Māori DHB directors isolated and over-burdened

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Mon May 20 2013 12:00:00 GMT+1200 (New Zealand Standard Time)

Māori DHB directors isolated and over-burdened

Monday, 20 May 2013, 11:36 am
Press Release: Massey University

Monday, May 20, 2013

Māori directors on district health boards (DHBs) are burdened by the responsibility of being the sole advocates for Māori health, according to new research from a Massey University PhD graduate.

Dr Joy Panoho wrote her doctoral thesis on the experiences of Māori directors on district health boards. All but one of the 18 directors she interviewed said that tokenism, stereotyping and political correctness were common.

She says directors felt they were burdened by the responsibility of being the sole advocate for Māori health on their boards.

“They described fulfilling the role of ‘a walking Treaty workshop’ – that was in their own words. Regardless of the best intentions of their non-Māori counterparts, enormous gaps in understanding about Māori politics, Māori expertise, and Māori networks exist,” Dr Panoho says.

“Well over half the directors I spoke to recounted incidents of confrontation where they had to educate their non-Māori counterparts about the underlying issues affecting Māori health. While this then led to improved levels of understanding, it can be quite an exhausting burden.”

Dr Panoho says some problems stem from “ambiguous legislation”. The New Zealand Health and Disability Act 2000 provided for regional Māori representation in DHB health governance, but according to Dr Panoho, there are many misunderstandings about what the legislation says.

“Most people believe the Act says there ought to be at least two Māori directors on every board. The wording is actually ‘best endeavours’ so in actual fact there are boards that have only have one Māori director, and some that have had none at all.

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“For directors with no other Māori counterparts the situation can be deeply concerning. The appointment process is a top-down one so it’s not particularly transparent and often unpredictable.”

Dr Panoho says the way the Government has organised and identified Māori groupings can also be problematic for representation and does not reflect the contemporary reality of Māori urbanisation and mobility.

“The Government consultation over who should be appointed to directors’ roles is done through a tribal process, which excludes some potential candidates. This can cause friction between manawhenua and pan-Maori groups,” she explains. “For example, I am Ngāpuhi even though I no longer live in Northland. If I wanted to be nominated as a Māori director of a DHB I would have to go back north.”

But the most difficult challenge faced by Māori directors, according to Dr Panoho, comes from the attitudes of other directors.

“Many felt there was little cultural or historical understanding of the damage to Māori health brought about by the process of colonisation. Māori directors have valuable grassroots experience that is an important strategic tool for DHBs. This experiential capital is as valuable a resource contribution as, for example, a law degree or an accountancy degree.”

Despite the difficulties many have experienced as “the Māori representative” on their DHB, Dr Panoho’s interviewees also recognised that without the legislation there would be little or no Māori representation.

“All participants recognised the importance of having a seat at the table even though progress was at times hard to measure. Most felt, overall, they were having a positive impact and there was an opportunity to change attitudes and help turn Māori health statistics around.

“For that sort of transformation to take place, there needs to be an improved understanding of Māori health issues by all DHB members,” Ms Panoho says. “Everyone at the board table needs to share the burden of improving Māori health.”

ends

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