An opportunity to challenge institutional racism within the public health sector

The Ministry of Health are currently consulting on how public health services are purchased. Provided within this blog post are a selection of informative links and the link to a submission template. Help challenge institutional racism within the administration of the public health sector by contributing your voice to the consultation process.- ed.


There has been great consistency in how public health services have been purchased by the Ministry of Health over the last twenty years based around the  Public Health Service Handbook.[1]

The Ministry of Health buy a range of health protection and health promotion services from environmental health, through to tobacco control services, problem gambling and health promoting schools. These services are traditionally brought from Public Health Units (based at District Health Boards), from Non-Governmental Organisations like Mental Health Foundation and the Heart Foundation, through to Primary Healthcare Organisations like Manaia Health and Māori Health Providers like Ngāti Hine Health Trust.

 shopping list




Over the last few years, the purchasing of public health services has been going through a process of reorientation as the public health specifications have been transitioned into the National Service Specification Framework Library (which has recently been made accessible to the public). As part of this reconfiguration, a background paper, Core Functions of Public Health was developed to re-orientate public health services. The new core functions include health promotion, health protection, health assessment and surveillance, public health capacity development and prevention interventions. The Ministry’s intention is that these core functions inform all public health contracts and will be used in conjunction with an overarching tier one (generic) public health service specification.

My understanding is that these core functions of public health were developed by a network of senior (Pākehā) public health staff within District Health Boards and were then adopted by the Ministry of Health. It is unclear what, if any, input Māori public health stakeholders have had into this process. A simple review of the document shows the Treaty of Waitangi is mentioned fleetingly in an appendix and the core functions paper comes strongly from a Western paradigm. Within the document, Māori are not positioned as a Treaty partner, but as a high-needs population needing access to health services (to advance an equity agenda).

Those of you familiar with my research into institutional racism will recall that service specifications (how public health services are purchased) are a site of institutional racism within the administration of the public health sector. Traditionally their framing and content have been strongly influenced by western bio-medical understanding of health and wellbeing at the exclusion of kaupapa Māori worldviews. This occurs despite longstanding traditions of Māori public health (Durie, 1994; Ratima, 2001, 2010). To date, the Ministry of Health has never developed a kaupapa Māori public health service specification; instead Māori providers have had to bend their practise into western-defined paradigms.

Expediently for those of us committed to eliminating institutional racism within the public health sector by 2017, the Ministry of Health are currently consulting on the public health service specifications.[2] If you are interested in this kaupapa, I encourage you to put pen to paper and complete a submission by 16th May 2014.

We are encouraging people to raise three key points in their submission:

  • Firstly, the urgent need to develop an overarching tier one kaupapa Māori public health service specification.

  • Secondly, encourage Crown agencies to address institutional racism within the administration of the public health system

  • Thirdly, strengthen the Māori public health content and Te Tiriti o Waitangi responsiveness across all the new proposed tier two service specifications.


Follow this link to a template submission to help you challenge institutional racism within the public health sector. I believe if we are going to transform health inequities in this country we first need to eliminate institutional racism within the health system. Please take this opportunity to take action.

Heather Came

References

Durie, M. (1994). Whaiora: Māori health development. Auckland, New Zealand: Oxford University Press.

Ratima, M. (2001). Kia urūru mai a hauora: Being healthy, being Maori: Conceptualising Maori health promotion. (Unpublished Doctoral dissertation), Otago University, Dunedin, New Zealand.

Ratima, M. (2010). Māori health promotion - a comprehensive definition and strategic considerations   Retrieved from http://www.hpforum.org.nz/assets/files/Maori/Strategic%20Issues%20in%20Maori%20Health%20Promotion%20-%20Ratima%202010.pdf

 

 







[1] Public health services in this context, refers to population based services that keep people well rather than the provision of clinical services through secondary and tertiary settings.




[2] This work is currently been led out by the Public Health Association Special Interest Group on Institutional Racism. For more information contact the author.









 


Popular posts from this blog

JOINING IN AS RADIO NZ DISCUSSES RACISM

I’d actually agree with people who say “I’m not racist”. I think racism is essentially the characteristic of the society we live in and all of us are caught up in it. Most of us are well adapted to living in a racist society. Of course, there are a few bigots who are enthusiastic and consciously participate rejoicing. Then there are lots of us who are uncritically accepting of how things are, or who have the luxury of putting it in the too hard basket. A growing number are trying to live in a resistant way.   It is good to have had a discussion on radio. If media would stop reinforcing the settler-coloniser mindset, I think the pace would pick up. However Jenny Rankine is doing a thesis about racism on social media, and at present that is a nightmare of prejudice where bigots romp and evangelise!   After focusing our energies on institutional racism, we haven't had much impact on personal prejudice as yet.  However there is some evidence that attitudes follow change rather than ini
Read more

New Support for School Boards Around Te Tiriti o Waitangi Application

Image
School boards are accountable for the performance of their school and student achievement. This includes making decisions that support Māori learners to enjoy and achieve education success as Māori. Congratulations to the New Zealand School Trustees Association for their new publication and resources to support trustees in their efforts to implement Te Tiriti o Waitangi. The resources include i) Te Tiriti and school governance information booklet, ii) board activities and inquiry scenarios and iii) video clips offering inspirational stories of school and community change. The governance booklet focusses on supporting boards moving from rhetoric to practices which are evidence-based and culturally responsive. It provides support to embed Te Tiriti o Waitangi into strategic planning, explores honourable kāwanatanga (governance) and provides up-to-date evidence on Māori students’ achievement. For the busy board member, the clips share powerful stories of how different schools have been p
Read more

This land is your land

Image
[caption id="attachment_589" align="aligncenter" width="300"] Woody Guthrie (undated)[/caption] Early in the US depression (1929-1939) Guthrie abandoned his family and joined the migration of Oklahoma farmers (Okies) off the land they had impoverished (made into a Dust Bowl) and on to California looking for work, any work. He learned their blues and other songs creating a strong foundation for his own song writing. But it was not until February 1940, while the US was sitting on the sidelines of World War II, that he penned what may be his most well known song: This land is your land.  You have probably joined in singing the first two verses at least once in your life. Just in case they have slipped your memory here they are. These verses have been covered by numerous performers since the 1960s: most recently in a full-length performance at President Obama’s inauguration in 2009 by Pete Seeger and others. This land is your land, this land is my land, From
Read more