Will New Zealand’s health reforms improve respiratory care?


By Mardi Chapman

5 May 2022

New Zealanders are hoping a permanent Māori Health Authority will be able to close the gaps in asthma and other respiratory disease care.

According to the Asthma + Respiratory Foundation New Zealand, Māori are almost three times more likely to be hospitalised with asthma than other New Zealanders, and Pacific peoples 3.2 times.

Similarly, asthma mortality rates are about three times higher in Māori and Pacific people than New Zealanders of European descent.

Medical director of the Asthma Foundation Dr James Fingleton said a national, co-ordinated response to address health inequalities was long overdue.

“At the government level, respiratory health needs to be a priority and investment must be made into targeted programmes aiming to reduce inequalities,” he said in a statement from the Asthma Foundation.

He is hopeful that the Authority, currently in an interim form and due to be permanently established in July 2022, will offer a solution.

In particular, he is keen to see the Authority commission new culturally appropriate, co-designed and targeted services aimed at improving care for the people most at risk.

“If they were willing to do that sort of thing, they could make a big difference.”

Dr Fingleton said while the existing health system had tried to make some of those changes, there was some advantage in designing programs from the ground up rather than trying to retrofit them.

“Something that would be controversial but I think would make a big difference to respiratory outcomes would be lung cancer screening for Māori because they have the highest death rates and the biggest gap between where we should be and where we are,” he told the limbic.

“They are the highest risk group for lung cancer. We don’t have to put it in for the whole country. We can start doing it for the people at highest risk. It would be massively controversial to put in a lung cancer screening service for only some people in the country but it would be absolutely logical and it would put down a mark that says we are here it improve outcomes for the people we are here to serve.”

Challenges ahead

The Māori Health Authority was announced by the NZ Labour Government’s Health Minister Andrew Little and Associate Health Minister Peeni Harare in September 2021 to work alongside Health New Zealand in the development of strategies and policies that work for Māori people.

Recently the interim Authority announced its inaugural funding package of $22 million to embed Māori perspectives and initiatives throughout the health system.

However the health reforms hasn’t been welcomed by all with National Party leader Christopher Luxon committed to scrapping the new Māori Health Authority if they win government in 2023.

A Māori Health Authority was recommended in the 2019 He Puapua report that sets out a roadmap to co-governance between the Crown and Māori by 2040.

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