Maori Health Strategy and Treaty of Waitangi in the New Zealand Healthcare System

New Zealand Healthcare System and the Treaty of Waitangi

Introduction

New Zealand Healthcare System (NZHS) has been established and shaped upon the Treaty of Waitangi (TOW). Likewise, the Treaty of Waitangi is considered as the foundation to health equalities among Maori and non-Maori (M?ori Health Policy, 2018). Accordingly, the Ministry of Health (MOH) has developed health strategies and policies to guide the Government and the health and disability sector to achieve optimum health outcomes for Maori (MOH, 2018). The aim of this essay is to bring to focus the objectives pertaining to the Maori Health Strategy and its involvement that supports the Ministry of Health and the district health boards to improve M?ori health with respect to the Treaty. Furthermore, the essay discusses the implications of Treaty of Waitangi for the health strategies and policies in the context of Aotearoa New Zealand’s health system. Next, it critically examines the strategies and guidelines that direct the government and the health and disability sector to achieve the best health outcomes for M?ori. Additionally, the strategies and policies discussed throughout this essay are the the Maori Health Strategy, New Zealand Public Health and Disability Act 2000, New Zealand Disability Strategy, Healthy Ageing Strategy and the Maori Health Plan. The essay further critically analyses those strategies and highlights how effectively the Treaty is being respected and followed in the context of health and wellbeing among the Maori community. Overall, the aim of this thesis is to critically assays the various health strategies and policies that address to improve wellbeing among Maori community with respect to the Treaty. 

New Zealand Healthcare System and the Treaty of Waitangi
New Zealand presently delivers a comprehensive and beneficial healthcare system which revolves around the principles and implication of the Treaty of Waitangi (Simpson, 2016). Likewise, the TOW is the foundation to universal health equity policy in New Zealand (Simpson, 2016). Therefore, the TOW has considerable bearing on the matters addressed in this essay associated with Maori health. The Treaty is the agreement signed in 1840 between Maori and the Crown aiming to ensure that equality is respected between both nations in New Zealand (M?ori Health Policy, 2018). Accordingly, the Treaty holds a key role in healthcare system of New Zealand to alleviate health disparities and ensuring well-being among Maori and non-Maori (M?ori Health Policy, 2018). At its heart it provides an instructive framework to guide the government of New Zealand to achieve optimum health outcomes for Maori (M?ori Health Policy, 2018). In the same way, the Ministry of Health (MOH) of New Zealand has adhered to the principles of the TOW in developing health strategies and policies to meet the needs of the nation and continuously improving health system (Maori Health Plan, 2018). 

Maori Health Strategy

Maori Health Strategy
The Maori Health Strategy (MHS) was initially developed in 2002 successively to New Zealand Health Strategy 2000. The entire aim of the MHS 2002 (MHS 2002) is to support Whanau Ora (Maori families) to achieve preferable health outcomes and to maintain wellbeing for Maori. Likewise, the MHS 2002 delivers structural frameworks that direct the MOH and DHBs to assume their responsibilities to support the health status of Maori communities (Oranga, 2002). The main focus of their responsibility is to alleviate the factors contributing to healthcare inequality. At its core, the MHS 2002 shaped these frameworks with respect to the principles of the TOW (Oranga, 2002). Accordingly, the MHS 2002 set guidelines for the DHBs to encourage Maori to establish their own aspirations and priorities for health and disability to ensure that appropriate healthcare services are delivered effectively. Equally important, the MHS 2002 aims to promote the involvement of effective partnership between Maori and New Zealand’s healthcare providers (Oranga, 2002). This is to be achieved by the DHBs who are committed to meet statutory objectives for Maori health and reduce health inequality (Oranga, 2002). 

New Zealand Disability Strategy 
The New Zealand Disability Strategy (NZDS) aims to improve and maintain a healthy wellbeing among disable New Zealanders. Correspondingly, the Maori Health Strategy directs the Ministry of Health and DHBs to enhance health among disable Maori (NZDS 2016-2026, 2017). Therefore, the MHS addresses the NZDS by putting into effect the principles of the TOW upon which the MHS is conceived. However, studies found that 23% of disabled Maori face discrimination as compared to 13% among disabled non-Maori (Statistics New Zealand, 2015). Statistics New Zealand (2015) stated that compare to 37% of disabled non-Maori, only 24% of disabled Maori reported to be in good health and 6% said to be living in poor condition. According to Leah and McIntosh (2017) disabled Maori were not experiencing an effective participation within the community and limited Whanau Ora support were delivered in the outskirt areas. Equally important, McIntosh (2017) explained that less cultural activities were put into practice which is pertinent to Maori beliefs. 

