Kaupapa Maori and responsiveness : management responsiveness to Maori health issues in the reformed health service of the 1990's : a thesis presented in partial fulfilment of the requirements for the degree of Master of Social Policy, Department of Social Policy and Social Work, Massey University, Aotearoa

Abstract

This thesis is about the responsiveness of the health system and health services to Maori needs. It examines the relationship of the Treaty of Waitangi to health and the commitment of organisations to biculturalism in health care provision. It focuses on the poor health status of Maori people and explores the issues of racialism, racism and exclusion as factors in the health and wellbeing of Maori people by drawing on literature, day to day observations and recordings as well as the responses of ten health service managers to the idea of biculturalism and the low status of Maori health. It takes the position that Maori people have been and continue to be disadvantaged by monocultural attitudes, beliefs and practices in the health system and that managers have the power to change that. The time it was written in was a time of major restructuring in health and encompassed the change from Area Health Boards through the funder provider split to Regional Health Authorities as purchasers and Crown Health Enterprises as providers of services. Change was everywhere, yet the major inequality between Maori and non Maori health status in Aotearoa remained stable. The thesis begins and ends with the Treaty of Waitangi, thus the past becomes the present and the future, for as the Royal Commission on Social Policy notes: The Treaty is always speaking. It has relevance to all economic and social policies. Not.only must the past be reviewed in the light of its principles, but the Treaty's promise must also be seen as fundamental to those principles, which underlie social well being in years to come. (Royal Commission on Social Policy. Vol. 2.3.-151.)