Medical controversy and the historian: A New Zealand case study

2017 John C. Burnham Lecture in the History of Medicine/Science, "Medical controversy and the historian: A New Zealand case study," November 2, 2017, The Ohio State University Richard M. Ross Heart Hospital Auditorium, Columbus, Ohio.Professor Bryder's talk examines her own experience of being drawn unexpectedly into the public arena when she wrote A History of the "Unfortunate Experiment" at National Women's Hospital (Auckland University Press, 2009), a publication which detailed the treatment of carcinoma in situ patients at National Women's Hospital in New Zealand since the 1950s. After her book's publication, Bryder was praised by the scholarly community yet viciously attacked by others who questioned her professionalism and integrity, branding her as being on the side of the medical profession and against the 'victims'. Bryder places the events in their historical context and shows how she came to be, in one critics words, on the side of 'baddies'. She also discusses the debates which followed and concludes with some reflections about the responsibilities of historians and the value of history

Universal healthcare for all? Māori health inequalities in Aotearoa New Zealand (1975)–2000

Despite establishing a so-called universal, taxpayer funded health system from 1938, New Zealand's health system has never delivered equitable health outcomes for its indigenous population, the Māori people. This article, using a case study approach focusing on Māori, documents these historic inequalities and discusses policy attempts to address them from the 1970s when the principles of the Treaty of Waitangi were first introduced in legislation. This period is one of increasing self-determination for Māori, but notwithstanding this, Māori continued to have significantly shorter life expectancy than the population as a whole and suffered poor health at much higher rates. Neo-liberal policies were introduced and expanded during the 1980s and 1990s in New Zealand, including in healthcare from the early 1990s. The introduction of the purchaser-provider split in health services and the focus on devolving responsibility to communities provided an opportunity for Māori health providers to be established. However, the neo-liberal economic and social welfare policies implemented during this time also worked against Māori and adversely affected their health. By analysing attempts to reduce inequity in health outcomes for Māori, we explore why these collective attempts, including by Māori themselves, did not result in overall improved health and increased life expectancy for Māori. There was often a significant gap between government rhetoric and action, and we suggest that a predominantly universal healthcare system did not accommodate cultural and ethnic differences, and this is a potential explanation for the failure to reduce inequities. While this is true for all minority ethnic groups it is even more crucial for Māori as New Zealand's tangata whenua (first people) who had been progressively disadvantaged under colonialism. However, the seeds of ideas around Māori-led healthcare were planted in this period and have become part of the current Labour Government's policy on health reform