BFA534 Corporate Governance : Groups of Citizens

Introduction

The Maori people are the indigenous inhabitants of the modern-day Australia. They have a vast settlement history starting around 250 and 300 CE. They settled introducing a wide range of cultural and economic practices including the warrior culture and the horticulture farming. The Maori people are believed to have originated together with settlers from Polynesia. But in the beginning of the 17^th century, there was turn of events that might have probably changed the lives of the Maori people for good. There was arrival of the Europeans into New Zealand, and with their influence and power, they gradually started converting the Maori into their culture.

The integration between the Maori and the Europeans in the New Zealand led to adoption of new European lifestyles and cultural practices and with time, the original Maori culture started waning. The initial interactions between the Maori and the Europeans led to the signing of the Treaty of Waitangi in the 1840 which meant that, the two communities were to coexist together as part of the British Colony. However, these interactions led to land sales-related conflicts and there were constant tensions between the Maori and the Europeans. In addition, there emerged an epidemic of introduced diseases, and Maori found their selves in a very tricky situation which culminated in the dramatic decline of their population.

Although there has been a steady fight to address the grievances of the Maori people, it is still apparent that they face challenging issues especially in health care provision. Documented studies and statistics indicate that the Maori people have not experienced systematic representation in the health sector and the labor force. There is a higher disparity between the Maori and the non-Maori. The Maori leads in higher cases of mortality rate, and high frequency of chronic diseases, than the non-Maori (Triggs & Coulson, n.d.).

Chronic Diseases Health Issue

Chronic diseases within New Zealand accounts for almost 40% of the health burden for the nationals. The health problems are largely attributed to diseases such as cardio-vascular disease, cancer, diabetes among others. But the most eye-catching observation is that The Maori people within the country are the most affected. The continued existence of disparities in terms of health care provision between the Maori and non-Maori people has constantly left most of the indigenous New Zealanders under unfavorable health position. It is clear from credible studies and statistics that most of the Maori people are more affected with chronic disease as compared to other non-Maori citizens (Oetze, et al., 2017).

According to the (Ministry of Health, 2012), Maori have the highest cases of chronic conditions such as obesity and diabetes. They also experience high levels of heart disease, stroke, and arthritis among others. The chronic condition such as asthma is even on a worse scale that almost one in every five Maori, including children (19%) and the adults (20%), do take medication for this chronic condition. This is unlike the other non-Maori groups of citizens. It is a clear indication that the Maori are sidelined in the health provision given the highest prevalence of chronic diseases among them than the other groups of citizens (Ministry of Health, 2012).

With all these problems surrounding them and less impact and solutions, Maori people furthermore have the poorest access to healthcare services. At least two in every five Maori, which translates into (39%), could not meet the primary health needs annually, which also included 28% of the children in this ethnic group. Lack of access to health care services for most of them does not bode well with the fact that they are the most adversely affected (CGB Health Research, 2011). The limited access to health services is a major setback in New Zealand.

Seemingly, the most hindering factor from the access of the basic health care needs by the Maori includes a variety of setbacks. The cost of medical services prevents most of them from accessing the basic healthcare needs even if they wanted to. This includes 28% of adults and another 8% of Maori children. The cost of accessing a GP and the medical appointments means that a significant number of Maori goes without basic medical care (Croxson, Smith, & Cumming, 2009). The most astonishing statistic according to the (Ministry of Health, 2012), is that in the year prior to 2011/2012 health review, a massive 47% of the Maori women had faced unmet necessity for basic healthcare.

The New Zealand’s government efforts in trying to eradicate the inequalities through various ways including the primary Health Care Strategy (PHCS) has not addressed much of the Maoris’ plights. They are still languishing in dark embers of modern-day medical advancements. Some of the main contributing factors to the ethnic healthcare inequalities may result from provision of quality health care to the specific non-Maori while the Maori are provided with poor quality healthcare. Another valid reason is the difference in access to the determinants of quality health care. Non-Maoris are most likely to have easier access to the quality healthcare.

The Maori people have a higher rate of obesity. More than 44% of them are obese, which translates to about 197, 000 people. And the national statics indicates that there has not been significant change that indicates any form of improvement or eradication of the disease. There have not been any progressive changes in terms of chronic conditions of the Maori people. Stroke, Heart diseases, obesity, high blood pressure is diagnosed in an estimated 300,000 Maori people. Even with the government’s efforts; equality disparities are still evident in health care provision (Gibson et al. 2015).

