Māori in Lakes DHB wait for treatment

Lakes DHB chairman Dr Jim Mather. Photo/Greg Bowker/NZ Herald

Māori are more likely to wait longer between referral and treatment at public health services in Rotorua and Taupō than non-Māori, new data suggests.

The figures come from a report to the Lakes District Health Board presented at a meeting on Friday.

The difference is particularly stark when it comes to cancer treatment, with Māori waiting an average of 32 days between referral and treatment, while non-Māori wait an average of seven days.

The national target, under Ministry of Health guidelines, is treatment within 62 days of referral with high suspicion of cancer.

However, the health board report was swift to state caution was required as the data set was small.

“We plan to extract data so that we can look at a rolling 12 month period which would give more certainty around the difference in waiting time.

“A similar picture exists for cardiovascular planned treatment, which shows that the average day waiting … is 113 for Māori versus 58 for non-Māori. Again, the actual numbers are small.”

The figures were part of a health board initiative to track Māori health outcomes in the Rotorua and Taupō region called Te Kaorerore, which was launched four months ago.

It aims to provide the board with information on the development and performance of priority health indicators and investigate the differences between Māori and non-Māori health outcomes.

The report found flu vaccination among Māori was greater than non-Māori, a difference of 69 per cent to 64 per cent.

The overall numbers were below the overall target of 75 per cent, however.

Speaking at the meeting on Friday, health board chairman Dr Jim Mather says he's pleased the dashboard provided not just data but an interpretation of what it meant.

“It’s not just providing the data but the underlying reasons why.”

The report found Māori did not have to wait longer than non-Māori at the emergency department.

Did-not-attend rates - the percentage of people who failed to attend outpatient appointments - were three times higher among Māori than non-Māori and five times that of non-Māori among those under the age of 15 years.

Te Kaoreore also found that in July, there were four Māori babies who were small for age. That accounted for five per cent of births. There were no small-for-age non-Māori babies in the same period.

The report showed Māori were more likely to be offered support to quit smoking than non-Māori.

“The ‘better help for smokers to quit’ health target is also showing improvement over time as system processes have been put in place across the hospital making both asking about smoking status, and offering support to quit, much easier for the clinical staff.”

Massey University Māori health expert Professor Chris Cunningham says there were “persistent patterns” in Māori health inequity that happened all over the country.

It was important to look not just at who the system disadvantaged but who it advantaged, he says.

Massey University Māori health expert Professor Chris Cunningham. Photo/Supplied

Did-not-attend rates were “very familiar” across the country and the “unfriendliness” of the outpatient systems could be a contributing factor.

Statistically, Māori tended to experience different kinds of cancers than non-Māori as well as being more likely to have comorbidities - other health issues which made diagnosis more complicated than it might otherwise be - and this could contribute to longer waiting times too, he says.

Waiting times could be exacerbated by socio-economic factors as well, he says, as Māori were statistically more likely to have to rely on the public system.

Māori also tended to have babies at a younger age, and younger parents tended to have smaller babies, which could contribute to small birth sizes, he says.

Cunningham says it's “encouraging” and a “very positive thing” that Lakes DHB was gathering data on Māori health outcomes, adding that data was persuasive in making the case for change.

“I’d encourage them to keep going down this pathway.”

District health board member and Whānau Ora chairwoman Merepeka Raukawa-Tait says there's “wide-scale systemic change required” to improve health outcomes for Māori.

“Te Kaoreore merely confirms what I, and others, have known for many years. 

"Māori do have to wait longer for specialist services and usually the range of interventions is not the same as for Pākehā.

Lakes DHB member Merepeka Raukawa-Tait. Photo/Andrew Warner/Rotorua Daily Post

“The excuse I often hear is that Māori present with a range of complex issues. So what? All the more reason to co-ordinate better oversight of the services and support provided. Some slip off the radar altogether.”

She says it comes down to all health boards “becoming fixated” on delivering health services for Māori “as early as possible and in a way that sees them respond positively by attending their appointments”.

She says better results came when Māori health service providers were involved.

“We must stop believing that's just the way it is and Māori don't care about their whānau health needs.“

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