Let’s continue to examine the substance of the NZ Herald’s article by Rob Campbell: Who on Earth is being hurt by co-governance? Read Part 1 here.

First of all, the author of the article, Rob Campbell, is the chair of Health NZ and a Labour appointee. So he is presumably pre-vetted to be supportive.

The article doesn’t really focus on how someone might be hurt by co-governance. It is more a personal opinion on two things.

One is how well the new health services are going to do (NZNE doesn’t know operational details yet), and even how well the old system generally did. There’s no basis provided to form that opinion. On the surface it seems Campbell wouldn’t really be in a position to know. He hasn’t been involved long, and doesn’t have any front line exposure or in-depth relevant experience with different medical systems. At least it’s positive thinking.

The second is, he seems to have totally bought into the idea that the old system was prejudicial to Māori (he says it is blindingly obvious to him so presumably he doesn’t think much of others who are doubters). Seemingly his idea of obvious inequity is that the Māori have a lower life expectancy and a significant part of that must be the fault of the previous system. Otherwise, would the huge effort and cost of this change be warranted? The higher rate of smoking among Māori is not mentioned although studies have attributed one third of the difference in life expectancy to it. He does mention poverty and other social circumstances as additional factors but doesn’t say how the new Māori medical system will overcome that.

Continuing with his praise, he gives the Māori credit for doing as well in their previous efforts under the old system since he notes Māori were already involved in the delivery of services to Māori communities before this reorganisation.

Campbell is enthusiastic about customising the medical system to not only focus on how the Māori would like medical services to be delivered in a culturally sensitive way. He also notes, without any specifics, other groups might benefit from an approach more customised to them. He cites the Asian community as one example, people with disabilities as another and the rural community as a third. It is hard to envision the health system having this degree of sensitivity, other than through the sensitivity of the individual health worker with that particular patient. Certainly there are no concrete plans regarding other chosen groups, but at least talking about it makes it seem that the Māori are maybe not getting such special treatment after all.

Since Campbell doesn’t suggest any answers for the question he poses about who could be hurt, here are a few:

1) It is not plausible that a parallel system will be less expensive than one well run system. Any wasted funds hurts all New Zealanders. 

2) Two systems seems like a two-tier society, which is divisive.  And this is especially so to the extent one system is perceived to be better than the other or more is spent per capita.