The Waitangi Tribunal recently released the results from stage one of its inquiry into Māori grievances relating to health services and outcomes of national significance. Stage one's hearings ran from October to December 2018 and focused on aspects of primary health care, which includes services provided in the community by general practitioners, nurses, pharmacists, counsellors, dentists and others.
The report addresses claims concerning the way the primary health care system in New Zealand has been legislated, administered, funded and monitored by the Crown since the passing of the New Zealand Public Health and Disability Act 2000, and explores whether the persistent inequitable health outcomes of Māori are indicators of a breach of the Treaty of Waitangi.
Some of the key findings include:
- The policy framework that administers the primary health care sector fails to consistently state a commitment to achieving equity of health outcomes for Māori.
- Māori primary health organisations have been underfunded from the outset, and ongoing resourcing is a significant issue.
- The funding arrangements for the primary health care system disadvantage primary health organisations and providers that predominately serve high-needs populations, particularly Māori primary health organisations and providers.
- Despite the significant, persisting inequities that Māori experience, Māori health outcomes are not systematically separately measured and reported on.
- The primary health care framework does not recognise and properly provide for tino rangatiratanga and mana motuhake of hauora Māori.
The report makes a number of recommendations to address its findings and, while the focus is on health care and inequity rather than health research per se, it has important implications for the health research sector when it comes to how research is carried out and addressing health research gaps and priorities for Māori.
Stage two of the inquiry will cover three priority areas encompassing mental health (including suicide and self-harm), Māori with disabilities, and issues of alcohol, tobacco, and substance abuse. You can find further information about this on the Waitangi Tribunal website.
With the support of our research committees, over the last two years the Health Research Council has undertaken significant work revising our consideration of Māori responsiveness in the assessment of research proposals. This is to help ensure that health research in New Zealand is realising all opportunities to address Māori health inequities. We will be releasing further details of these changes shortly, along with guidelines to support health researchers to consider how their proposed research may contribute to Māori health advancement. These changes will be communicated to the health research community through multiple channels, including via our e-newsletter Update, our website, and discussions with research offices and research institutions.