like 'race based' something or other, but all it's doing is attempting to remove the bias.
AB's comment earlier has a good differentiation between addressing inequity and positive discrimination.
.https://thestandard.org.nz/open-mike-19-06-2023/#comment-1955177
Introducing bias to address bias is not solving bias.
taking an abstract philosophical position when people are being harmed in real life is a form of bias.
Nonsense
It's not an abstract philosophical position. It's a logical position.
Solving bias requires it to be addressed head on. Call it out and correct it from where it stems.
Being logical doesn't mean it's not abstract.
I am calling it out. The problem is systemic racism. You are avoiding looking at that, and the your philosophical position is an aid in that.
You may be calling it out but you also seem to be willing to accept it as some sort of counter measure thinking that is solving it. Is that correct?
Because it's not solving it.
Systemic racism. I'm not avoiding looking at that. I'm saying you won't solve it by adding more bias. That will only fuel the fire.
You say the problem is systemic racism. Therefore, to solve it you must directly address that, not merely attempt to offset it with further bias.
Seems to me that is avoiding the problem.
Positive discrimination has been around for years and is part of the solution.
FFS it is worth about 2 points out of 100 in terms of prioritisation. Enough to make a subtle difference not enough to not have overall medical need as the primary consideration.
It isn't like the moaners about this are putting up any viable solutions – like pay more tax so more operations can be done or to bring services closer to the communities they serve or to actively recruit and train staff from those communities. They are the same people that oppose services for Maori by Maori and pretty much any attempt to solve these disparities.
They are pretty good at blaming the individual – don't turn up to appointments, access services late, etc almost like the system itself. Our local hospital got closed as part of the Douglas reforms and it wasn't unusual to travel 2 hours to hospital and find your appointment was cancelled but they couldn't get hold of you – cause you were travelling 2 hours leaving at 6:30 in the morning, or to be greeted with the ever welcoming "what are you still living in that shithole for". A predominantly Maori population who once had a good rural hospital.
The argument that it is not helping solve it is non-sensical. If their is capacity to do 100 operations and currently only 13 Maori can access those operations when 20 should be and this means 15 now do it is part of the solution. That 2 non-Maori have to wait longer is always going to happen regardless of the method used. Pulling names out of a hat could equally be viable. A small tweak to shift the balance is just that.
Bill English did a similar thing to prioritise children. That is what governments do – prioritise resources to particular groups to help solve particular problems. All governments do it.
You may disagree on the prioritisation but that is why you elect different governments. Pretending that the world is going to end because there is some prioritisation of Maori or Pacifika in order to address systemic difficulties and currently worse outcomes for those communities is just nonsense.
More of the iwi/kiwi bullshit.
And, having looked at systemic racism in Aotearoa NZ, what are your timely solutions for "directly addressing that" – assuming you can see systemic racism, and cause-and-effect relationships between systemic racism and iniquitous health outcomes for some Kiwis.
Here's a link to a thought-provoking NZMJ viewpoint, written by two Kiwi health professionals – makes you think?
Challenging stuff (for me), but what do 'they' know. And wot DoS said.
Sorry Chair, I couldn’t bring myself to read beyond "So Ginny (our Police Minister)".
Some interesting All Black selections. It loos well rounded though and generally based on form.
Nerve wracking 4 -5 months ahead of us.
Foster's selections are as baffling as ever. He says he wants us to be more direct and quicker, but he picks a nobody from Canterbury at second five and has gone out of his way over the past four years to not select or scapegoat the direct options. Laumape, Fainga'anuku, Aumua – "direct" options all – have all been treated shabbily or ignored by Foster. I don't know what some of those lazy, gutless wonders in the Blues forward pack have to do to get dropped. Beauden Barrett? I think Foster would pick him even if he had a leg amputated. He has had a dreadful season. It obvious – Barret has lost his pace and with that his confidence has gone.
But anyway, ""more direct and faster" just seems code for trying harder to do what hasn't worked since the 2017 Lions worked Hansen out.
