If it’s cultural care you need then get yourself to Hawke’s Bay – but what about the medical care?

Alf will let St Peter know about the cultural competence of his hospital carers...

St Peter will be asked to take note that Alf’s arrival is somewhat premature but his cultural care in a Hawke’s Bay hospital was top-class. 

Alf read with some bemusement a newspaper report that “Maori representation of the Hawke’s Bay District Health Board’s (DHB) workforce continues to increase…”

This seems to be a roundabout way of saying the board is lifting its quota of Maori staff.

The figures certainly are there to show this is so:

At the end of January, 12 per cent of the workforce described themselves as Maori, up from 11 per cent for January 2014, a report states. The DHB, Hawke’s Bay’s largest employer, aims to help increase its engagement with Maori through a more representative workforce – Maori comprise 25 per cent of the region’s population – as well as staff training.

Alf would like to think the board aims to help increase its engagement with all people.

But he lives in a society transfixed by the obligations to special people it believes are laid out in some treaty signed in 1840. A special effort therefore tends to made to increase engagement with indigenous persons.

One consequence is that the board measures its performance against two sets of indicators – general health indicators and Maori health indicators.

One way to do this is set a quota for the hiring of indigenous persons.

The DHB decided to use its staff as one strategy to accelerate Maori health indicators in 2013. The target for Maori staff representation is set annually by the senior management team. Over the previous four years the target increased about 10 per cent. January’s figure is short of the 2014/15 target of 13 per cent, giving a shortage of 39 Maori.

Uh, oh. The target has not been met.

It is not clear, however, if this is because the board decided to make appointments on merit or whether other forces were at work.

Oh, and let’s note the board is paying special attention to the hiring of indigenous nurses.

Of the DHB’s 2815 staff more than half are nurses, with 10 per cent Maori. Of 267 medical staff, 3 per cent are Maori.

A report to the DHB, by Chief Nursing Officer Chris McKenna and Human Resources General Manager John McKeefry, said nurses offered the biggest opportunity to increase Maori representation.

“We continue to promote the recruitment of Maori to all hiring managers and utilise our Maori networks to promote roles to Maori,” the report said.

And so keeping Alf alive will be top priority, should he have his heart attack or whatever while in Napier and is hauled off to the local hospital?

Because he is not an indigenous person, perhaps not.

All staff have training courses available such as Engaging Effectively with Maori and on the Treaty of Waitangi.

Oh dear. Engaging effectively with Alf might not be part of the training course.

On the other hand, as Alf’s life ebbs away in his Hawke’s Bay hospital bed he will be able to take enormous satisfaction from knowing the staff who have failed to keep him alive  have a bloody good grasp of Treaty matters.

He will mention this to St Peter when he is met at The Pearly Gates.

He will also tell St Peter this board is doing splendidly with hiring indigenous persons (perhaps in preference to others who might be better qualified)

… as it works towards a more “culturally competent workforce”.

Mind you, he might be tempted to also say he would have preferred being cared for by a medically competent workforce, and his somewhat premature  arrival at The Pearly Gates is the unfortunate consequence of being cared for instead by health workers whose strong suit was their cultural competence.

But that would be churlish.

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