Healthcare a ‘lolly scramble’

Healthcare inequities are an ongoing challenge for many Māori and Pasifika people across Aotearoa New Zealand and the region.

In a recent interview with PMN Niue host Faama Viliamu, Pacific health leader Sir Collin Tukuitonga stresses the need for healthcare reform and Pacific advocacy.

He highlights the structural inequalities in global healthcare systems, likening it to a “lolly scramble”.

“When we have a lolly scramble, the kids all chase after the lollies,” Tukuitonga says.

“Global funding for health research or healthcare or training of young people is a bit of a scramble, and if you don’t have the connections, if you don’t have the money, you generally miss out.”

To address these challenges, Tukuitonga is determined to ensure that Pasifika people are seen and heard in global healthcare discussions.

He says regardless of whether you are in New Zealand, people would know about the challenges faced in its health system.

Watch here for Sir Collin Tukuitonga's full interview on PMN Niue.

“So imagine small islands in the region, they struggle,” he adds.

"One of the ways we get support for them is to make sure that their voices are heard in New York and Geneva and other parts of the world where these decisions are made.

“That’s why I think talking among ourselves isn’t really going to get the information to the people we need it most.

“With the United States opting out of the World Health Organisation (WHO), it reduces the budget for WHO by a significant amount.

“In other words, even less money is available for use in other parts of the world, but these considerations are even more important in the Pacific.

“Small island states in the region tend to compete amongst themselves for what they can get, and that’s why I try to support them as best as I can,” Tukuitonga says.

Turning his attention to New Zealand’s healthcare system, Tukuitonga criticises the Government’s spending priorities, arguing the country invests significantly less in health than many of its Organisation for Economic Cooperation and Development [OECD] counterparts.

Measured against a selection of countries, based on 2023 OECD figures, New Zealand is at the lower end of the scale. Photo/OECD.

Based on 2023 OECD data, New Zealand spends US$1,917 per head of population (per capita) on health, compared with Australia at US$2,578, Germany at $3,329 and the United States at US$5,728.

“We don’t spend a lot of money as a country on health…it’s underfunding and successive governments have not really invested the money we need in health and that explains a lot of problems we have.”

One reason is most people rely on the public hospital system, he says.

“There’s not a large private sector…so all of the healthcare New Zealand needs is provided by the public sector.

“That’s why we don’t have enough doctors where they’re most needed, and the people that suffer most are Māori and Pasifika people.

“The sooner the politicians are honest about health spending in our country, the better off we will be.”

Tukuitonga criticises the Government’s spending priorities. Photo/RNZ/Dom Thomas.

Recently, Tukuitonga was made co-director of Te Poutoko Ora a Kiwa – Centre for Pacific and Global Health at the University of Auckland.

While the centre is purely focused on research, Tukuitonga says it supports young people undertaking a profession in health.

“Whilst Poutoko is not directly involved in the training of young people for medicine or nursing, we have colleagues who go out to schools, communities, clubs, and events to meet with young people.

“We’ve got advisors, parents, caregivers preparing them for a career in the health sector.”