Flavell Te Ururoa: Estimates Debate — In Committee 
Flavell Te Ururoa: Estimates Debate — In Committee 
[Volume:632;Page:4298] 
TE URUROA FLAVELL (Maori Party—Waiariki) 
: 
 Tena tatou katoa. In the last month a number of ground-breaking reports have been released that add to the depressing chronicle of evidence about the state of health in Aotearoa. The Maori Party welcomes these reports; however they become drained of any moral value if we fail to act. The estimates debate is an opportunity for the Government to dare to act in the interests of the health of the nation. 
So let us set the scene. The world’s leading independent general medical journal  
The Lancet 
 surveyed over 10000 New Zealanders asking them about any incidents of discrimination when they approached a health professional. The study described the health system of this country as “racist and discriminating against Maori”. It claimed that 4.5 percent of Maori experienced unfair treatment by a health professional compared with just 1.5 percent of Pakeha. It stated: “The findings of this survey show that deprivation and experiences of perceived racial discrimination contribute to inequalities in health outcomes between Maori and Europeans. Indeed the combination of deprivation and discrimination as measured seems to account for much of the disparity in the health outcomes assessed.” 
The impact of multiple factors of disadvantage in limiting health outcomes has always been well understood by tangata whenua. Ngati Hine leader Moe Milne for example described te oranga o tangata whenua as being influenced by factors other than purely the absence of disease. She stated: “I was told ‘We lose our tangata whenua status when we don’t have whenua to stand on. We lose our whenua status when we don’t have tangata to stand on it.’ ” It is in this relationship of all the intersecting parts that the greatest damage lies. 
Reference is often made in this Chamber to the most vulnerable of our communities—the so-called welfare cheats the dole bludgers the welfare dependants and those who are said to be ripping off the system. But I have to ask who the greatest beneficiaries are. Who feels good about the theft of Maori resources—our waterways the land confiscations and the foreshore and seabed—and who feels bad? 
The relationship between health wealth and well-being is absolutely linked. The determinants of health are overlapping and multiple. Poverty intergenerational and lifestyle factors ethnicity racism and ill health are factors that are all related yet this Government persists in treating one factor in isolation. These are systemic issues. We are always told that people must take personal responsibility—and yes people must do that—but who in this Chamber will take personal responsibility for the creation and support of systems and policies that will guarantee disadvantage and that will not change the lives of the most disadvantaged? This Parliament is frequently swamped with accusation denial and decision makers who will not take responsibility for decisions they have made to create what to many of our people is an unjust system. If we are really to eliminate health disparities we need to address the institutionalised racism that reveals itself in the link between racism morbidity and mortality. We need to treat the health of the whanau as being intricately associated with the health of the individual—we need to make the associations and we need to act. 
The National Party must also stand up and take responsibility for its role in planting the seeds of racism amongst the public mind. I wonder how many members in this Chamber have had calls from Maori who are sitting in their homes listening to National members talk about Maori in terms of privilege and I wonder how that wounds the psyche of Maori people. The focus on so-called Maori and Pacific privilege is in itself creating disadvantage. That party is allowing people to talk about us in a negative way. That party is giving people permission to be racist and that must stop. 
Last week the Public Health Advisory Committee released its report called  
Health is Everyone’s Business 
. That report urged New Zealanders to rise to the challenge of reducing health disparities particularly between Maori and non-Maori. The committee advised the Government of the widening social and economic inequalities that are resulting in whole population groups being left behind. It described how in New Zealand ethnicity presents an independent and significant effect. The committee concluded that being Maori or Pacific further increases the risk of death or ill health across all socio-economic categories. I repeat—being Maori or Pacific further increases the risk of death or ill health across all socio-economic categories. If we were to say that being Pakeha further increased the risk of death or ill health would that be ignored? If we were to say that being an MP further increased the risk of death or ill health would attention be taken? So why is it that the association of being Maori or Pasifika with the risk of ill health and death is so casually described—almost taken for granted—as a universal assumption of truth? 
The Public Health Advisory Committee identified that there is no easy solution to health inequalities no quick fix no one-size-fits-all. Collaborative effort is required to address the social and economic determinants of health. Health cannot be treated in isolation. The final report released just a week ago proved that although poor health can be expected to lower living standards there was also evidence that poor living standards increase the risk of poor health. And who are the New Zealanders most at risk of poor living standards? Forty percent of Maori and 58 percent of Pacific people experience some degree of hardship compared with 19 percent of Europeans. That is not a gap; that is an ocean. 
Disparities emerge and grow from the overlapping disadvantages of racism and poor health and impoverished living standards and deprivation. If we add to those factors the variable of being Maori or Pacific the result will be severe and significant hardship. Yet the appropriation has allocated a measly $3 million to policy advice on reducing disparities in health status for Maori. Worse still there is no specific funding at all for Pasifika health. I like many others have heard all the excuses that the priority of better health for all perhaps means reducing inequalities for Maori Pasifika and those on low incomes without actually having to spell it out. Well I am a firm believer in spelling it out telling the truth and facing the facts. 
The reports I have spoken of today are not Maori Party documents. They are not the reports of Maori researchers academics or wananga graduates. They are not the reports of the United Nations special rapporteur. They are the reports of Professor Peter Davis of the University of Auckland of the Public Health Advisory Committee and of Ministry of Social Development. We must act decisively with courage and information to make the connections explicit and to treat the whole rather than the separate parts. Within Te Ao Maori we know we live the reality of taking into account all aspects of our spiritual physical social cultural intellectual and psychological selves when we consider the concept of health. Kaore te taha wairua i te tu i tona kotahi; the spiritual side does not stand by itself. We cannot divorce the water from the lake and still call it a lake. So we understand only too well the impact of multiple disadvantage—that everything is connected that nothing can be treated in isolation. Solutions must be all-embracing and inclusive. We must all take responsibility for being a part of that solution. I ask today: who in this Chamber will address the living conditions that create poverty misery and the underclass? Who in this Chamber is prepared to burst the septic boil of racism and stand up to protect the well-being of all? When will we invest in raising the standards of living? Only then will the state of health in Aotearoa be something we can all be proud of. Kia ora.