Foster is a bad coach. His tactics are so stale even Argentina worked him out. His selections and management appointments are so loyal they have veered in crony mediocrity. His selections have been bizarre for four years now, with a ton of players who have worked out that the All Blacks set up under Foster has become a chummocracy that smells of boiled cabbage having left to go offshore.
Still, I think we'll beat the French, who'll be over-confident, and probably make it to the semifinals cos we have got the Saffa's number in the head department. And our journey will end there.
Neanderthal in-fighting update: https://www.stuff.co.nz/national/politics/300908441/political-party-democracynz-in-turmoil-after-candidate-exodus
The far-right in kiwiland often looks like a rabble due to lack of consensus on a political brand to unify the disparate elements. You could go with the Fundamentalist Freedom Front (FFF)…
Embarrassing that Leighton's party is called The Leighton Baker Party. Me First.
Even Winston Peters didn't stoop that low. Last I read, Baker was struggling to sign on enough members at $20 a pop to reach the 500 member/$10000 threshhold.
Mihingarangi Forbes
https://twitter.com/Mihi_Forbes/status/1670513323882991616
It's systemic, both health access and media coverage. This means that the systems are structured in such a way as to create barriers. We could change that.
It feels like prioritizing surgery by ethnicity is actually an ambulance at the bottom of the cliff approach designed to obscure the fact that the real issues are poverty and access to appropriate and timely primary healthcare.
Sadly from what I hear Te Whatu Ora have pulled or heavily reduced funding to a number of community health organizations that did a heap of the heavy lifting during covid and are actually well placed to help address a bunch of the issues around access.
I suspect that the answer to number of the issues sits with funding small community based service providers that are embedded in the community rather than top down edicts from bloated national bodies.
I tend to agree. Problem is, when Clark’s Labour government tried to fund in that way, there was a racist backlash and the funding got axed. Sad we are still so bad at this, including apparently on the left.
Concentrating on ethnicity is a real mistake imho the focus needs to be around class. Poverty is what drives the horrific and worsening outcomes in New Zealand. Everything else is just obfusticating that undeniable fact.
I disagree. Two working class people, one Māori the other Pākehā, both face class based barriers. The Māori person faces ethnicity based ones too. Ethnicity factors in at least two important ways: one is that the system is structurally prejudiced against Māori in terms of assessment and treatment. The other is that even if the system weren't that, it would still be designed around Pākehā needs, which is an additional barrier for many Māori.
An example. How family can access patients in hospital is based around Pākehā family structures and needs, not whānau extended family structures and needs. Isolating Māori from their whānau makes it harder for that person to navigate the system, deal with the stress, make good decisions.
The good news is that if we change that part of the system, it benefits everyone.
in case it's not obvious, we should definitely be addressing socioeconomic class issues, including within the health system.
Due to cultural, societial and govt policies at the time and still exist there is a large number of people out there who are missing predominately their paternal but can also be their maternal lineage. This is due to factors like no father being listed on the birth certificate, adoption etc. if we are going to have ethnicity as a contributing factor for the basis of delivering resources what of these people ?? Or do we say they look european/Asian /Māori/PI so deliver based on appearance ?? And even if you are aware of the missing family link but it is not documented or there is no accountability/acceptance by the father to acknowledge ?? Do then accept another injustice ???
what’s the another injustice?
Where due to fathers names missing on birth cert (Plus those adopted) – Those children have lost their paternal link. I am predominately thinking of the instance where there is a un recorded Maori/PI father and an European mother. There are many out there who this example fits !!!
Right. I am going to identify as being Maori and insist on getting priority medical treatment.
It isn't my father that is missing from a birth certificate but there is one of my ancestors who was in this situation. No father given.
Like those men who self-identify as female I am going, from now on, to identify as Maori. Let them prove otherwise if they don't want to prioritise my operation.
Sounds reasonable Alwyn and if anyone has an issue with your identification you can complain that you are the victim of a hate crime.
Pretty racist, but because of the rise of the ACT party that shit just flies in today's New Zealand.
