Tariana Turia – Speech Notes - Launch of PHARMAC Maori Responsiveness Strategy
Matangireia, G033, Parliament Buildings, Wellington.
Tena koutou katoa.
E nga mana o tenei whenua, tena koutou.
E nga iwi e huihui nei, i te aroaro o nga Minita o o ratou wa, tena koutou.
Honourable Annette King, tena koe.
I want to be perfectly honest with all of you: I have mixed feelings about launching a Maori Responsiveness Strategy for
Pharmac.
There is no doubt that tangata whenua suffer serious health problems, and medication is a key tool in our box of
solutions.
Many of the chronic illnesses that affect our people can be quite well managed with modern drugs, provided the users
fully understand the whole process of medication. Their knowledge is as important as the drug.
A survey among my own people a few years ago showed that, when they felt sick, many didn’t go straight to the doctor or
the pharmacist. First they went to their relatives’ cupboards, and prescribed their own treatment from whatever they
found.
Tangata whenua often have old medicines in the cupboard because, as soon as prescribed drugs start working, we stop
taking them, instead of finishing the whole course of medicine.
We may laugh, but poor understanding of medication is a serious problem. I congratulate Pharmac for recognising it, and
actively seeking a solution.
My reservation is whether Pharmac, in developing its strategy, built up strong enough relations with tangata whenua to
support the next phases of your work.
Let’s be blunt. A strategy may be a careful plan for managing major changes within an organisation – or it can be a
smokescreen that allows an organisation to kick a complex issue into touch.
Tangata whenua have seen a dazzling variety of Maori responsiveness strategies that promised great changes, and in the
end, made very little difference to them.
I have met far too many pretty cynical people who are good at assessing whether or not the strategy will deliver.
Many tangata whenua have come to the view that, in most cases, the content is less important to success, than the
process by which the strategy was developed.
For example, the appointment of a Maori Manager should provide an organisation with expert advice at the top level.
Other managers should not feel they have been let off the hook.
The outcome usually depends on the process leading to the decision to appoint that manager.
If the strategy was designed in full consultation with tangata whenua stakeholders, if they ‘own’ the strategy, and
therefore ‘own’ the person with prime responsibility for carrying it out, then the manager will be more likely to
deliver.
If the manager was appointed by the organisation to serve its own needs, then he or she is more or less doomed to fail.
In other words, what really counts is not the appointment of the manager per se, but the strength of the relationships
that the organisation has built up with tangata whenua in the process of developing the strategy.
It’s the follow through that counts.
This is an issue for health agencies right across the sector.
Tangata whenua have felt that in the past, health professionals and their organisations have failed to understand them
properly. They believe this has affected the health status of our people, and their trust in conventional medicine.
It’s noticeable that, in recent years, many people have been quite keen to try to treat their illnesses with rongoa
Maori and alternative medicines.
Some alternative therapies are not cheap, so the cost of visits to the doctor, and prescription charges, are not the
only reason, though they clearly contribute.
Our people are not dumb. As I said, we’ve become quite cynical.
At some level, many of us are well aware of advertising for pharmaceuticals. We know the drug business involves big
money. Perhaps we don’t trust commercial enterprises to have our best interests at heart.
This may raise complex issues for Pharmac’s Maori responsiveness, among other agencies. The attitudes of tangata whenua
to medication are linked with their attitudes to health services generally.
Tangata whenua want more control over their lives, and their health.
One thing we can probably all agree on is the benefits of green prescriptions – expert advice on lifestyle changes that
improve our state of health, and help prevent disease.
Another thing it appears we can agree on is that tangata whenua want full involvement in decisions that affect them.
From my preliminary reading of this strategy, it appears that Pharmac is moving in that direction.
I urge you continue, with a humble heart, and with eyes and ears open to the views of tangata whenua. Our people will no
doubt lead you straight into problem areas, like inter-agency co-operation, a focus on whanau health rather than
treating individuals, Pharmac’s own shortcomings as they see it, and self-determination for tangata whenua.
But persevere, because if you can create solutions, there will be huge benefits, not just for tangata whenua, but for
the nation as a whole.
Mixed feelings aside, I welcome Pharmac’s Maori Responsiveness Strategy, and look forward to Pharmac, in partnership
with tangata whenua, ensuring that our health goals are reached.
Kia ora tatou katoa.