Hospitals ‘hostile, racist’ for M¯aori

‘‘To put it simply, there is no point solving someone’s transport barrier by giving them a taxi chit if the taxi drives them towards a racist health service,’’ Dr Emma Espiner writes.

It’s the line in her paper in today’s New Zealand Medical Journal a reviewer advised her to take out, because it didn’t sound ‘scholarly’.

But the former broadcaster, now a house officer at Middlemore

Hospital, didn’t become a doctor to pontificate, she did so to make sure people understand why Ma¯ ori have ‘‘persistently shitty outcomes across every imaginable health indicator’’, and help to fix it.

Espiner (Nga¯ ti Tukorehe, Nga¯ ti Porou) led researchers from Middlemore and the University of Auckland, in a review on access to hospital services and found Ma¯ ori experienced hostility, racism, poor communication, practical barriers to accessing care, and roadblocks to community-based care, including feeling culturally unsafe.

The team reviewed a total of 23 papers, which landed on five ways to improve things – including basic relationship building – whakawhanaungatanga – with health providers, along with mana¯ kitanga (extending love and care), wha¯ nau involvement, cultural safety, and offering practical things like payment options and transport.

The key was, barriers to hospital services should be understood as more than just lack of transport, Espiner said.

‘‘It’s all the stuff around Ma¯ ori experience in healthcare. We share stories and there are stories of wha¯nau members who have had bad experiences and that stuff really leaches into a whole wha¯nau and whole community and creates that barrier – emotional, mental whatever. You’re already thinking . . . this is going to be a bad experience.’’

This was reflected in the vaccine rollout and vaccine hesitancy among Ma¯ ori, she said.

Espiner was hopeful the incoming Ma¯ ori Health Authority would pave the way for her list of solutions. Removing barriers to hospitals for Ma¯ ori would remove barriers for all New Zealanders, she said. ‘‘Really responsive, joined up services with good communication, removing practical barriers will improve the experience for nonMaori as well.’’