Today is Waitangi Day, one of the most important days for all New Zealanders. It celebrates and acknowledges the signing of one of New Zealand’s founding documents: the Treaty of Waitangi.
It’s a good time to think about how the Treaty shapes the work all healthcare professionals do in New Zealand. It also raises important questions about the role the Treaty plays during the integration of internationally trained healthcare professionals.
A very brief History of New Zealand
According to Maori oral histories and other archaeological evidence, Maori arrived in Aotearoa (New Zealand) from east Polynesia in the fourteenth century. Maori lived there for close to 500 years before European contact.
The first European to reach New Zealand was the Dutch explorer Abel Tasman, who was followed 127 years later by Captain Cook. His three voyages, beginning in 1769, started a series of encounters between Pakeha (a term referring to people of European descent) and Maori.
By the 1840s, the settlement and colonisation of New Zealand by the British were well underway.
In 1840, the British government signed the Treaty of Waitangi with local Maori chiefs. Written in both Te Reo and English, the Treaty contains three articles which set out a range of principles that guide the founding of the New Zealand state.
What is the Treaty of Waitangi?
The Treaty is the founding document of New Zealand. It’s an agreement between the New Zealand Crown and Maori representatives that sets out a range of principles that come together to govern New Zealand.
Specifically, it guaranteed Maori Tino Rangatiratanga (independence), entrenching the right for Maori iwi (tribes) to manage themselves and the resources they consider taonga (treasure). It also requires the government to act in good faith, while ensuring it addresses grievances brought forward by iwi. Ultimately, it establishes equality for all New Zealanders.
Unfortunately, the Maori- and English-language copies of the Treaty held different meanings and led to different expectations. This led to successive governments taking actions that led to Maori losing much of their land as well as driving the decline of their social, cultural and physical wellbeing
But since the 1970s, there has been an ongoing commitment to resolving these challenges.
What does the Treaty mean for Maori healthcare?
A key area of focus for both parties has been delivering effective healthcare to Maori.
Ministry of Health statistics show that Maori have higher rates of illness and higher mortality compared to Pakeha. There is a general agreement that much of this comes back to the inequalities the Treaty works to remedy
According to the Ministry of Health, the Treaty of Waitangi sets out three key principles that facilitate the relationship between the Crown and Maori in healthcare.
- Partnership means working closely with Maori to develop plans that drive Maori health benefits.
- Participation ensures Maori take part in all levels of healthcare decision-making, planning and delivery.
- Protection makes sure the New Zealand Government works towards Maori having the same health benefits as Pakeha.
Healthcare professionals employed by a government-funded agency are also Crown agents and need to understand how to uphold these three concepts.
As Maori comprise a salient proportion of health services’ users, nurses, doctors and other healthcare professionals need to be responsive and committed to the Waitangi concepts and ultimately Maori health outcomes.
Building Treaty competence in overseas-trained healthcare professionals
Working in New Zealand is unique and thus requires a knowledge base that includes Treaty concepts.
Healthcare workers educated in New Zealand work through modules specifically designed around Maori health. This includes an understanding of tikanga (Maori values) and health models that contribute to hauora (wellbeing).
For overseas-trained healthcare workers, employers support them through education modules and training programs that explore the Treaty and how it shapes the New Zealand healthcare environment. In some cases, registration boards, such as the Nursing Council of New Zealand, may require health workers to complete a course as part of their registration process.
Nurses trained outside of New Zealand, for instance, may need to take a Competency Assessment Program. These courses explore the Treaty in part and help set a foundation for engaging with Maori that upholds the three Ps.
All registered nurses, overseas or domestically trained, must meet the National Competency Standards. While these don’t specifically cover the Treaty, they do set broad competencies that align with what’s set out in the Treaty.
Take Competency 2.3, it requires registered nurses to:
“Practise in a way that acknowledges the dignity, culture, values, beliefs and rights of individuals/groups.”
While it doesn’t mention the Treaty, it does facilitate the same values that are essential to upholding the principles set out by the Treaty.
Personal benefits for overseas-trained healthcare workers
The treaty can also have a positive impact on the professional and social lives of overseas-trained healthcare professionals.
A 2014 thesis by Saburo Omura found that psychological integration of Asian immigrants was facilitated through Treaty learning. Rather than just adjusting or coping with their new environment, they began exploring and redefining their cultural and ethnic identities in New Zealand.
Overseas-trained healthcare professionals who learn about the treaty may perform better and enjoy a better private life.
Treaty knowledge is highly important for delivering effective healthcare in New Zealand. For overseas-trained healthcare professionals, learning how the Treaty impacts their work is essential to delivering effective care to Maori. It can also help them better acclimatise to New Zealand’s unique social and cultural environment.