Reports that Deputy Health Minister David Seymour he said The words of Pharmac, the pharmaceutical supply agency, to “stop taking Te Tiriti o Waitangi into account in its decisions” should not entirely true.
His five-page list of expectations Pharmac has only passed on a couple of lines of the Treaty of Waitangi. Seymour said Pharmac should now not follow the previous government’s instructions to “consider how it can contribute to embedding Te Tiriti o Waitangi across the health sector”.
In short, whatever “embedding” means, Pharmac mustn’t consider it. Instead, he instructed:
Pharmac’s role should give attention to delivering higher health outcomes supported by robust data and evidence, in step with its statutory duties. This should serve all New Zealanders based on real need, without attributing their past as an alternative choice to need.
Seymour he later said“We need to openly acknowledge that sometimes ethnicity matters and sometimes it doesn’t.”
Genetic influences on disease and drug response are best left to those with the appropriate expertise. But the politics of the issue are one other matter. The fact is that ethnicity (let alone “race”) will not be mentioned in te Tiriti or in the detailed Pharmac Treaty Policy.
Treaty and ethnicity
Concepts of race – in modern times overthrown colonial concept – and ethnicity often accompany these debates. But serious interpretations of the meaning and importance of te Tititi don’t include discussions of race.
At its heart, te Tiriti stands for equality, including the concept that health policies should serve Māori in addition to anyone else.
On the other hand, Seymour’s interest in “solid data and evidence” is vital. There is evidence from around the world that culture and colonial experiences influence how people perceive health and well-being.
There can be global evidence that racism contributes to poor healthIn New Zealand there may be evidence that the Maori population they do not at all times have the same access to the medicines they need. Te Tiriti won’t explain why this is occurring – but he says we must always discover.
Te Tiriti may not tell Pharmac which of two drugs is the higher treatment for a given condition. But if “robust data and evidence” shows underfunding for a drug used to treat a condition that disproportionately affects Māori people, te Tiriti could help address the problem.
This is because te Tiriti is an agreement on how government actually works. It is about who makes decisions, how, why and for whom.
Though Pharmac’s Tiriti Policy could possibly be criticized for being too long and vague in places, not unusual in policy writing. But it does indicate that Pharmac was pondering seriously about how these Tiriti could improve health outcomes.
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Content of the Treaty
Pharmac is just one in all many public agencies that use the “critical evaluation of Tiriti“to direct his work.
It is a technique of policy development and evaluation developed by policy scholars Heather Came, Tim McCreanor, and me to assist policymakers (and anyone who desires to comment on policy) move beyond the ambiguity Treaty principles to the essence of the contract.
The central argument is that the right to manipulate granted in Article One of Te Tiriti was never a right to cause harm. preamble to the Treaty says that the queen was thinking about:
to guard the Chiefs and Sub-Civilians of New Zealand, and to desire to preserve their Chiefdom and their Lands, and to keep up Peace and Good Order, (and) to ascertain Government, that no Evil may come to the Maori and Europeans living in a State of Lawlessness.
The preamble is a transparent statement of the division of power, authority and responsibility. The government’s powers were limited by the rights and opportunities Kingdom in article two, which simply implies that Māori make their very own decisions.
The idea of government as an exclusive non-Māori authority is rejected by Te Tiriti’s promise of citizenship based on equality methodor cultural equality.
Te Tiriti and Citizenship
Who buys what medicines, for whom and why, affects Māori residents as much as anyone else. How available these medicines are to which residents and why, affects them as well.
As Tiriti’s critical evaluation suggests, it may be assumed that every one public policy should include evidence of Māori participation and leadership and acceptance of their worldview and conceptions of well-being.
It can be fair to argue that if policies are to learn Māori as much as anyone else, it’s Māori who ought to be the judge of whether that is actually true.
There is solid data and evidence to indicate that independence and voice – the ability of Māori experts to influence policy and decision-making – contributes to health outcomes. That is why te Tiriti will help.