.

  • Written by Dominic O'Sullivan, Associate Professor of Political Science, Charles Sturt University
The Treaty of Waitangi obliges the state to ensure that public policy is as effective for Māori as it is for everybody else. from www.shutterstock.com, CC BY-ND

Indigenous public policy fails consistently. The research evidence is compelling. Across post-settler colonial societies like New Zealand, Australia and Canada, schooling is not as effective for Indigenous citizens, employment and housing outcomes are not as good, and health outcomes are worse.

In Canada, the government says the solution lies in stronger nation-to-nation relationships between the state and First Nations. In Australia, the federal government proposes stronger consultation to “close the gaps in Indigenous disadvantage”.

In New Zealand, the Treaty of Waitangi is broadly accepted as an agreement offering solutions to policy failure. It protects the Māori right to self-determination and obliges the state to ensure that public policy is as effective for Māori as it is for everybody else.

Last week, the Waitangi Tribunal affirmed both these general principles in respect to health policy, but in its comprehensive report on the primary health care system, it found that despite clear intentions, the state fails to deliver good outcomes for Māori.


Read more: Racism alleged as Indigenous children taken from families – even though state care often fails them


Lack of self-determination

In effect, the tribunal found the state fails because it does not stand aside to allow Māori self-determination to prevail. Self-determination is a right that belongs to everybody. Under the United Nations’ Declaration on the Rights of Indigenous Peoples, which New Zealand accepts as an “aspirational” document, self-determination means that:

Indigenous peoples have the right to determine and develop priorities and strategies for exercising their right to development. In particular, Indigenous peoples have the right to be actively involved in developing and determining health, housing and other economic and social programmes affecting them and, as far as possible, to administer such programmes through their own institutions (Article 23).

Under the Treaty of Waitangi the right to self-determination may be expressed in at least two ways. Firstly, the treaty affirms Māori rangatiratanga, or chiefly authority over their own affairs. Secondly, it gives Māori the “rights and privileges of British subjects”.

The latter was a relatively meaningless status in 1840, when the treaty was signed by representatives of the Crown and Māori tribes. But in 2019, citizenship has replaced subjecthood as a substantive body of political rights and capacities for many New Zealanders, though not always for Māori.


Read more: Explainer: the significance of the Treaty of Waitangi


Proposal for Māori health authority

The tribunal’s Health Services and Outcomes Inquiry report is explicit. Poor Māori health persists because health policy doesn’t honour the treaty. Solutions, it says, lie in the treaty partnership between Māori and the Crown.

The idea of a treaty partnership is well established in New Zealand policy. But the tribunal report reinforces the idea that it is an unequal partnership, with the Crown acting as a senior party and crowding out space for Māori policy leadership. On the other hand, it makes at least two potentially transformative recommendations.

The first is that the Crown and Māori claimants in health care agree on a methodology for assessing underfunding of Māori health providers. The tribunal found that underfunding is in breach of the treaty and one of the variables that explains poor Māori health outcomes.

Secondly, the tribunal recommended the Crown and claimants “explore the possibility of a standalone Māori health authority”. This authority could become the principal funder of primary health services for Māori citizens. Māori health providers would make bids for contestable funding to the authority which, unlike District Health Boards, would have a predominantly Māori membership.

The authority would assess self-defined Māori health needs against established Māori cultural values. It could also have the capacity to commission research and contribute to national policy debate.

Māori at centre of policy decisions

This parallels a recommendation made to Kevin Rudd’s government in Australia in 2009 by a National Health and Hospitals Reform Commission.

Services would be purchased from Aboriginal community controlled health services, mainstream primary health care services and hospitals, and other services. The authority would ensure that all purchased services meet set criteria including clinical standards, cultural appropriateness, appropriately trained workforce, data collection and performance reporting against identified targets such as the national Indigenous health equality targets.

The proposal’s rejection was never fully explained. But it remains instructive to New Zealand as a way of making Māori policy work through self-determination.

Independent Māori decisions about which health programmes to fund, and from which providers, potentially brings Māori people and values to the centre of the policy process. It means that Māori people are not the subjects of state policy. They become its agents, exercising meaningful citizenship and the right to take responsibility for their own affairs. The concept of Māori as junior partners to the Crown is replaced by decision making authority.

An independent funding agency could also strengthen democratic accountability to Māori people who would not need to wait for an invitation to join the policy process, but would be at its centre. Liberal democracies exclude Indigenous people and perspectives as a way of protecting majority interests. But as the tribunal found, exclusion can explain why policy fails.

Meanwhile, Indigenous Australians have proposed a constitutionally enshrined “voice” to parliament, a truth telling commission and treaties between Indigenous nations and the state to acknowledge enduring Indigenous sovereignty. Victoria and the Northern Territory have started the process of treaty negotiation, but last year, a new government in South Australia “paused” the negotiations begun by its predecessor. It didn’t think that treaties could contribute to better lives for Indigenous people.