The role of the Government in addressing Health Inequalities for Maori

The persistent inequalities in healthcare between the Maori and the non-Maori citizens within New Zealand have presented the government with a huge challenge of trying to eradicate the disparities. But even in the struggle to dignify the existence of the Maori by the government, these efforts have not yet bore visible fruits that cannot be termed as an effective solution to the problems of the Maori individuals. It is however good to acknowledge the fact that the government has tried to harmonize the provision of healthcare to bridge a gap between the discriminated Maori and the privileged non-Maori (Ministry of Health, n.d.).

The New Zealand government proposed a strategic framework that aimed at tackling the problem in four different levels. The first is the structural level which focuses on the root causes of the problems. It is important to understand the beginning of everything that led to the current situation as it is. The historical development of the New Zealand as a country led to convergence of the numerous ethnic groups. While the Maori were the indigenous group of the country, rapid changes from the visiting Europeans led to subsequent changes in all aspects of the Maori life. This included social aspects of the life, economic aspects as well as the political state.

Another level in the government’s framework to tackle the issue was intermediary pathways. Under this level the government would undertake all the psychological analysis and elements, including behavioral changes that can impact on health. Social and behavioral patterns can affect how people operate within an environment. It is imperative to understand cognitive elements of the Maori ethnic group in trying to understand the best possible ways of addressing their problems. The complexity of the health care inequalities within New Zealand means that the solution is not just based on the conclusive opinion but rather a deeply analyzed approach that touches every aspect of the society (Russel, Smiler, & Stace, 2013).

The New Zealand government further has undertaken special concentration on the health and disability services and devising frameworks that lead to extensive address of people with disabilities. Then the final level is the impact of the process, and working sure to minimize on the negative effects the inequalities have on the socio-economic situation (Blakely et al. 2007). The government acknowledges the fact that they are dealing with current situation caused by historical impacts of colonialism. It is understandable countries with a past history of colonialism have characteristically poor indigenous people who cannot afford basic health care services (MH Durie n.d.).

In the bid by the government to bring the equality in the health sector, the involvement of the Maori people themselves is invaluable. They have a role to play in addressing their problems and this involves taking part in the policy formulation and being part of every health policy within New Zealand.  A number of policy formulations and creations saw Maori being considered in the subsequent amendments that would see them being actively involved in the inequality eradication process (Raymont & Cumming, 2009). Policy guides were put in place and they involve greater involvement of Maori in all divisions of the health sector. There were further given the priority in the resource allocations which took their health needs and perspectives into account and finally developing culturally acceptable practices that will promote healthcare.

Iwi governance provides a basic ground for the advancement of government health policies to the Maori people. The Iwi in the pre-colonial era, were the biggest political formation within the Maori society. In this formation they were divide into Hapu (clans) and their social function were primarily to support each other and defend themselves against foreign invasion. These political formations within the indigenous Maori can provide good grounds for advancing the policies created to address the healthcare inequality problem.

Te Tiriti o Waitangi (The Treaty of Waitangi)

The Treaty of Waitangi signing in 1840 summed up a lot of about the New Zealand’s policies. It was the socially binding treaty and even in the current modern era, the treaty has been used to address important governance problems and issues (Oh, n.d.). The increased influx of people into New Zealand and increased competition for resources was the primary reason why the agreement was signed. The treaty was signed to safeguard the interests of the Maori and to protect their social and economic well being. However, it is important to note that the treaty was an agreement of settlement of non Maori into New Zealand therefore they are all treaty partners.

The Treaty of Waitangi therefore provides the best basis for reference in the address of the inequalities that have seen the Maori people being on the sidelines for better part of the post-European era. The Treaty of Waitangi addresses the citizenship of the Maori together with the non-Maori and Maori’s guaranteed continued enjoyment of their Maori rights without objection on hindrance. The New Zealand country is ethnically diverse. The signing of the treaty was a better step in accommodating all the kinds of people within the country. There are other non-Maori ethnic groups living in the country, who have their independent cultural practices and traditional customs (Population Health, 2012).

