The level of underfunding of Māori primary healthcare provided ‘by Māori’ has finally been calculated in a ground-breaking 66-page document handed over to the government on Monday.
The report was commissioned by six Waitangi Tribunal claimants (Wai 1315 and Wai 2687) who, along with several members of an expert advisory group on the report, briefed the Minister of Health and Associate Minister late last week.
The government was also asked to commit to negotiating compensation with the Māori health organisations.
The findings by independent research group Sapere were based on extensive evidence extrapolated back to 2003 and provide a robust formula that indicates significant historical underfunding to Māori primary health organisations and providers.
To demonstrate the magnitude of the underfunding, the report calculates that, for a group of Māori providers with an enrolled population of 332,051, the losses could be as high as $531 million (this calculation is based on a test population only, and not the whole Māori population).
The report also indicated the proper investment into sector leading "by Māori" primary healthcare was $1 billion a year and the cost to the country of not making this investment has been $5 billion a year.
Put the wrong right
It also calculated the level of investment required to achieve the promises made in the 2001 Primary Health Care Strategy and the cost of the significant inequities borne by Māori.
“The government has known about this deficit for years. It admitted it to the Waitangi Tribunal but didn’t do anything, so now is the time to put that wrong right,” National Urban Māori Authority chair Lady Tureiti Moxon says.
The claimant group, which comprised Lady Tureiti Moxon, Janice Kuka, Taitimu Maipi, Hakopa Paul, Simon Royal and Henare Mason, expects the report will lead both to continued discussions with the government and ministers over compensation for the underfunding and should be a baseline for the government in determining funding for a new Māori Health Authority.
One of the original claimants, Taitimu Maipi, says the pursuit of mana motuhake and the ability for Māori to lead and implement health initiatives for its people has always been the primary motivation.
Another claimant, Janice Kuka, the managing director of Ngā Mataapuna Oranga, says she has witnessed first-hand the impact on whānau and hauora Māori that have carried the social and financial burden of an underfunded health system.
“This inequity was constantly made known to the government. They in turn have ignored us or put in place numerous working groups that went nowhere. This report now places more value on our future,” Kuka says.
Māori bore the brunt
Claimant Simon Royal, chief executive of the National Hauora Coalition, believes the report backs up the 2019 Waitangi Tribunal findings.
“The report shows the significant funding challenges we and other Māori providers have faced since 2002 while we aim to deliver primary health care services that actually work for whānau Māori,” Royal says.
A future focus that is self-determining is echoed by Maipi.
“This report gives independent findings to our claims we advocated in the Waitangi Tribunal, that Māori bore the brunt of a failed and racist New Zealand health system. Let's bring on the health reforms that are Iiwi/Māori designed, owned and operated," he says.
Redress is also on the minds of others.
"My tūpuna of Ngāti Pikiao were humiliated and accused of fraud by the Crown trying to stand up a Māori primary health organisation. This report validates, in the very least an apology to my Iwi," Paul says.
“Our view is that this report resets and recalibrates how Māori health is valued. It offers a principled funding framework to support the new Māori Health Authority to succeed. We’ve used an approach that the government already uses as standard practice,” Moxon says.