The Grand Hall Parliament
Fakaalofa lahi atu, talofa lava, mālō e lelei, kia orana, taloha ni, ni sa bula vinaka, mauri, noa’ia, kia ora, tēnā koutou katoa. Warm Pacific greetings to you all.
I would like to acknowledge Doctors Debbie Ryan, Corina Grey and Api Talemaitoga who authored this report, and the people who supported them . Malo fa’atefetai for your efforts and for continuing to shine light on darkness and for holding the torch up for Pacific Health experts in our communities.
I would like to thank and recognise Dr Dale Bramley, Dr Colin Tukuitonga who made it happen.
Thank you also to the many contributors who shared their real-world experiences to give the data life: the hard-working, under-resourced Pacific health workers, leaders, and church leaders working in a system not designed by or for them
Thank you to those of you in our community who engaged again and again with a health care system that doesn’t work for them, represented here today by the consumer advisory group assembled by the Commission, and whose report in response to Bula Sautu is also available today.
Bula Sautu’s Findings
You’ve heard here tonight about the realities that many of us know and see, in our own lives, in our families and in our communities. For Pasifika and Māori people we live and breathe the inequities Bula Sautu highlights – as if it were normal and acceptable , while the health system looks on.
Pacific people live six fewer years of life than non-Māori, non-Pacific people, and the gap is widening.
Bula Sautu looks at every stage of life – maternity, child, youth and adult – to answer the question: why?
Midwifery care is inaccessible for our Pacific mothers. Less than half of pregnant Pacific women are enrolled with a midwife for crucial screening and health checks in their first trimester.
This leads to unidentified complications, blood loss and ‒ for 10 years ‒ consistently higher rates of mortality for Pacific mums and their babies.
Why have we as a country allowed this ?
Four out of ten Pacific babies in their first year of life missed out on the five core Well Child Tamariki Ora health checks for them and their families in 2018. That’s a 20 percent equity gap, and 700 Pacific babies and their families in total who didn’t get checked on.
Subsequently, between birth and age four, Pacific babies end up in hospital for serious skin conditions like cellulitis at much higher high rates. This pattern is the same for dental issues, asthma and other issues.
In 2020 more than 300 Pacific children under four went to hospital for cellulitis, a painful bacterial skin infection that can spread to blood, muscles and bones. This is six times the rate of non-Māori, non-Pacific children. More than 500 Pacific children under four were hospitalised for asthma, three times the rate of non-Māori, non-Pacific children. Again we ask why ? why? why?
Why have we allowed this to be normal and acceptable ?
This is not just a question I am asking my colleagues. I am asking Dr Bloomfield and Mr Stephen McKernan and their teams as well . I am asking every public servant . Everyone who is in this room .This is all our business . Not Pasifika , Not Māori but it’s all of our business.. Each of you I ask why?
For Pacific adults, long-term conditions, such as cancer, cardiovascular disease, gout and diabetes, and combinations of these, are the major issue.
Diabetes, for example, is a plague on Pacific adults of all ages. There are higher rates than other ethnicities in all ages. Half of Pacific elders over 65 have diabetes and this rate has remained the same for five years.
Although Pacific people with diabetes are accessing care, their diabetes is not well-controlled, and their outcomes are the worst in the country. The issue is not access to care, but the quality and effectiveness of that care, including care models that systematically disadvantage Pacific peoples.
Now I’m told that those with diabetes are the most vulnerable to the Covid-19 virus.
Pacific people are not adequately represented in our health workforce, especially in governance and leadership levels.
But we all know what incredible and successful work Pacific communities and providers did during COVID-19.
When we provide the freedom and resources to Pacific people to care for their communities, they are able to match it with unprecedented innovation and success. Pacific models should be adopted, supported and resourced en masse.
Imagine what could happen in a system that invested more in our Pacific workforce and providers.
When COVID-19 reached Aotearoa New Zealand’s shores we knew Pacific communities would be at very high risk of contracting the virus and experiencing adverse effects. This was borne out in the second outbreak in August 2020.
The COVID-19 response for Pacific communities in New Zealand highlighted the strengths, resiliencies and innovations within Pacific communities, providers and organisations.
Our Pacific organisations took their duties and responsibilities to the next level – community connections, knowledge and insight meant that when we are resourced and enabled we can do the job properly – for our people, by our people.
And while we are talking about Covid . Can I remind you that this as the Prime Minister has said is “the Year of the Vaccine.”
So let’s make sure we all get the jab like I have . The Vaccine is safe and effective.
Looking to the Future – Health Reforms
This is a damning report. But it is timely. With the recently announced Health System reform we have an opportunity to ensure that when we look back on tonight in the future, we are measuring the progress we have collectively made. We need to ensure that Pacific health wellbeing is lifting and that addressing equity has become not just words, but action.
When the Government announced the reform, I immediately themed it “E fofo e le alamea, le alamea” . This describes in my mind what is needed to be done to address Pacific inequalities . The solutions are found in the Pacific Communities.
Tonight I wasn’t sure I was going to make it here . Our plane initially touched down then took off again . The pilot announced that we were going round one more time . It was bumpy. But I remained calm when I saw beside me Tevita , in front was Silao of South Seas and Dr Api , and behind me was Dr Colin Tukuitonga and others. I gained confidence seeing them all there, knowing this launch will not be complete without us all . It also reminded me that this reform requires innovation and thinking outside the box.
We are literally building the plane as it flies off and swings around one more time .
In my role, I am working hard to ensure that the equitable health outcomes for Pacific peoples is at the forefront of design, planning and implementation within the new health and disability system. To lead this, I and my colleagues have the help of Pacific experts and leaders – many of them here tonight, that will help guide decisions to ensure the system is established in a way that will work for our communities.
As we progress in this process, I will be reaching out to more of you in the community, for your valuable feedback and input too.
I believe that our Pacific expertise and leadership needs to be involved at all levels. This is necessary to provide me confidence that we will address inequities meaningfully. I also believe that our Pacific values , cultural worldviews and beliefs should be central to everything we do. Any decisions around policy, commissioning and service design which aims to deliver better outcomes for Pacific peoples, need to reflect our cultural values to be truly impactful for our Pacific communities.
Services which resonate with and reflect our shared principles such as – mutual respect, family and I mean extended family, reciprocity, collectivism and spirituality is what has and will work best for our people. We need more services built on the ‘by Pacific for Pacific’ philosophy.
To close, the launch of Bula Sautu needs to be a line in the sand. I look forward to later on reflecting on this work as we together witness a system that that at it’s heart exists to eliminate the inequities that are preventing Pacific people from living their best, fullest lives.
I have confidence and pride in our committed Pacific health workers and providers. COVID-19 has shown us that when they are given the freedom and resources to respond they do so brilliantly. The system needs to enable and support this brilliance, and foster Pacific health leadership from training to the highest levels.
All of us have a duty and responsibility to ensure that the most vulnerable in our society are lifted up , cared for and empowered to become healthy strong and resilient citizens. I believe this is the Kiwi way . It was once upon a time . We need to reclaim it and make it so again.
In my role I will continue to advocate for total system transformation for our people. I encourage those of you already doing so, and those that could do more – I urge you to take up the challenge today. I also ask all Pacific and Maori public servants, that irrespective of the roles you hold, it is important that you also play a role in advocating for the most vulnerable including for Pacific, Maori and those with disabilities.
Kia kaha. Fa’afetai ma Soifua. It is my pleasure to now publically launch Bula Sautu : A window into Pacific health.