The three major non-Maori ethnic groups include the Pakeha, Pacific people and the Asian people. The diversity means that they are also part of the New Zealand society, and while they may have the upper hand in equality ladder; they must be considered in the policies that aim at empowering the Maori. This scenario brings in the relevance of the Treaty of Waitangi in addressing the equality disparity. Therefore, in reference to the principles laid down in the treaty, there are a number of recommendations that can be derived to effectively boost the government’s bid in addressing the issues in equality disparity.

The Proposed Recommendations

Based on the principle number one which is Partnership, it is imperative for the government to engage in comprehensive partnership programs that would aim at addressing the disparity in the health care provision. These partnerships encourage collaborative process that yields desired results. The government therefore, should partner its health policies together with those formulated by Maori to create an atmosphere of cooperation and understanding. For instance, the Maori health policy provides a bridge for partnership between the government and the local Maori communities. Furthermore, the ministry of health in can partner with other stakeholders in addressing all the pertinent issues affecting inequalities.

The second recommendation is based on the second principle which is Participation. In the process of addressing the inequalities in the healthcare service provision, the government and all the stakeholders involved should emphasize on participation of all the affected parties. This is more important for the Maori people, given their record of inadequate participation in health matters. The policies formulated should aim at enabling easier access to medical services and enforce a policy which allows clinic visits for the affected people. The formulation and implementation of the policies should follow close insistence on participation.

And finally, the last recommendation is based on the third principle of Protection. There should be a defined way of protection of all the health policies formulated as well as safeguarding the values, beliefs and Maori status. The protection of these policies and addressing various health provision issues including the state of chronic diseases among the Maori will ensure longevity of all the government and other policy stakeholders’ efforts in addressing equality disparity in the health sector provision that has for long affected the Maori people for several decades even after the colonial era.

The Impact of Policies in Addressing Inequalities

The historical inequality in health among Maori has seen formulation of a significant number of policies and strategies that have tried to address and solve all these problems. The extent of their success is not conclusive because currently the Maori people of New Zealand are still faced with poor outcome of basic healthcare provision. It is clear that, even policies alone cannot have the sole impact but rather, action is more appropriate to drive the agenda home. With the Maori ethnic group still having the highest cases of health-related complications, including high prevalence chronic diseases, the policies need to go a step further.

However, policies have played a significant role in addressing the equality disparity in healthcare in some ways. They have provided a good foundation on which any actions taken can result in the desired outcome. For instance, the Maori Health policy which is based on the Treaty of Waitangi, addresses inequities within the healthcare while outlining the fact that, the rights of the indigenous people are rightly enshrined and protected under the treaty. This policy advocates for the continued monitoring of these inequities in while appreciating the contemporary aspects of the Maori health. However actions are necessary to cement the power of the policies created to address the inequality problems (Medical Council of New Zealand, 2008).

In addition, the government’s efforts through proposal of principles that would address the inequalities with a comprehensive strategy at four levels is a good step forward towards addressing the issue. The strategy which involves a structural level, intermediary pathways, disability services, and the impact level are a key foundation for the solutions required to address the Maori health problem. These policies and formulations however; have relevance only if the actions can follow the writings effectively.

The Rationale of the Recommendations

From the recommendations suggested in this document, a lot can be utilized to promote improvements for health outcomes of the Maori people. This ranges from designing a proper practical foundation within which the aspects of partnership, participation and Protection can fully be undertaken for the bettering Maori health outcomes.

In addition, these recommendations can provide solutions in addressing Maori’s continued prevalence of chronic diseases, meaning that, the government strategies and other policies formulated should address specific areas of concern, such as higher cases of obese population particularly in one group of the citizens (Regional Public Health, 2017).

The recommendations further insist on the actions rather than theory such that, policies and strategies formulated are useless without action input and this involves participation processes, that is, allowing the Maori people more chances to access affordable healthcare and specifically involving them actively not just on paper but in practice.

Conclusively, the historical occurrences that resulted in the discrimination of the Maori may be a source of all the inequality problems. But the government through effective management and systematic communication channels can address all these inequalities effectively (Hussain & Ahmad 2012). Furthermore, good management and specific address of the Maori people’s health problems practically would ensure proper handling of the equality disparity and bring services much closer to everyone. The government has a sole responsibility of ensuring equity and good governance is defined by actions not words; hence, the New Zealand government still has an uphill task in continued address of the equality disparity among its citizens.

References

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