I Stuart, Ōpōtiki

In his letter, The Highest Court in the Land (Beacon, November 20), D Dawson  rails against Te Pati Māori for it’s vocal opposition to a bill introduced by David Seymour, which Mr Dawson claims seeks equal rights for every New Zealand. Mr Dawson ends with his demand for equal rights for all.  

Such a demand is hard to disagree with, but clearly there is opposition – so let us look at these issues.    

Data and reports from our public institutions clearly demonstrate they do not treat people equally now, to the detriment of Māori.  

So, let’s look at three significant ones: police, courts and health care intuitions.

The police’s own report into their actions Understanding Policing Delivery 2024 demonstrates inequities, including for Māori and other ethnic groups, and disabled people, in interactions with NZ Police.  

An earlier report showed that police interacting with Māori are more likely to make an arrest than when interacting with non-Māori for the same actions. Once arrested, they are more likely to be charged with an offence than non-Māori.  

The Justice Department’s own report, Over-representation of Māori in the criminal justice system (available at https://www.corrections.govt.nz/resources/research/over-representation-of-maori-in-the-criminal-justice-system) shows that Māori taken to court are more likely to be convicted than non-Māori, for the same actions, and once convicted are more likely to be treated more harshly than non-Māori.  

As a former court reporter (not in the BOP) I have seen this in action. I have seen non-Māori given a fine or maybe probation for the same offence for which a Māori offender was jailed.  

Turning to health services, the bias against Māori is more obvious. There are many research reports which demonstrate the inequities of our health system.  

The easy to read What You Can’t See can Hurt You  – How do stereotyping, implicit bias and stereotype threat affect Mäori health? (available online) provides a compendium of the research findings (complete with references to original research)

These studies found that:

n Māori cancer patients were significantly less likely than other ethnic groups to receive chemotherapy and were more likely to experience a delay of at least eight weeks before starting chemotherapy.

n Māori men are less likely to receive medical intervention for cardiac disease compared with Pākehā men.

n Māori are less likely to receive screening for, and treatment of, ischaemic heart disease.

n Māori women are less likely to receive pain relief during labour and childbirth than Pākehā women. A different study found that Pākehā doctors spent 17 percent less time interviewing Māori than patients from other ethnic groups.

n All Māori men (150) diagnosed with prostate cancer in the Midland Cancer Network region between 2007 and 2010 were identified and age-matched with a comparison group of New Zealand European men.

Māori men were managed less proactively, suggesting that these differences were likely to be a “direct consequence of these ethnic differences in medical management”.

n Further studies have found that Māori spend more time on waiting lists than non-Māori. (this can only happen if non-Māori are moved ahead of Māori on the waiting list).

n In one of the most appalling findings, a survey released in 2018 showed Māori, Pacifica and Indian,  premature babies were less likely to be resuscitated (NZ Herald, Oct 13, 2018).

The 10-year study showed a disturbing ethnic divide – resuscitation was tried on 92 percent of Māori babies, 89 percent of Pacific and 86 percent of Indian. That compared to 95 percent for “other” – mostly Pākehā and non-Indian Asians. Medical experts say the numbers were significant.

The Perinatal and Maternal Mortality Review Committee concluded that institutional bias or implicit biases played a part. That response looks like a cop-out. A doctor is holding a new-born premature baby with the possibility of life – but decided not to even try? Now, admittedly this data is six years old – and we have no idea what the current situation is, but the fact that this happened at all is appalling.

Well aware of these inequities, in an attempt to address these issues, Te Whatu Ora in 2023 introduced an Equity Adjustor Score, which aimed to reduce inequity in the system by using an algorithm to prioritise patients according to clinical priority, time spent on the waitlist, geographic location (isolated areas), ethnicity, and deprivation level.  

Many people objected, saying that ethnicity should never play a part in health delivery, a position I agree with.  

In the uproar, Te Whatu Ora was forced to remove the ethnicity requirement. However, the reality is that our health system is demonstrably riddled with inequities. To say ethnicity must not count is to ignore that reality of what is occurring. It also stymies any discussion of these inequities.  

In a tragic demonstration of these inequities, in August, 2023 Māori woman Jane Brunt went to the Gisborne Hospital Emergency Department, dizzy and in pain.  She had a history of heart issue.  

This woman was left unseen in the waiting area, despite her partner’s repeated and unsuccessful attempts to get her seen by ED staff.  

Finally, she collapsed and subsequently died. In August this year, Te Whatu Ora apologised to her family and cited “unconscious bias” for her lack of treatment and death.

So, now we have a new label for our lexicon.

“Unconscious bias” now sits alongside “systemic racism” and other such labels. Perhaps unconscious bias is more palatable for non-Māori, but bias remains bias, whatever the label.  

Commenting on the death, Dr Elana Curtis, who led the most comprehensive research into inequities in emergency departments, said: “The death rate for Māori within 10 days of presenting to an ED is higher, significantly higher, than non-Māori. The odds were 60 percent higher for Māori,” Dr Curtis said.

That’s a shocking finding. An identifiable portion of our citizens are 60 percent more likely to die in emergency situations, and being treated by medical staff, than citizens not in that ethnicity.

Perhaps if the medical staff had considered Jane Brunt’s ethnicity, as Te Whatu Ora had suggested, she might still be alive today.  

This clearly demonstrates that the health system does not treat Māori the same as it does non-Māori.  

There is no equality. Similar data can be found in other institutions, such as the education system and other social agencies.

Now, let us look at the second statement in the proposed bill. That there is no special treatment except by Waitangi Tribunal decisions.

If this bill is accepted into law (and I do not accept that it will be) these two provisions will be used to block any attempts to redress the current situation, to make all these public institutes treat all New Zealanders equally.

Just as Te Whatu Ora tried to get medical staff to think about (not do anything, but rather think about the ethnicity of their patients).  

With the charge of special treatment these public institutions will be able to maintain their current biased treatment of Māori.

Māori are not asking for “special treatment” by any of our government departments and public institutions.  

Māori are asking for the same (equal) treatment as non-Māori. They are demonstrably not receiving equal treatment now.  

How many more of our citizens have to die at the hands of our demonstrably biased health systems? How many more of our citizens have to go to jail because of their ethnicity?  

This bill allows people like David Seymour, and his ilk, to smugly claim they are not racist, while they continue to fight to support and maintain a demonstrably “biased” system. It is said that actions speak louder than words. Seymour’s actions should certainly speak louder than words.  

For D Dawson’s demand for equal rights to have any credibility, Mr Dawson must oppose the Treaty principles bill and support (at least morally support) those who are working for equality in all our public institutions and government policy.

I Stuart

Ōpōtiki