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The Association of Salaried Medical Specialists (ASMS) is the professional association and union uniting doctors and dentists in New Zealand.

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Tribunal to hear claims of Crown treaty breaches harming Maori health

17 March 2017 Virginia McMillan - New Zealand Doctor

Maori doctors are to get their day in the Waitangi Tribunal, nine years after lodging a claim of Crown treaty breaches dam­aging to Maori health.

Many health-related Treaty of Waitangi claims will be advanced this year under one overarching Health Services and Outcomes Kaupapa Inquiry.

Among claimants is Te Ohu Rata o Aotearoa – Maori Med­ical Practitioners’ Association (Te ORA), which filed a claim in August 2008.

Te ORA spokesperson and Auckland GP Rawiri Jansen was chair at the time and signed the letter of claim.

Strong focus on solutions

Dr Jansen says the kaupapa inquiry is likely to be significant, “not least because there will be a strong focus on solutions, informed by evidence from Aotearoa and internationally”.

In 2013, Te ORA told the tribunal of numerous Crown practices detrimental to Mao­ri health. In a letter, it said the Crown acted with insufficient determination to remedy ineq­uitable Maori health outcomes.

Among other things, it point­ed to the Crown failing to: achieve parity of Maori health workers in relation to the Maori population; establish culturally safe therapeutic environments; address substandard housing; and control tobacco, alcohol and gambling.

The claim has historical and contemporary elements, Dr Jansen says.

Maori PHOs lodged claim in 2005

The Te ORA membership has strongly endorsed pursuing the claim and members are working diligently to prepare for the first judicial conference, he says.

For their part, Maori PHOs lodged a claim in 2005, say­ing they were at a disadvantage when the Primary Health Strat­egy was introduced.

The former National Maori PHO Coalition was part of the claimant group, and successor the National Hauora Coalition has been considering its involve­ment, chief executive Simon Royal says.

Speaking personally, ahead of any decision on the case by the coalition trust board, Mr Royal said he recalled Maori organisa­tions setting up as PHOs in the early 2000s.

Many felt the resources avail­able to them were tiny compared with those of established main­stream bodies, he says.

No transformative change

The Maori PHOs also ques­tioned whether Services to Improve Access and Health Promotion funding formulas sufficiently recognised dispari­ties in the burden of disease.

And, since then, despite some breakthrough thinking, there has been no “transformative change in Maori health out­comes”, Mr Royal says.

Kaitaia GP Lance O’Sullivan among claimants

Kaitaia GP Lance O’Sullivan and Canterbury University so­cial and political scientist Lindsey Te Ata o Tu MacDonald are oth­ers who have registered a health-related claim and could now bring evidence to the tribunal.

Dr MacDonald, in his claim, says the persistence of dispar­ities in Maori health, and evi­dence that the health system contributes to these, suggest a serious contemporary breach of the treaty principles.

Tribunal judge Stephen Clark issued a memorandum just be­fore Christmas 2016, ask­ing claimants to outline by 13 March the main health issues they want to raise. Eligibility will be checked.

New Zealand Doctor asked the Ministry of Health about its in­put into the Crown response to claims. In a statement, chief legal advisor Phil Knipe says it would be inappropriate to comment, noting the matter is before the tribunal.

The scope of the hearing, in­cluding specific claims to be cov­ered, is still being determined, Mr Knipe says.

The inquiry’s first judicial con­ference is tentatively set down for early May, Judge Clark wrote in December. The Ministry for Justice had no further update last week.