File photo. Photo: 123rf
An editorial piece published in the New Zealand Medical Journal has found Māori still have a long road to go for good healthcare.
Otago University research associate and author Jason Gurney who grew up around Te Tai Tokerau in Whananāki spoke about his observations in the area.
The nearest hospital is an hour away.
Locals get around this problem by having a First Response team, made up of an indefatigable group of trained volunteers who respond to 111 calls from anywhere.
When it comes to chronic care, patients also face challenges because some major surgeries cannot be performed at Whangārei Hospital and they are referred to Auckland instead.
He said Māori were more likely than Pākēha to live away from big cities.
"Around 25-30 percent of Maori live rurally compared to around 20 percent of Europeans, 7 percent Pacific ... which means that getting the kind of healthcare they need, it's just that little bit harder," Gurney said.
He said when it came to cancer care, Māori would likely have to travel 120 kilometres to access their first surgery compared with about 60km or less for non-Māori.
Māori were 50 percent more likely to have to travel more than 200km to access their first surgery.
He said in this issue of the NZMJ, an article by Cormack and colleagues found that from 2004 to 2009 about one in ten Māori hospitalisations and a quarter of all transfers between hospitals required Māori to travel to a hospital that was outside their home region.
Another study published in this issue of the NZMJ by Loring and colleagues spoke about the disparities Māori faced compared with Pākēha.
The authors note over 40 perecnt of the Māori population have lived in the two most deprived deciles for the past several decades, compared with less than 15 percent of NZ Europeans.
Gurney said this highlight was not only Māori were more likely to travel further for healthcare but were not able to afford the travel costs included.
"If we then add that the fact Māori are more likely to live in deprivation, Māori are less likely to have access to resources that our European population have. Therefore, it's harder for them to make that jump to get that care to access that care from further away."
Gurney has three recommendations to improve healthcare for Māori, including schemes such as the National Travel Assistance to help provide whānau and patients with upfront funding rather than relying on reimbursements.
"If you're already living in an impoverished situation, you don't have that money, that can act as a fundamental barrier to accessing that care in the first place."
Secondly, he suggested clinics where patients needed to attend in-person be held closer to where Māori lived. This would mean more clinics in remote regions such as Te Tai Tokerau, Tairāwhiti and Waikato.
"There's some care that just is very unlikely to be able to be decentralised, like your radiation therapy care. It's very expensive and difficult to build these big bunkers that you need to deliver that care. But in those situations where we can move that care closer to home, we explore how we do that, because we know if we increase access to that treatment, that many are more likely to be able to access it," Gurney said.
The third is to recognise the need for more Māori health support workers such as cancer care navigators to help Māori work through and understand care options, different appointments and clinical information.
"There's health support coordinators, providing wraparound care to sort of demystify the clinical pathway for our Māori patients.
"We have to remember that we are living very much in a western-medicalised European-based-on-English system medical system. And so we have to recognise that and provide the sort of wraparound care and support that family find a need to sort of navigate their way through clinical pathways."
Gurney said he remained hopeful the Māori Health Authority was heading in the right direction to make systemic changes.