In Zealand, the treaty is not a panacea for better lives for Māori. But in 2019, it remains as the Māori government minister, Sir Apirana Ngata, put it in 1922.

[It] is widely discussed on all marae. It is on the lips of the humble and the great, of the ignorant and of the thoughtful.

Ultimately, the treaty’s transformative capacity depends on how it is interpreted, especially whether self-determination is allowed to trump partnership.

Dominic O'Sullivan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Authors: Dominic O'Sullivan, Associate Professor of Political Science, Charles Sturt University

Read more http://theconversation.com/how-to-improve-health-outcomes-for-indigenous-peoples-by-making-space-for-self-determination-120070

'An insult' – politicians sing the praises of the cashless welfare card, but those forced to use it disagree

The grey cashless debit card cannot be used at any alcohol or gambling outlet, nor used to withdraw cash. www.shutterstock.com“This is a bit controversial, we know that,” deputy prime mini...

Eve Vincent, Senior Lecturer, Macquarie University - avatar Eve Vincent, Senior Lecturer, Macquarie University

As pressure on Iran mounts, there is little room for quiet diplomacy to free detained Australians

Former Foreign Minister Julie Bishop has offered to help free three detained Australians in Iran, but the attacks on Saudi oil facilities have made the situation vastly more complicated. Stringer/EPAA...

Tony Walker, Adjunct Professor, School of Communications, La Trobe University - avatar Tony Walker, Adjunct Professor, School of Communications, La Trobe University

The gloves are off: 'predatory' climate deniers are a threat to our children

A child jumps from a rock outcrop into a lagoon in the low-lying Pacific island of Tuvalu. AAP/Mick TsikasIn this age of rapidly melting glaciers, terrifying megafires and ever more puissant hurricane...

Tim Flannery, Professorial fellow, Melbourne Sustainable Society Institute, University of Melbourne - avatar Tim Flannery, Professorial fellow, Melbourne Sustainable Society Institute, University of Melbourne

Civilization: The Way We Live Now – powerful, troubling photographs of a crowded planet and uncertain future

Cyril Porchet, Swiss born 1984, Untitled 2014 from the series Crowd, inkjet print 139.0 x 169.0 x 3.5 cm. © Cyril PorchetIn 1955, an enormous photographic exhibition, The Family of Man, challenge...

Sasha Grishin, Adjunct Professor of Art History, Australian National University - avatar Sasha Grishin, Adjunct Professor of Art History, Australian National University

Keeping the city cool isn't just about tree cover – it calls for a commons-based climate response

Where’s the shade? Trees are not an immediate or whole answer to keeping cool. Cameron Tonkinwise, Author providedThis story is part of Covering Climate Now, a global collaboration of more than ...

Abby Mellick Lopes, Senior Lecturer in Design, Western Sydney University - avatar Abby Mellick Lopes, Senior Lecturer in Design, Western Sydney University

Why it's time for New Zealanders to learn more about their own country's history

New Zealand is one of few places in the world where teaching the country's own history has not been compulsory. from www.shutterstock.com, CC BY-NDFrom 2022, New Zealand history will be taught at all ...

Michael Belgrave, Professor History, Massey University - avatar Michael Belgrave, Professor History, Massey University

Curious Kids: why are some twins identical and some not?

Identical twins look the same, are the same sex, share the same birthday and shares the same genes. www.shuttershock.com , CC BYIf you have a question you’d like an expert to answer, send it to...

Alison McEwen, Head of Discipline of Genetic Counselling, Graduate School of Health, University of Technology Sydney - avatar Alison McEwen, Head of Discipline of Genetic Counselling, Graduate School of Health, University of Technology Sydney

Suddenly, the world's biggest trade agreement won't allow corporations to sue governments

The 16 nations negotiating the Regional Comprehensive Economic Partnership account for almost half the world's population. Shutterstock/DatawrapperThe Regional Comprehensive Economic Partnership has b...

Pat Ranald, Research fellow, University of Sydney - avatar Pat Ranald, Research fellow, University of Sydney

Greens' challenge aptly described by Paddy Manning, but with no solutions in sight

Paddy Manning’s excellent account of the Australian Greens will not be the last word on Australia’s most successful third party, but will doubtless remain important and influential for man...

Marc Hudson, Researcher, University of Manchester - avatar Marc Hudson, Researcher, University of Manchester

Explainer: what happens when magnetic north and true north align?

Very rarely, depending on where you are in the world, your compass can actually point to true north. https://www.shutterstock.comAt some point in recent weeks, a once-in-a-lifetime event happened f...

Paul Wilkes, Senior Research Geophysicist, CSIRO - avatar Paul Wilkes, Senior Research Geophysicist, CSIRO

Politics with Michelle Grattan: Jim Chalmers on the need to change economic course

Shadow Treasurer Jim Chalmers says it’s time to change Australia’s economic course “in a responsible and affordable way which doesn’t jeopardise the surplus”. Chalmers p...