On the other hand, Burri, Rice, Kluger and Kluger (2018) demonstrated that the NZDS 2016–2026 has for objectives to enhance communication and participation as well as to provide support to improve quality of living among disabled Maori in the community by valuing culture based activities and promoting Whanau Ora. Additionally, Burri et al., (2018) stated that taking into consideration the MHS, the NZDS aims to encourage the use of Maori language by nurses and other health providers in residential home care. Consequently, a better milieu of wellbeing will prevail among disable Maori in residential home care. Overall, the NZDS 2016-2026 has visioned to aide a healthy quality of life among the disabled Maori communities. Under these terms, Leah and McIntosh (2017) claimed that despite the presence of some challenges, the NZDS 2016-2026 does qualify in fulfilling most aspects of the MHS. For instance, socio-economic factors are constant challenges to be overcome to mitigate disparities in delivering healthcare services to disabled Maori.

New Zealand Disability Strategy

New Zealand Public Health and Disability Act 2000
The New Zealand Public Health and Disability Act (NZPHD) 2000 was enacted to provide funding allocation to the public health sector and other health organisations aiming to deliver healthcare and disability support services. Similarly, the NZPHD Act has for objective to continuously improve health and wellbeing among New Zealanders as well as to reduce health inequalities among Maori (New Zealand Legislation, 2018). Under these terms, the NZPHD Act focuses on promoting independency and participation of people with disabilities in the society. These objectives are to be pursued by the MOH, DHBs and other health provider organisations (New Zealand Legislation, 2018). Therefore, with respect to the NZPHD Act, the Maori Health Strategy set directions for the DHBs aiming to deliver the best health outcomes for Maori through equitable funding distribution and disability support services. 

Healthy Ageing Strategy and Positive Ageing Strategy
The Healthy Ageing Strategy (HAS) is arrayed along the New Zealand Health Strategy and Maori Health Strategy (Associate Minister of Health, 2016). The HAS also holds strong connection with the Positive Ageing Strategy (PAS) which together aim to provide a healthy, independent, connected and respected milieu for older people to age well in place (Associate Minister of Health, 2016). In this respect, the New Zealand government has released the HAS 2017 with main objective to achieve equity among older Maori. Successively, the PAS 2018 was announced which collaboratively guides the MOH and DHBs to deliver the described strategies goals (Edwards, Theodore, Ratima & Reddy, 2018). Likewise, the MHS addresses both the HAS and PAS to comply with the principles of the TOW pertaining to older Maori wellbeing (Edwards et al., 2018).

Maori Health Plan 
The aim of the Maori Health Plan (MHP) is to guide the DHBs to achieve optimum health outcomes for Maori. Likewise, the DHBs are committed to respect the TOW and its aspects of implication through the MHS. Accordingly, the MHP provides a structural framework to assess and priorities Maori health. This framework underpins the principle of health equity, Whanau Ora support and Maori participation which is also pertinent to the MHS objectives. Equally important, Gee (2016) stated that through application of this MHP, the DHBs hold the responsibility to assess and control diseases among Maori by developing preventive measure which is relevant to MHS.

Conclusion
Came and Tudor (2017) said that New Zealand has been constantly developing health strategies to alleviate health disparities and promoting a comprehensive healthcare system. However, they argued that there is still space for improvement for older Maori area of care because figures show that older Maori experienced more discrimination compared to older non-Maori. Came and Tudor (2017) also added that more attention should be paid in respect to the MHS and culture centred healthcare services should be encouraged in community rather than individually. Likewise, this essay concludes that despite the MHS plays a key role in addressing Maori wellbeing, yet it is for the Ministry of Health and DHBs to apply those strategies to achieve optimum goals. Subsequently, the essay summarises the main strategies and policies developed to reduce health disparities with respect to the principle of the Treaty of Waitangi and highlights the importance of Whanau Ora support in delivering the best health outcomes for Maori. Furthermore, it can be stated that even though the DHBs do not excel completely in conforming the framework and principle of the MHS, still to some extent their responsibilities are achieved in terms of allocating equitable funds. Additionally, this essay shows evidences of the unmet healthcare needs for Maori with disabilities and achieved a critical analysis of disease prevalence among the Maori community. Under those terms, it can be said that the Maori population is more vulnerable to infectious and chronic diseases which commonly happen as a result of inappropriate care such as culture oriented care withdrawals. Consequently, all things considered, it is safe to say that the MHS strives to provide an equitable and desirable healthcare services to Maori people while addressing the various health strategies and policies designed to continuously improving New Zealand healthcare system.