International evidence suggests it is helpful for a nation’s health workforce to mirror the diversity in the population of its communities. The global literature is unequivocal that concordance between the health care provider and user (patient) improves patient outcomes. Health care users (patients) also report positive experiences of their interactions with health care providers of the same ethnic origin. It is not difficult to conclude that better health outcomes will reduce ethnic inequities in health that has been a chronic feature of the NZ health care system. Ultimately, better health outcomes for those who have high health needs is good for the nation as a whole.
“We must address the health inequities in our nation and we should consider all the interventions at our disposal”, says the President of the Pasifika Medical Association, Dr Kiki Maoate, Paediatric Surgeon (ONZM, FRACS, MBCHB). “This is particularly relevant in the training of our healthcare workforce. This may mean that we adopt measures that provide more assistance to some sections of our community in order to address the inequities that exist”.
Despite documented benefits of a more diverse workforce that reflects modern NZ society, it is not easy to achieve. But there is one resounding success. Medical schools in both the University of Otago and Auckland have used the Maori and Pacific Admissions Schemes (MAPAS) successfully.
In 2010, the share of Maori and Pacific students at Otago University was 7.6% and 5.6% respectively. In 2020, the combined proportion of Maori and Pacific students had risen to 32%. This is an achievement worth celebrating says Dr Maoate.
In 2019, there were a total of 102 students of Pacific heritage from a total pool of 1,380 medical students at the University of Auckland. The share of Pacific medical students at the University of Auckland has been static at about 7% since 2015, in a city where 15.5% (2018 Census) of the population are of Pacific descent.
We have work to do in order to make the changes that we need, says Associate Professor Collin Tukuitonga (MPH, FRNZCGP, FNZCPHM), the inaugural Associate Dean Pacific in the Faculty of Medical and Health Sciences, University of Auckland.
Associate Professor Tukuitonga notes that the cap in enrolment numbers, the increase in the number of Maori and Pacific students will have consequences elsewhere in the enrolment process. That is the nature of policies that seek to address chronic health inequities, where Maori and Pacific people have struggled to obtain good health care from the current health care system.
We have to accept that we will need to be creative and accept that we will not be able to treat everyone the same way, if we are seeking different health outcomes.
“Pacific graduates are making an outstanding contribution to improve the health of all New Zealanders. They are now working in a range of areas including radiation oncology and surgery and as general practitioners and public health physicians across New Zealand and the Pacific region.” says Associate Professor Sopoaga (FNZCPHM, FRNZCGP, MPH, MBChB), Head of Va’a o Tautai, Assoc. Dean (Pacific), Division of Health Sciences at the University of Otago.
Our medical workforce still does not reflect the diversity that is needed to better serve our nation says Associate Professor Tukuitonga. The NZ Medical Council shows a total of 15,819 doctors registered in NZ, of which 3.6% are Maori and 1.8% are Pacific (NZ Medical Council 2017).
Registration data for dental, nursing and midwifery professionals tell a similar story.
Pasifika Medical Association commends the positive actions taken by medical schools in New Zealand to address a chronic shortage of Maori and Pacific doctors. We should be celebrating the success of policies adopted by two medical schools in our nation, says Dr Maoate (ONZM, FRACS, MBChB). Drs Maoate and Sopoaga are medical graduates of the University of Otago.
Date: Thursday 11 June 2020