Michelle Grattan, Professorial Fellow, University of Canberra - avatar Michelle Grattan, Professorial Fellow, University of Canberra

Reality slippages and narcissistic stereotyping - watching Content, a TV show made for smart phones

Lucy spends much of her life living through her phone screen – what happens when we are let into this vantage point? Mia Forrest/ABCLucy (Charlotte Nicado) is a pink-haired millennial having a q...

Emma Maguire, Lecturer in English and Creative Writing, James Cook University - avatar Emma Maguire, Lecturer in English and Creative Writing, James Cook University

You can help track 4 billion bogong moths with your smartphone – and save pygmy possums from extinction

Healesville Sanctuary, Werribee Open Range ZooEach year, from September to mid-October, the tiny and very precious mountain pygmy-possums arise from their months of hibernation under the snow and beg...

Sally Sherwen, Director Wildlife Conservation and Science, Zoos Victoria, University of Melbourne - avatar Sally Sherwen, Director Wildlife Conservation and Science, Zoos Victoria, University of Melbourne

Is vigorous exercise safe during the third trimester of pregnancy?

Vigorous exercise is safe while pregnant, even in the final trimester. But if you don't feel up to it, lighter exercise is beneficial too. From shutterstock.comExpectant mothers receive an avalanche o...

Kassia Beetham, Exercise Physiology Lecturer, Australian Catholic University - avatar Kassia Beetham, Exercise Physiology Lecturer, Australian Catholic University

Climate change is the defining issue of our time – we're giving it the attention it deserves

The Conversation has joined more than 250 news outlets around the world to focus on climate change coverage. We provide 100% evidence-based coverage on climate change. Stay informed BY subscribing to...

Nicole Hasham, Section Editor: Energy + Environment - avatar Nicole Hasham, Section Editor: Energy + Environment

Australia to attend climate summit empty-handed despite UN pleas to ‘come with a plan'

The Port Kembla industrial area in NSW. Industry emissions can be cut by improving efficiency, shifting to electricity and closing old plants. Dean Lewins/AAPThis story is part of Covering Climate Now...

Frank Jotzo, Director, Centre for Climate and Energy Policy, Crawford School of Public Policy, Australian National University - avatar Frank Jotzo, Director, Centre for Climate and Energy Policy, Crawford School of Public Policy, Australian National University

'Climigration': when communities must move because of climate change

Flood damage in Bundaberg, Queensland, in 2013. Most communities are at some risk from extreme events, but repeated disasters raise the question of relocation. srv007/Flickr, CC BY-NCThis story is par...

Tony Matthews, Senior Lecturer in Urban and Environmental Planning, Griffith University - avatar Tony Matthews, Senior Lecturer in Urban and Environmental Planning, Griffith University

As Scott Morrison heads to Washington, the US-Australia alliance is unlikely to change

Wes Mountain/The Conversation, CC BY-NDPrime Minister Scott Morrison’s official visit to Washington this week carries some prestige. It is just the second “official visit” (includin...

David Smith, Senior Lecturer in American Politics and Foreign Policy, Academic Director of the US Studies Centre, University of Sydney - avatar David Smith, Senior Lecturer in American Politics and Foreign Policy, Academic Director of the US Studies Centre, University of Sydney

Apple's iPhone 11 Pro wants to take your laptop's job (and price tag)

What a week it has been in the Apple core. In recent days the tech giant has released a litany of products, including new phones, watches, tablets, and more. The big-ticket items are clearly the new ...

Andrew Maxwell, Senior Lecturer, University of Southern Queensland - avatar Andrew Maxwell, Senior Lecturer, University of Southern Queensland

Sick and Tired of Your Dead End Job? Try Teaching!

Tired of the same old grind at the office? Want an opportunity to impact lives both in your community and around the world? Do you love to travel and have new experiences? Teaching English is the perfect job for you! All you need is a willingness to ...

News Company - avatar News Company

The Impact of an Aging Population in Australia

There’s an issue on the horizon that Australia needs to prepare for. The portion of elderly citizens that make up the country’s overall population is increasing, and we might not have the infrastructure in place to support this. Australians h...

News Company - avatar News Company

LifeStyle

Picking The Right Crystal Yoni Egg: Tips And Instructions

When you are ready to pick your own crystal yoni egg, you need to decide what you will use it for...

Top 5 Tips for Paddleboarding In Whitewater

Paddleboarding can be relaxing as well as intense. If you occasionally want to do something differen...

3 Most Promising Career Occupations for Graduates in 2019

Studying in college is a great adventure which opens up lots of career opportunities. Yet, at times...

SCARmed Silicone Gel

AUSTRALIA LEADS WAY WITH ALL-NEW RAPID-DRYING SILICONE GEL WORKING WONDERS IN SCAR REDUCTION   ...