Editorial

The last few weeks have been an interesting if not disturbing time in New Zealand politics. Regardless of one's political affiliations it has been disturbing to see the unleashing of what has to be described as a deep seated level of racism in New Zealand society which appears to have been cynically unleashed by Dr Don Brash with the aim of increasing the political fortunes of the National Party. Most disturbing has been the realisation that many people in New Zealand hold wildly inaccurate ideas as to the extent and level of so called "special treatment" for Maori New Zealanders.

I have heard people suggest that Maori "do not pay fees to go to University", that Maori "pay lower interest rates on home loans" and that "doctors are paid more for treating a Maori patient". These statements have no truth but this does not stop such statements fuelling a significant level of public misinformation and subsequent disquiet.

For example, in The Press (Feb 6, 2004) Brash suggested he would hire a non-Maori New Zealander over a Maori of equal merit because he said Maori could claim "unlimited tangi leave". Under the new Holidays Act there is no such thing as unlimited bereavement leave and no reference to tangi leave and no differentiation on the basis of race or religion. In his Orewa speech (27/1/04) Brash commented that Primary Health Organisations are established on a racial basis. This is a gross oversimplification of the notion of population based funding which factors in features of a population known to influence need such as age, gender, ethnicity and levels of poverty. The health needs of certain groups are greater and they have a greater need for services. If he is to be even-handed in his analysis he should also complain about any additional funding for the elderly. There are numerous other such examples of public media based statements which feed public perception.

When Don Brash states rather disingenuously that the National Party will provide for New Zealanders on the basis of need not race he makes a seemingly sensible point to a public inflamed by false notions of free handouts to some New Zealanders on the basis of skin colour. It is worrying that Dr Brash does not seem to realise that the situation is infinitely more complex than he has suggested. Need is already the principal driver of Government funding but that is also based on absolute evidence that even within the same socio-economic group there are disparities between Maori and non-Maori. Need itself dictates particular attention to Maori health concerns. Even so Ministry figures show that little more than 2% of the health budget and 1.6% of the education budget is spent on specific services for Maori.

Non-Maori have a significant longevity advantage over Maori. Life expectancy at birth for females of Maori ethnicity was 73.2 years, compared with 81.9 years for non-Maori females. For males, life expectancy at birth was 69.0 years for Maori and 77.2 years for non-Maori. This is an average difference between Maori and non-Maori of about 8.5 years, slightly less than the estimated difference of 9.1 years in 1995-1997. Lower non-Maori mortality rates at ages 50-74 years account for over 60 percent of the difference between Maori and non-Maori life expectancy at birth (Statistics New Zealand).

What is not being said in this shameful debate is that "the dangerous drift towards racial separatism" as cited in the Orewa speech simply has no evidential basis. A recent article in the NZ Listener (March 20) provided a substantive challenge to this perspective offering clear evidence that in the last twenty years Maori, on many fronts, are doing better. One point made strongly in the article is that without the economic restructuring of the late eighties and early nineties, presided over by Dr Brash as Reserve Bank Governor, they would be doing even better! This is a major irony.

Quoting directly from Professor Mason Durie (Listener, March 20) comparing a young Maori of today with a young Maori in the early seventies.
"You are much more likely to have had an experience of early childhood education. You are more likely to have a sense of being Maori. You're more likely to have had your vaccinations completed by the age of two. You are more likely to be looking towards tertiary education, and beyond that to professional employment. You are more likely to have a better standard of living than your parents did when they were children. You're more likely to be playing sport, and that can realise positive health outcomes."

This is good news but should not be allowed to create a false impression and detract from the significantly poorer statistics that Maori hold for personal income, crime and levels of hospitalisation. There is still work to be done and gains to be made.

The Listener article provides numerous statistics of improvement between 1971 and 2001 statistics. Most noteworthy include: the percentage of Maori school leavers with no qualifications has dropped from 75% to 35%. The level of university qualifications in Maori has risen from 0.4% (1971) to 21.2% (2001) and those speaking fluent te reo has risen from 18% to 25% over the same period. Interestingly home ownership has only risen from 46% to 50% suggesting low personal income levels.

Responding to need alone is a blunt and insensitive measure. The improvement in the above and other statistics for Maori is probably the direct outcome of two things. One is the enormous energy expended by Maori in directing their own achievements and in reasserting the vibrancy of Maori culture and the other is the previous consensus that by Maori for Maori services is an appropriate basis from which to address the glaring disparities, especially in health. It is unthinkable that we should begin to unravel this positive trajectory and return to the situation of the past.

The grace and dignity and sheer generosity of spirit that has characterised Maori response to their circumstances is indeed humbling. One public speaker (Pat Sneddon from Auckland District Health Board) reported the response of Ngati Whatua following a Waitangi Tribunal decision. He noted:

"In his second claim before the Waitangi Tribunal (Wai 9) Joe Hawke and others outlined the case related to the disposal of the Orakei Block, the land deemed in the mid-19th century to have been inalienable. The outcome was unequivocally in their favour and Bastion Point in 1991 was finally transferred back into Ngati Whatua's hand by Act of Parliament. This was one of the first successful appeals to the Tribunal of any Maori iwi in the country and was the precursor for the many claims currently filed.

Let's for a moment pause to consider the first thing Ngati Whatua did when it took back the land.

The first thing it did was to give a huge chunk of Bastion Point back to Aucklanders. That's right, they gave it back to you and me for our unimpeded use. The land I am talking about is the whenua rangatira land. The land with the best views in all of Auckland. The land where Michael Joseph Savage rests. Ngati Whatua agreed to jointly manage this with the Auckland City Council (the same Council that had ordered the burning of their marae) for the benefit of all the people of Tamaki Makaurau.

When I therefore reflect on the mana of Ngati Whatua, I remained truly humbled. That a people who sought for 150 years to get some form of justice that recognised their cultural destitution, could in their moment of triumph, react with such generosity to those who dispossessed them is an act of munificent genius."
(Pat Sneddon: public speech notes circulated electronically)

New Zealand as a society has much to learn and many decisions to make about our pathway forward. We have very much to gain by making some of this grace, dignity, tolerance and generosity of spirit a stronger part of our shared culture in New Zealand.

To date nursing has made its own contribution through the process of teaching cultural safety and expecting competence in this area as a most basic nursing skill. Many of us remember the dreadful days when National Party politicians in the previous National government announced that teaching cultural safety was inappropriate and conducted a trial by media and a select committee hearing. It is therefore alarming to have read already that Don Brash considers cultural safety teaching in nursing courses to be 'race-based political correctness' and 'social engineering'. Congratulations to NZNO on their strong press release headed "Brash Ignorance" in which Geoff Annals stated

"It has nothing to do with political correctness and everything to do with enabling nurses and midwives to give safe, non-judgmental care to all people, whatever their race, social circumstances, religion or sexual orientation."

I would like to think that College members would similarly stand tall and reassert the value of recognising the fundamental teaching of Dr Irihapeti Ramsden. When we provide health care as nurses we do it in a manner that is regardful rather than regardless of the culture of the person for whom we care. I would also hope that as nurses we will remain unmoved by the sixty second sound bites which characterise media communication and apply the same rigorous standards of evidence as we expect to apply to nursing practice.

It is also my hope that we will seek opportunities to lead by example by continuing to regard culturally safe practice as a cornerstone for good practice and in publicly owning that stance.

Professor Jenny Carryer

Back to Top
All rights reserved © College of Nurses Aotearoa (NZ) Inc.