Health Minister David Clark admits institutional racism in health system

Health Minister David Clark says there is institutional racism in the health system, but he's doing what he can to fix it. 

Next week he's expected to release the findings of the New Zealand Health and Disability System Review, aimed at coming up with ways to "ensure the system is better balanced towards wellness, access, equity, and sustainability". It was originally due to come out in March, but delayed thanks to the COVID-19 pandemic. 

An interim version of the report released late last year said Māori experience "poorer access, poorer treatment, poorer outcomes, and institutional racism".

"Racism can be manifest in three ways: institutional (systemic), interpersonal (personally mediated), and internalised," the interim report claimed. "While all three manifestations impact on health, the effects of institutional and personally mediated racism are particularly important."

Earlier this month Police Minister Stuart Nash said there wasn't any systemic racism in the police force. Asked if there was in the health system on Newshub Nation on Saturday, Dr Clark somewhat dodged the question.

"I certainly believe there is a long, long history of difficulty with intergenerational poverty, and the system does seem to have a way of perpetuating that," he told host Tova O'Brien. 

"It is being confronted through our system - I'm now requiring DHBs to be very explicit about how they are improving outcomes over time. It's now part of their standard reporting - it hasn't been in the past."

She asked him again - is there institutional racism in the health system? This time, Dr Clark addressed the question.

"We can see historic evidence of that... I think there is. I think that it's very difficult to point to specific examples - that's the nature of institutional arrangements.

"But we are, as a Government, absolutely committed to making sure that we improve things into the future. I am seeing that change happening. I've appointed four Māori chairs - we didn't have any in our health system before, at all, in our DHBs... 

"Those people are making a huge contribution to the way the health system thinks about meeting equity, as are all of the people working across our health system." 

Asked if he thought Māori should be prioritised on hospital waiting lists, Dr Clark said bigger differences could be made in prevention, screening and primary care. 

"Those are tweaks at the end of the system and they have to be supported by clinical judgement. I'm not convinced that that's where the big gains are to be made." 

As for whether he'd implement the recommendations in Simpson's report, which may include scrapping the DHB system, Dr Clark said he'd wait until it was released before revealing what he had in store. 

"What I will say is that the report is very thorough, very detailed and very long. It warrants good consideration. I've been talking with colleagues about it, and I will have more to say on it soon... We know our system's really good, but I'm yet to meet someone in the health system who doesn't know things we could be doing better."