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ABSTRACT
The Health and Disability System Review (the 'Simpson Review') was an opportunity for health sector transformation, particularly in light of the recent damning WAI 2575 Waitangi Tribunal report released during the review process. There appears to have been a concerted effort to engage with the sector, an impressive Māori Expert Advisory Group and an extensive body of available scholarship documenting where improvements could be made.
In this viewpoint, the authors, tangata whenua (Indigenous people of the land) and tangata Tiriti (people of te Tiriti) and health scholars and leaders undertook a high-level review of the Simpson Review report and analysed it against key elements of te Tiriti o Waitangi.
The Simpson Review was an opportunity to share power, commit to Māori health and embed structural mechanisms, such as the proposed Māori health authority, to uphold te Tiriti o Waitangi. It was also an opportunity to recommit to health equity and eliminate institutional racism. We conclude that the Simpson Review did not take up these opportunities, but instead perpetuated further breaches of te Tiriti.
Addressing the United Nations Committee on the Elimination of All Forms of Racial Discrimination in 2017, the New Zealand Government argued that our health service justifiably ranks highly in international comparisons of both health and quality of life outcomes.1 In stark contrast, the recent WAI 2575 Waitangi Tribunal report2 raised significant concerns about the longstanding systemic failure of the health system to address population-level health inequities between Māori and non-Māori.3-6
Acknowledging many of these longstanding problems, the new Government initiated a wide-ranging review of health and disability services7 led by Heather Simpson, the Health and Disability System Review (the 'Simpson Review'). The Simpson Review was tasked with improving accessibility of the health system and health outcomes with a focus on fairness, equity and effectiveness.8
The review team consisted of a sevenperson expert panel supported by a secretariat of Crown officials and a Māori Expert Advisory Group (MEAG). The consultation/engagement process included diverse stakeholders, wānanga/workshops and an open online submission process.
The final Simpson Review report8 noted that, by world standards, we have a very good publicly funded health and disability system. But the review conceded that the health and disability system is under stress and has a history of differential...