Crown Admits Institutional Racism Exists in the Health System
2 July 2019
The Waitangi Tribunal has released stage one report yesterday in the Wai 2575 Health Inquiry. In a bold decision, the
Tribunal has called for structural reform of the primary healthcare system and that the Crown commit to exploring the
concept of a stand-alone Maori Primary Health Authority.
The Tribunal has given the stage one claimants 7-months to design and draft terms of reference to explore the
possibility and report back in January 2020.
Pay parity was a key concern for the Maori nurses. Research indicates that significant pay disparities of up to
approximately 25% exist for kaimahi who work in Māori and Iwi providers compared to their counterparts empolyed by the
District Health Board.
Professor Tim McCreanor gave evidence in the Tribunal and agreed that funding pressures on Maori providers had acute
impacts on their workforce. He said that “the funding structures that apply to Maori health providers are part of the
structure of institutional racism that effectively drives down the pay of the workers in those places and contributes to
disparity between different groups of nurses”
Kerri Nuku, Kaiwhakahaere of NZNO related this amount to a difference of “up to $600 in a fortnight. All these pay
discrepanices occur even between nurses with the same qualifications.”
Maori nurse Tracey Morgan, highlighted in the Inquiry how the Crown’s insufficient resourcing of Maori providers
translates into significant extra work for their staff. “Maori nurses working in institutions such as DHBs that do not
refelct Maori values are asked to work beyond their job description such as leading powhiri, but are still paid the same
as their collegues who do not have this expertise”
Dr Heather Came-Friar gave evidence how institutional racism manifests as the outcomes of mono-cultural institutions
which simply ignore and freeze out the cultures of those who do not belong to the majority and that participation by
minorities is conditional on their subjugating their own values and systems to those of ‘the system’ of the power
Crown witnesses acknowledged under cross-examination that institutional racism exists and is unaceptable in the Health
system. “This, along with personal racism and stereotying, is a signifiacnt barrier to giving effect the the meaning of
the Treaty and its principles” the report reads.
The report states that the Crown is responsible for identifying instritutional racism, in partnership with Maori, and
implementing solutions to mitigate its impact. The Crown failed to do that and this in turn impacts on the way Maori
experience and receive care.
The Tribunal report states that “...the fact that Maori nurses are financially penalised if they choose to work for
Maori providers, under significant strain from the way the Crown has legislated and organised primary health care, is
unacceptable. Maori nurses should not be paid less or have to tolerate adverse working conditions simply to work for an
employer who refelcts their values, or to work for health providers which service their communities”
The Tribunal has also recommended that the Crown conduct an urgent and thorough review of funding for primary health
care, to better align it with the aim of achieveing equitable health outcomes for Maori.