2021 RNZ report on worse outcomes for Maori during trauma care
"Māori youth aged 15-18…were over three times more likely to die in the 30 days following major trauma than non-Māori in the same age group. Overall, it found Māori were 56 percent more likely than non-Māori to die in the first month after a major trauma, excluding serious brain injury.
Māori were 37% more likely to not receive a CT scan, which is used to assess and understand the severity of the trauma and has an impact on mortality outcomes…"I think every clinician would like to think [unconscious bias] doesn't have a role to play but there's a chance to examine not only your own hospital but also yourself and have a think about those questions."
We know unconscious bias exists for treatment of women compared with men. I don’t believe the criterion of ethnicity was added to the evaluation guidelines simply for woke reasons. A 3x increased chance of dying is huge.
A '2018 study found that doctors often view men with chronic pain as “brave” or “stoic,” but view women with chronic pain as “emotional” or “hysterical.”…doctors [of both sexes] were more likely to treat women’s pain as a product of a mental health condition.'
I get where you are coming from, what im trying to get across is to make the political focus class based, within that the solutions could be informed from a maori world view and from the view of other marginlized communties.
Its about finding things that work. Currently we're just generating animosity and no real solutions.
I agree our current approach is causing problems, and likely to get worse as the world crises deepen. Using a class based approach and finding Māori and Pasifika world view within that is an interesting idea. Can say more about that?
Yes we have to own our built in racism and call it when we see it.
Of note in OM today is that we are relying on a MSM article and not a lot else, and people are forming strong opinions on the basis of that.
From Health New Zealand has introduced an Equity Adjustor Score, which aims to reduce inequity in the system by using an algorithm to prioritise patients according to multiple criteria, one of which is ethnicity, to prioritizing [sic] surgery by ethnicity.
//
This paragraph from a Spinoff article on a study examining medical bias in NZ seems to capture the crux of the race-based debate going on here.
'Here, it’s important to note that “population specific needs” is not a term that supports biological determinism, which is the concept that biology is the defining factor in health risks and outcomes – a concept that leads straight to eugenics. Biologically, ethnic groups are not fundamentally different from one another. Research shows that the use of ethnicity as a determinant of health is actually a stand-in for many other complex issues. Rather than being a purely biological difference, ethnicity often dictates how we are perceived by others, and therefore how we are treated.'
Ar 9.37 I wrote, "but I'd like to see the wording of the directive, as it might just be being misrepresented."
I haven't seen anyone give any evidence to what Barry Soper wrote in that MSM article.
What did the agency say, and what did it mean?
The Herald ought to be ashamed.
Trying to use a teacher’s reaction to a teenage trans student as a wedge issue by putting it at the top of their page and emphasising religion in their headline.
Not often acknowledged by those banging on about keeping children in bathrooms safe is that trans teens suffer terrible mental health consequences and high suicide rates.
Re-publicising and hyping this story can only affect its original victim. Shame on you.
https://www.nzherald.co.nz/nz/christian-teacher-stripped-of-registration-after-refusing-to-use-trans-students-pronouns/WFGT2FVSSNGGDGY4ZEQ5U2E74I/
The headline is certainly misleading. We need to read a long way through the article to find out what really bothers this teacher …
The teacher’s submissions also comprised what he believed was the “obvious next sin” after transitioning, which he claimed was homosexuality.
He also presented to the tribunal multiple examples of scripture from the Bible that read “man should only lie with a woman” and homosexuality steps away from “God’s plan”.
So, not really about pronouns at all.
The teacher went as far as comparing changing one’s name to potential circumstances of a child identifying as a different race, an animal – “a cat, a dog or a dinosaur,” or as “Your Honour.”
“Compelling me to call a girl student by a boy's name is asking me to go against my core Christian belief, the belief that is also foundational for New Zealand,” he said.
Bigot. Gives Christians a bad name.
And I notice there has been a lot of flapping from the usual suspects about ethnicity being included as one of the criteria for the speed required on surgery.
I have a modest proposal to bring us to more equality in ethnic health outcome statistics and it would possibly help the housing market too…