Equity, Ethnicity & the Aotearoa Health System: Why It’s About Rights, Not Just Needs

At a hui in March 2025 with Lady Tureiti Moxon and Dr Elana Curtis, I heard something I wish every New Zealander could hear, especially those confused, angry, or misinformed about the place of ethnicity in healthcare.

There’s a lot of (misinformed) kōrero these days about “race-based policies,” about so-called special treatment. But the truth is far simpler, and more uncomfortable: our health system already treats people differently, it just does so quietly, and in favour of those it was designed for.

What Lady Moxon and Dr Curtis reminded us that night is what I see every day as a Māori clinical pharmacist: equity isn’t about giving Māori more. It’s about fixing the fact that the system already gives us less.

When You’ve Always Had a Full Cup, You Don’t Notice It’s Full

If you’ve always had a doctor who understands you, medication that’s explained in your own language, and policies designed around people who look like you, that doesn’t feel like privilege, it just feels normal.

But for Māori, those things are not guaranteed. They’re the exception.

As Elana said at the hui, privilege is often invisible to those who hold it. You don’t see the water you’re swimming in. That’s not a moral failing, it’s a reality of living in a system built to serve you.

So when Māori call for equity, we’re not asking to take anything away from others. We’re asking to stop being treated as less.

Why Ethnicity Matters in Healthcare – and Always Has

Some (misinformed) people argue that healthcare should be “needs-based, not race-based.” It sounds logical – until you realise that ethnicity is the strongest evidence-based marker of health need in Aotearoa.

Not because of biology. Because of history.

Colonisation, racism, poverty, cultural disconnection, these things don’t just create social problems. They make people sick. They increase your risk of dying earlier. And in Aotearoa, these burdens fall disproportionately on Māori.

Ethnicity captures that. It is a reflection of the structures that have consistently made Māori sicker and made it harder for us to access the care others take for granted. Removing ethnicity from funding formulas or screening guidelines doesn’t make the system “neutral”, it makes it blind.

Rights-Based, Not Charity-Based

One of the most powerful moments in the hui came when Lady Moxon reminded us that Māori health equity is not just about fairness, it’s about rights. Māori are not a special interest group. We are Treaty partners. We are tangata whenua.

Te Tiriti o Waitangi guarantees us tino rangatiratanga – the right to lead our own wellbeing. That includes healthcare. It’s a constitutional obligation, not a “handout.”

A Treaty-compliant health system, as Elana explained, would put Māori at the centre. Because what’s good for Māori – systems grounded in manaakitaka, whanaukataka, wairua, is ultimately, good for everyone. The problem isn’t that Māori health models are “separatist.” The problem is we haven’t been allowed to lead with them.

What I’ve Learned from Working With Whānau

In my own clinical work, I’ve seen what happens when we do things differently.

When you walk alongside a whānau, not just tell them what to do.
When you centre mātauraka Māori, not just Western guidelines.
When you ask “what matters to you?” instead of “what’s the matter with you?” – outcomes shift. Trust builds. Hope returns.

That’s what equity looks like. Not more. Not less. The same chance to live well.

To Those Who Still Feel Uneasy

If you’ve read this far and still feel unsure about why ethnicity matters, I get it. We’ve been fed a steady diet of “one law for all” rhetoric, often from people who benefit most from the status quo.

But here’s a thought: What if we measured fairness by outcomes, not intentions? What if we admitted that some of us have been getting a head start for generations, and that it’s time we did the mahi to even the playing field?

Because when Māori thrive, Aotearoa thrives. That’s not a threat to others. It’s a promise to all of us.

And in the words of Dr Curtis: “The end game is aroha.”

Let’s build a system that lives up to that.