Flavell Te Ururoa: Estimates Debate — In Committee 
Flavell Te Ururoa: Estimates Debate — In Committee 
[Volume:648;Page:17648] 
TE URUROA FLAVELL (Maori Party—Waiariki) 
: 
 Tena koe Madam Chairperson. Kia ora tatou katoa. The first sentence of the report of the Health Committee on the 2008/09 estimates for Vote Health should have made us feel pretty good. According to the Minister health expenditure has doubled in the past 9 years and New Zealand is beginning to see the results of this investment. Although that is great and I am all for results the funny thing is that the word “Maori” did not come up in the Health Committee report. Why should Maori be noted distinctively in this report? Because Maori are 18 percent more likely to get cancer and twice as likely to die from it; heart disease kills nearly twice as many Maori but they are only one-third as likely to have angioplasty; avoidable death rates are almost double for Maori than other New Zealanders; and on average Maori die 8 to 10 years earlier than non-Maori. Tema Whero—team Labour—is constantly crowing that the Government spends 1 in 5 tax dollars on health. So why is it that Maori obtain fewer referrals fewer diagnostic tests and less effective treatment plans? 
The Maori health statistics I quoted earlier paint a lousy picture. Where is the plan to address it? That is the question. The report of the Health Committee happily covers district health board deficits inherited deficits and operational deficits but the biggest deficit of all appears to be missing—that is the systematic deficit that we might call racism. There was perhaps one vague suggestion of this in the transcript of the discussion that took place on 25 June with the Minister and his merry men of the ministry—well to be fair there were a couple of women there as well. When responding to questions about the aged residential care industry the Minister raised the issue that wage rates are so low that turnover is very high and he concluded that there are “some very valid concerns about working conditions for the workforce many of whom tend to be Pasifika or Maori and that is not a situation which is either sustainable or proper.” We will give the Minister the benefit of the doubt and presume that it was the working conditions that were neither sustainable nor proper not the fact that the workforce is dominated by Pasifika and Maori. It is indeed neither sustainable nor proper that such gaping inequalities and levels of deprivation and deficit characterise Maori health within our national health system. 
What can be done to urgently turn the situation round? Well first off we have to get to grips with the reason why the Maori population is overwhelmingly dominant not only in the low-wage sector of the health workforce but also in every negative statistic across the health system. To help Dr Matire Harwood the director of Maori health for the Medical Research Institute suggests that the basis for such inequalities is found in the fact that racism is thriving in the health system. She describes three levels of racism that must be confronted. There is the systematic racism that drives inequalities and health determinants there is the one-on-one racism within the doctor-patient relationship and finally there is the level of internalised racism that is observed in individuals—in this case Maori feeling as if we do not deserve to have certain procedures. 
Although the media profiled these revelations of racism which Dr Harwood talked about just this morning on Radio Waatea the faces of racism are not exactly unknown to the State. I am thinking back to the report some 20 years ago called  
Puao-te-ata-tu 
—Day break 
 and it is fitting to refer to that ground-breaking report today on the day that Tuhoe have come to Parliament to sign an agreement with the Crown to settle their historic grievances. The group that produced  
Puao-te-ata-tu 
 was of course chaired by John Te Rangianiwaniwa Rangihau of Ngai Tuhoe who made a major contribution to the renaissance of tangata whenua through his work with Government departments as well as through the wananga he founded in culture and history for the people of the Tuhoe nation and wider.  
Puao-te-ata-tu 
instructed the Government that the most destructive form of racism is institutional racism—the outcome of monocultural institutions that simply ignore or freeze out the cultures of those who do not belong to the majority. Why is it that 20 years after Parliament received this report we are still witnessing the desperate statistics that constitute the crisis in Maori health care yet the Health Committee’s report neglects to even speak the name Maori out loud?