Image: Matthew Tukaki outside the Maori Affairs Select Committee room refusing to leave until the Inquiry was announced
The New Zealand Maori Council has welcomed the report of the Maori Affairs Select Committee into Health Inequities for Maori with its Executive Director, Matthew Tukaki, saying the Government now has a clear path forward when it comes to cancer, terminal illness and much more.
“Nineteen recommendations have been made that cover cancer treatment, early detection and prevention as well as end of life care – all of which are fundamental to lowering death rates but more importantly bringing to light the social and economic challenges that also play into Maori health.” Tukaki said
The New Zealand Maori Council was instrumental in establishing the Inquiry pointing out that many Maori are unable to afford life saving and extending medications.
“What has been recognised is this plays into our view around the establishment of a single National Maori Health Authority and a National Maori Health Promotion Agency but equally so taking a significant look at workforce development and the integration of Matauranga Maori went it comes to all facets of the health system – its also recognition of ensuring cancer services are accessible, particularly in the regions, and that we have a focus on end of life palliative care. As someone who has spoken to hundreds of our whanau across the nation when it comes to the health system I can tell you we would be doing a lot more to bring down health inequities if we had the right tools to do so.” Tukaki said
“It is now down to myself and the team at the New Zealand Maori Council to ensure that in the next term of Government all of these recommendations are fully implemented by whomever is in power. I thank the Mulholland whanau who bought light to the challenge of inaffordable medications and the select committee, led by Maori MP Rino Tirakatene for being bold and brave.” Tukaki said
Delivering equitable Māori health outcomes
1. We recommend to the Government that a Government-funded entity be made responsible for eliminating health inequities for Māori, and be given the authority and resources to do so, and that strategic decision-making be reported and monitored annually (page 49).
New Zealand Cancer Action Plan
2. We recommend to the Government that it review the New Zealand Cancer Action Plan 2019–2029 every five years (page 50).
Bowel cancer screening age
3. We recommend to the Government that it provide a more flexible bowel cancer screening programme that responds more effectively to the specific needs of those affected (page 53).
4. We recommend to the Government that the Ministry of Health build up its number of colonoscopists to meet demand (page 53).
5. We recommend to the Government that it implement primary HPV screening, and that self-testing for HPV be made available (page 55).
Introducing a lung cancer screening programme
6. We recommend to the Government that it introduce and resource an equity-positive lung cancer screening programme and that it take note of the outcome of Auckland and Waitematā DHBs’ lung cancer screening pilot (page 55).
Smoking habits among Māori
7. We recommend to the Government that it review the Māori Affairs Committee’s 2010 report, “Inquiry into the tobacco industry in Aotearoa and the consequences of tobacco use for Māori”, to identify further strategies to drive progress to achieving its Smokefree 2025 goal, and that it report back to this committee (page 56).
Breast cancer screening for wāhine Māori
8. We recommend to the Government that it ensure all Māori women can access screening programmes, with a particular focus on Māori women residing in rural areas (page 57).
The relationship between alcohol and cancer
9. We recommend to the Government that it require the Health Promotion Agency to develop a programme to increase awareness about the link between alcohol and cancer (page 58). Increasing health literacy for whānau 10. We recommend to the Government that it develop and fund health literacy programmes for whānau (page 59). Establishing a te ao
Māori Health Promotion Agency
11. We recommend to the Government that it establish a te ao Māori Health Promotion Agency run by Māori for all Māori, regardless of their geographic location (page 60).
12. We recommend to the Government that Pharmac conduct a five-yearly review of its “variation in medicines use by ethnicity” analysis (page 62). Kaupapa Māori cancer navigation roles 13. We recommend to the Government that it establish new kaupapa Māori cancer navigation roles and fund existing ones (page 65).
Increasing and upskilling the health workforce
14. We recommend to the Government that it take measures to increase the number of Māori working in the health and disability system (page 66).
15. We recommend to the Government that any tertiary programmes or qualifications on hauora Māori are evaluated to ensure that they are up to standard, well designed, and comprehensive (page 67).
16. We recommend to the Government that healthcare workers (and supporting staff) are required to undergo comprehensive training to ensure they are culturally capable to treat Māori (page 67).
17. We recommend to the Government that healthcare workers undergo accredited cultural safety training as part of their professional development, and that workers be re-assessed annually to retain a medical practising licence (page 67).
18. We recommend to the Government that it support and fund the implementation and evaluation of Mauri Mate and draw on the framework for service development in the wider palliative care sector (page 69).
19. We recommend to the Government that it fund a public health campaign targeted at Māori (with engagement at a national and local level) to increase their understanding of the palliative care sector. This campaign would aim to raise awareness and improve access to hospice services for Māori (page 69).
Context in terms of cancer:
Māori rates of mortality from all types of cancers are twice that of non-Māori.
Māori women are approximately twice as likely to die from breast cancer compared with non-Māori. Explanations include presenting symptoms at a later stage at diagnosis and less breast screening.
Māori women have a cervical cancer registration rate twice that of non-Māori but the mortality rate for Māori females is disproportionately higher at four times that of nonMāori females.
Māori females have a lung cancer registration rate four-and-a-half times that of nonMāori females and a mortality rate five times that of non-Māori females.
Māori male lung cancer registration and mortality rates are three times those of nonMāori males.
For Māori males, the liver cancer registration rate is five-and-a-half times that of nonMāori males. · Rates of stomach cancer registration and mortality are almost three times higher for Māori males than for non-Māori males.
Prostate cancer registration was lower for Māori males than for non-Māori males, but Māori males had a prostate cancer mortality rate twice that of non-Māori males.
Māori are more likely than non-Māori to access services later and to experience serious disorders and/or co-existing conditions.