Getting healthcare right for Māori means getting it right for everybody

By MAS Team | 15 September 2020

Te ORA has been advocating for equitable health outcomes for Māori and Pasifika communities for more than 25 years. 

Māori patients and doctors alike face inequalities in the Aotearoa healthcare system, whether it's the inability for patients to access equitable care from healthcare providers or the barriers preventing Māori entering into higher realms of the profession. 

This year's pandemic and impending recession have heightened existing societal inequalities. Māori patients and Māori doctors are now faced with overcoming more hurdles to have their voices heard and to receive fair medical care. 

The Medical Association by Māori for Māori 

Since 1996, Te ORA has been supporting Māori and Pasifika medical practitioners in their ongoing efforts to achieve fair outcomes for Māori patients. 

Te ORA was started by a small group of Māori doctors who were teaching at Auckland Medical School, to provide pastoral and professional support to Māori medical practitioners. 

One of the organisation's founding members, Dr David Tipene-Leach, says Te ORA initially had two objectives. 

"One was looking after the pastoral care needs of Māori doctors and the other was looking after academic and professional needs. From there we began addressing wider Māori health issues and also dealing with the very low numbers of Māori in the medical profession."

Change is happening but there's always room for more

David says there have been positive developments in the number of Māori training in medicine since he was in medical school, but he says there is still a long way to go. 

"Medical schools have changed significantly – albeit with a bit of pushing. They took on new entry policies designed to more accurately represent New Zealand society, although there is still a part of our society that doesn't want to accept these changes, preferring an education system and entry process that offers no assistance to Māori students wishing to pursue medicine. 

"The education system and medical school entry criteria was firmly based on institutional racism and while that has changed a lot, institutional racism still underpins much of what Māori medical practitioners and patients are dealing with today. 

"A lot of medical care excludes Māori and Pasifika people completely because they do not meet stipulated criteria for care and in turn do not qualify for certain tests or procedures. This continues the cycle of poor access to care and inequitable outcomes," he says. 

Covid-19 disproportionately affected Māori 

David says the Covid-19 pandemic has been especially difficult for Māori doctors because they carry the weight of more than just their professional role – they have a responsibility to their community especially during times of uncertainty. 

"We have plenty of evidence that Māori doctors are being stretched really thin. While I readily acknowledge that health workers and essential workers across the board have all been really stretched by this pandemic, Māori doctors have a lot of additional pressure on them because they are thrust into these community leadership roles before their time."

David believes Māori patients' needs weren't taken into consideration throughout the handling of the pandemic either. 

Despite applauding the government's overall response to the pandemic, David remains disappointed when it comes to the lack of public health measures tailored to Māori and Pasifika communities. 

"When it came down to it – the government was generally not interested in a wide range of advice. They certainly didn't listen to any Māori or Pasifika public health experts," he says. 

Still waiting for a seat at the table

David hopes that the next government will begin to address some of the inequitable social determinants of health in New Zealand by reviewing things like screening for lung and bowel cancers and appropriate medicine for diabetes. 

But to produce more equitable outcomes for Māori communities, Māori doctors need to be invited into the planning room. 

"If you get it right for Māori, you get it right for everybody. Everybody benefits when you look after those who need it the most," David says. 

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