Te Tiriti, me & HQSC…oh…and you

Kiri Rikihana Group Manager MRC Secretariat

May 2019

Te Tiriti ... the school years

Te Tiriti... The Uni years

Te Tiriti ... The 90s & 2000s

The picture today 2019…

Te Tiriti and Equity...

“My core priority as Minister of Health is improved equity of

health outcomes and New Zealanders experience” Hon David Clark, Minister of Health, 1 August 2018.

“Achieving equity within the New Zealand health system

underpins all of my priorities….Māori-Crown relations is a priority for this Government and I expect the HQSC to meet Treaty of Waitangi obligations. “Letter of Expectation , Hon David Clark, Minister of Health, 13 March 2019.

The relationship ....

Te Tiriti o Waitangi

• Rangatiratanga

• Kawanatanga

• Oritetanga

• Wairuatanga

Partnership Protection Participation

You can influence...• The person is not the diagnosis

• Shared understanding- language has meaning

• Whānau inclusion- involve whānau

• Community leaders- endorse leadership and lived experience

• Stigma & shame- use language that inspires not insult

• Healing and treating – Rongoa AND Medical

• Information – Records to the patients & whānau

• Joined up care- Collaboration of primary & secondary

• Make contact – a kawa for engagement

• Beyond crises – A focus on recovery and wellness

Institutional racism I define racism as a system of structuring

opportunity and assigning value based on the social interpretation of how one looks (which is

what we call “race”), that unfairly disadvantages some individuals and

communities, unfairly advantages other

individuals and communities, and saps the

strength of the whole society through the waste of human resources

Dr Camara Jones (2016)

What are our thought leaders saying ?

• Explicitly design policies for equity

• Hold healthcare systems accountable

• Address determinants of health

• Share power with racial minorities and indigenous peoples

• Have free, frank and fearless discussions about racism Chin et al (2018)

Summary 1. Whakapapa connects everything

2. It’s been said before – the Treaty is a foundation for good health

3. The legal and evidential foundation for the Treaty in public policy has been well established

4. The economic and social state of Māori health makes action unavoidable

5. The Treaty has the potential to be a powerful improvement framework

Health systems have a role in creating and exacerbating inequities

Wayne J Riley