asbn3

OPINIONSocietyAugust 19, 2020

Alice Snedden: Why the healthcare system needs to change

asbn3

In all my dealings with the healthcare system I’ve received incredible service – so why isn’t this the case for all New Zealanders?

Watch Alice Snedden’s Bad News – Healthcare Inequity and other episodes in the series here.

When I was in primary school one of my great brags was that I’d never been to hospital. I used to wait for people to say, “na-uh, you were born in hospital”, then wow them with the fact that I was a home birth. It was a truly groundbreaking bit that I can only assume made me loads of friends.

I saw the fact I hadn’t had any interactions with the health system as a badge of honour, but I think the universe misunderstood and thought I was actually disappointed to be missing out. So at the peak of my bragging, aged 10, I broke my arm twice in quick succession and had to spend three months in a cast. Since then I’ve been to hospital more than a dozen times – I’ve broken bones, got stitches, developed infections, had five surgeries, three ambulance rides and countless injections. My luck became so bad that when I was 20 and wanted to join the Territorial Force my surgeon told me sternly that if I did, I’d be a liability to my country.

Throughout all of my dealings with the healthcare system I’ve received incredible service. My life has been improved by every interaction. This, however, is not the experience of every New Zealander. In fact, statistically it seems that this is the experience of Pākehā exclusively. If you are a Pākehā living in New Zealand, you get to live on average 7-10 years longer than your Māori next door neighbour. That’s a significant amount of time, approximately 10% of your life. It’s enough time to fit in intermediate, high school and a gap year where you find yourself. It’s also tangible evidence that the system is riddled with systemic racism, that decisions made decades ago are still having terrible consequences today, and that not enough is being done to rectify it.

Systemic racism is pervasive in our health system – Māori wait longer to be seen by health professionals, they don’t receive equivalent treatment to their Pākehā counterparts and they live shorter lives. It’s an unforgivable reality and it’s sustained by people like me who have been to hospital many times, thought the quality of care I received was great and never thought to wonder if it’s the same for other people.

Over the last century and a half, Pākehā have been either the perpetrators of, or complicit in a system, that has oppressed Māori. We’ve done it with our governments and we’ve done it as individuals who didn’t protest our governments. We have stood by while a colonial system has been brutally enforced and we are not the ones suffering the consequences of our mistakes. In the face of overwhelming evidence to the contrary, we have continued to assert colonial practice as best practice.

The good news is that we can change, and that process has already begun with the government considering a Māori Health Authority to focus on Māori health outcomes and restructuring the DHB system. Whether or not this authority will have the necessary power to make all the changes needed remains to be seen, but it’s clear we need a Māori-led healthcare system.

We need district health boards to be at least 50% occupied by Māori, we need more Māori healthcare professionals, and we need our Pākehā healthcare professionals to see tikanga as equally crucial as any other facet of treatment. We need to let Māori care for themselves in the way that they determine is best for them and we need to trust as Pākehā that when Māori are leading this system that they will care for us too. I think to do it any other way would be to continue to knowingly cause harm.

Keep going!
Photo: Getty Images
Photo: Getty Images

OPINIONSocietyAugust 19, 2020

Jailing the Christchurch terrorist will cost us millions. Here’s how he could be repatriated to Australia

Photo: Getty Images
Photo: Getty Images

All it would take is for New Zealand to enact a law that is already common in other countries, writes law professor Alexander Gillespie.

There is no death penalty in New Zealand, unlike the United States. But the Christchurch terrorist, due for sentencing next week, will be going to jail for a very long time.

A minimum of 17 years is required for a murder committed as part of a terrorist act, and he has admitted to 51 such murders (among other crimes).

Also unlike the US, New Zealand does not allow cumulative sentences. But it does allow for the imposition of what could become an indeterminate sentence, with no minimum parole period.

To lock him up in perpetuity will be very expensive. He is currently costing just over NZ$4,930 a day due to the extra levels of security, considerably more than the average of about $338 for a standard prisoner.

The next two years alone will cost New Zealand taxpayers about $3.6 million. The final sum for the 28-year-old terrorist will depend on how long he lives and the ongoing level of security he requires. If he has a normal life span the cost may be in the tens of millions per decade.

Should he stay or go?

In the minds of many, the costs and hassle of incarcerating the terrorist will be an acceptable price to pay. Foreign citizen or not, there is a symbolic and ethical responsibility for us to keep the rat we caught.

New Zealanders old enough to remember are still jaundiced from the last time we caught terrorists, the French agents Dominque Prieur and Alain Mafart who were directly linked to the bombing of the Rainbow Warrior in 1985.

The two were handed back to France as part of a reconciliation deal. But the French government quickly broke the terms of agreement, repatriating the prisoners from their detention on a South Pacific atoll to a normal life in France.

The Rainbow Warrior at Marsden Wharf, Auckland, after the bombing of 10 July 1985. (Photo: John Miller/Greenpeace)

Another such act of bad faith is unlikely, as the Christchurch terrorist has no government in his corner arguing for his repatriation. He does, however, have a government behind him that has implemented specific legislation to obtain the transfer of its own citizens when incarcerated in foreign countries, to serve their sentences on home soil.

This is not unusual legislation. Although there is no overarching international law, regional and bilateral initiatives are common. Australia’s International Transfer of Prisoners Act, for example, aims to facilitate the transfer of prisoners between Australia and countries with which it has agreements.

Prisoners can serve their prison sentences in their country of nationality or in countries with which they have community ties. There are strong economic, social and humanitarian reasons for this approach.

The deportation of ex-prisoners will increase

Here is the catch. New Zealand has no such relationship with Australia. Unlike most comparable countries, we have little interest in the international transfer of prisoners, preferring to take a hard line when it comes to Kiwis in foreign jails.

Partly because of this, since 2014 Australia has allowed non-citizens to have their visas cancelled on character grounds, including having been sentenced to prison for more than 12 months. So, although New Zealand prisoners in Australian jails may not be transferred to serve their sentences at home, they will be deported at the end of their sentences.

From early 2015 to mid-2018, about 1,300 New Zealander ex-prisoners had been deported from Australia. After a brief interlude due to Covid-19, the deportations resumed.

The Villawood Immigration Detention Centre near Sydney, where many New Zealanders are held before being deported (Photo: Greg Wood/AFP/Getty Images)

It is no exaggeration to say this policy (and the cruel standards by which it is applied) are a significant irritant between the two countries. If it doesn’t change it’s likely to get worse, too. As of mid-2019, New Zealand prisoners made up 3% of the total Australian prisoner population (43,028) – about 1,100 people.

Conversely, there were only about 35 Australians in our jails, out of about 320 foreigners in New Zealand’s much smaller prison population (9,324 as of March, 2019).

Time for new deal on expat prisoners

Somewhere in the middle of this darkness there is a glimmer of hope – the chance of a deal and a better relationship between the two countries.

Sign a prisoner transfer agreement. Exchange the Christchurch terrorist and make him serve out his sentence in Australia, as ruled by the New Zealand judicial system.

Revise the rules for the deportation of New Zealanders who have committed crimes in Australia but been resident for a long time. Move the threshold for deportation from one to three years in prison and make it reciprocal.

Thereafter, recent arrivals in either country who commit serious crimes are transferred home to serve their time in accordance with their sentences.

Do this and we might start to move forward.The Conversation

Alexander Gillespie is a professor of law at the University of Waikato

This article is republished from The Conversation under a Creative Commons licence. Read the original article.