No sooner had we published the latest BayBuzz Digest, with an article by Elizabeth Sisson on Maori health underspending, then we discovered that the problem had already worsened.

Here’s Elizabeth’s article. It reports on $947,000 in unspent funds that have been allocated for Maori health services in the HBDHB’s budget for the current fiscal year (the same thing happened the previous year). As Elizabeth writes:

“With some sixteen weeks remaining in the fiscal year, the Hawke’s Bay District Health Board has yet to allocate $947,000 in available funds earmarked for Maori health care. This represents a major chunk of the total $7.6 million dedicated to Maori health programs. Is the DHB holding on to the money to bring down its projected deficit, which will run around $4.9 million? Or is it simply a question of funds being allocated before services and programs have been put in place?”

At last week’s DHB Board meeting, staff reported that the unspent number has now climbed to $1,326,000, and will likely end the year at an even $1 million. This despite the protestations of the DHB’s Maori Relationship Board and its Chair, Ngahiwi Tomoana.

In the ensuing Board discussion, various Board members expressed concern, noting that health stats for Maori in Hawke’s Bay are notoriously terrible.

The staff did a bit of tap dancing around the issue, but in bureaucrat-speak pointed to the reality: Maori want their health services delivered by Maori, and there’s a commitment in this direction within the healthcare community, but there is insufficient Maori capacity to provide the services. So contracts remain unawarded and/or unimplemented.

This led to the obvious question by Kevin Atkinson: “Can we use some of the unspent funds to build capacity?” The staff response revealed a classic Catch-22: apparently the main Maori provider of capacity-building services itself lacks the capability to take on more work, so that contract hasn’t been concluded … it is part of the unspent budget!

So there we sit.

And it isn’t going to get better anytime soon. In 2008, 45.3% of all babies born in Hawke’s Bay were Maori. If present trends hold, they will live on average seven years less than non-Maori, suffering higher incidences of all sorts of illnesses, from cancer to heart and kidney disease, as well as underlying factors like smoking, hazardous drinking and obesity.

All of this must be addressed for the well-being of Maori, first and foremost … but also because of the enormous costs the entire community must bear for these levels of ill health.

It seems like heaps of change must occur here in Hawke’s Bay — the capacity issue must be addressed with urgency; Pakeha health practitioners need a serious dose of cultural sensitivity training to deal with Maori medically; and individual Maori health literacy and personal responsibility must be drastically improved. Just for starters.

The DHB Board discussion ended with a request by Sir John Anderson for a full presentation on these issues at the next Board meeting. For the benefit of the community and public accountability, hopefully that presentation will be made in open session.

Tom Belford

P.S. The entire March BayBuzz Digest can be downloaded here.

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