At last week’s urgent inquiry, Māori health providers gave evidence before the Waitangi Tribunal, while the Crown defended its Covid-19 response for Māori. Gabrielle Baker followed it all.
Since day one of the Covid-19 response, Māori have been concerned that the government’s response would forget equity and te Tiriti o Waitangi in the interests of speed and centralised control. To make sure our communities had the best protection, iwi set up structures to collectively communicate with whānau and engage with the government on Covid-19, Māori communities were out in force to protect their people with checkpoints and ensure they had the essential supplies they needed to be safe under the more restrictive Covid alert levels, and collectives like Te Rōpū Whakakaupapa Urutā, a group of Māori health experts and professionals, united to support a Māori- and equity-centred response to Covid.
But while the government rhetoric was that we are all in this together, the inequities highlighted by the delta outbreak call that into question. Māori vaccination rates are lower than non-Māori in every DHB in the country, with no DHB having reached 90% coverage of its Māori population. Māori have also been disproportionately affected by the delta outbreak. This is the backdrop to the hearing held in the Waitangi Tribunal last week.
This hearing was prompted by a claim from the New Zealand Māori Council (NZMC), which sought a priority inquiry into Covid-19 because of the change to the alert level system and the imminent ability of Aucklanders to travel around the motu. A technical point here is that the hearing time had been set aside to inquire into Māori disability issues. This has been postponed, as a result, until next year (probably March).
The fact it was a priority hearing with very short notice (only a couple of weeks) meant, out of practicality, only a few elements of the Covid response were within scope. Specifically:
- Covid-19 vaccine sequencing and programme implementation
- The introduction of the Covid-19 Protection Framework (or as you may know it, the traffic light system).
So issues like the government’s woeful approach to tangihanga guidelines, for example, were not covered in the hearings.
The NZMC was joined by a set of interested parties that included claimants from Māori health groups Te Puna Ora o Mataatua, Te Kohao Health (based in Kirikiriroa), Tāngata Turi (Māori who are deaf), Te Ohu Rata o Aotearoa (Māori doctors) and Te Roopu Waiora. To quote National Hauora Coalition chief executive Simon Royal:
“Simply put, our main argument is that the Crown’s approach to Covid-19 has been inadequate and inequitable.”
On a surface level, the evidence presented shows the government knew the higher risk of Covid-19 to Māori, and had a “plethora” of advisory groups with Māori and Pacific health experts, as well as other public health experts, who were all saying similar things about the need to prioritise Māori in the vaccine rollout, and in the decisions to change to the Covid-19 Protection Framework, abandoning alert levels and the elimination strategy. However, this did not change the decisions made by cabinet that continued to leave Māori exposed to harm.
In the case of the vaccine sequencing strategy, which set the timing of eligibility for the Pfizer vaccine, no specific provision was made to ensure an appropriate allocation of vaccine for Māori. As Mike Smith, who gave evidence to the tribunal on behalf of iwi leaders, has said elsewhere:
“The vaccination strategy failed Māori and Pacific communities. It didn’t recognise the different demographics in our respective communities – Pākehā have a high number amongst its elderly, for us the highest proportion of our population is our youth, so when the government’s tier approach targeted the elderly, it did not reach into our communities.”
Liam Rātana has written more about this for The Spinoff.
In the case of the Covid-19 Protection Framework, the subset of Māori groups that Te Arawhiti (the Office for Māori Crown Relationships) consulted with rapidly (at very short notice), plus science and technical advisers who provided urgent advice, were unanimous that a move to this framework would make sense only if it was based on much higher levels of vaccination for Māori. Yet the government’s decisions were that we would move when DHB regions reached 90% vaccination. As we can see in the latest data, this doesn’t assure 90% vaccination rates for all of a DHB’s population (for example, Canterbury DHB is at 92% fully vaccinated, but the Māori vaccination rate is about 79%, meaning about 3,900 Māori in Canterbury still need to be vaccinated before the DHB reaches 90%).
Beneath the surface of these issues, the evidence presented by claimants and the Crown show fairly consistent themes. To me the most apparent was the disconnect between Crown rhetoric and tangible action.
Let’s take racism as an example. In the first stage of this inquiry, the director general of health Ashley Bloomfield agreed that racism was a determinant of health for Māori. Since then, in its policy documents, the Ministry of Health has said racism is bad and we need to do something about it collectively. Yet given the opportunity to take anti-racist action (like in making decisions on the vaccine framework to prioritise Māori), they didn’t.
As Lady Tureiti Moxon said on day one of the hearings last week, “We’re battling every single way, and you know that the tribunal report was clear about racism and about all of that, and yet here we are having to fight for every little morsel we get.”
What Bloomfield and Jo Gibbs from the Ministry of Health emphasised in response was that whānau-centred approaches were put in place around vaccination to counter the negative impact of government decisions. Speaking from personal experience, I know you couldn’t make whānau bookings on the booking system and in my DHB area, nothing about whānau was advertised until August, five months after the whānau-centred approaches were supposed to have started.
Whānau Māori and Pacific families can be vaccinated together when one member of the family is eligible to be vaccinated. To make a whānau booking all you need to do is call the COVID Vaccination Healthline on 0800 28 29 26 (8am to 8pm, 7 days a week). https://t.co/AifkMb2p4A
— Ministry of Health – Manatū Hauora (@minhealthnz) August 4, 2021
The evidence also raises some serious concerns about the advice given to ministers and whether it was followed. Officials from Te Arawhiti, Te Puni Kōkiri and the Ministry of Health all at varying times gave advice that would have aligned with what Māori were asking for. But in many instances, cabinet made decisions that didn’t reflect this advice and it isn’t exactly clear why. Ministers of course don’t have to follow any one agency’s advice, but the pattern emerging is that they are more likely to deviate from advice when it is about acting on Māori concerns.
There was a lot of other ground covered in the hearing week. Data quality and access was a big theme, with considerable attention given to the Whānau Ora Commissioning Agency’s recent High Court action to access data that would allow it to find and offer vaccination to Māori who haven’t had two doses. Bloomfield spent three hours answering questions, which would provide fodder for a future PhD on the public service. But for me, maybe the biggest impression I’m left with is that Māori frustration at the Covid response is palpable, and kaimahi Māori on the frontline are at high risk of burnout as they take on the heavy work of protecting and supporting our communities who have been knowingly put at risk by the Crown.
In the closing submissions on Friday, it emerged that the NZMC and the Crown have been in talks to set up a group called Ngā Mana Whakahaere to work together on the Covid response. It remains to be seen if this is just another of the plethora of advisory groups or if it’s the step change we have needed to drive te Tiriti o Waitangi-centred action, but experience over the last two years (not to mention the decades before that) must tell us that odds are not in its favour.
The tribunal has said it will issue its report speedily, which could provide recommendations on how to strengthen the NZMC’s proposals, or might take into account the submissions of many interested parties who seek solutions more focused on action and less on having a seat at a government table. However it goes, I can tell you with certainty the Māori providers who spent the past two weeks preparing and then giving evidence will today be offering vaccinations to their communities and will carry on showing us what tino rangatiratanga looks like.