Doctors issue challenge to do more for Māori children

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Health workers should not stand by and accept worse health for Māori children and the industry must do more to help, says a doctors’ group.

Doctor using stethoscope in examining a small boy

Photo: 123rf

The Royal Australasian College of Physicians has released a series of landmark recommendations on how to provide better healthcare for indigenous children in Australia and New Zealand, including incorporating cultural safety and indigenous health practices.

Danny de Lore, the chair of the organisation’s Child Health Working Group, said he sees a lot of Māori children hospitalised due to preventable problems, and a tangible ‘health gap’.

“It is the major issue in child health. I see a lot of Māori children presenting to hospital coming to clinics with health problems that they shouldn’t have. We looked at these numbers and say ‘these differences are inequitable’ – meaning they are reversible, they are preventable, they are unjust, they shouldn’t be there.

“That’s means I’m seeing children, babies, young people in hospital and clinics with problems that we could prevent; we could reverse it – they don’t need to be suffering these conditions, they don’t need to be having these outcomes.

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“So for me that’s a real experience when I’m working, and I want other people to reflect on that as well, and to avoid the temptation to just feel like this is just how it’s always been – and this is how it’s always going to be.”

He said the ACP’s recognition this was a major issue in children’s health could produce meaningful change.

“There’s a great opportunity and responsibility for the specialist doctors who are within that college … to make a major contribution to the removal of these health inequities that we see.”

Many doctors and specialists understood that uneven health outcomes were “a big issue”, but felt at a loss to know what more they could do. So the recommendations were intended as a framework to guide action.

The recommendations included understanding colonial history, and how racism and privilege operate in healthcare facilities. Which de Lore said were valuable to inform doctors’ practical efforts, not just as philosophy.

“If I don’t understand those things about why the health of indigenous children is the way it is now, it’s much harder for me to know where to start about how I can improve it.”

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“We’ve tried to keep our recommendations pretty practical and concise … things that if you sit down and think about them, ‘yes, there are practical things I can do’.”

The group said better use of indigenous health practices would encourage more Māori to become health care professionals, and specialists. And better training would increase the rate of Māori doctors, which currently sits at around three and a half per cent, (about 16 percent of people in New Zealand are Māori).

“We can make our workplaces and our organisations more attractive to Māori people… places where they come and they see us role- modelling that we value te ao Māori and tikanga Māori and kaupapa Māori and te reo,” de Lore said.

“And then they’ll say: ‘well maybe this is the sort of place that I want to come work as well, and these are the sort of people that I can work with’.”

Medical schools had done a good job in recent years of attracting young Māori into medical schools, he said. But there was still a lot to be done.

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“We should really be shocked by the numbers when we see them… these are outcomes that our health systems are achieving, these are outcomes that our governments and societies are achieving… it’s about systems and people in the systems, and particularly about what doctors’… roles and responsibilities in making changes.

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