Iwi and medical union in dental dispute

By Hone Edwards

A Wellington iwi has raised concerns about the medical specialist's union wanting to extend their collective agreement to include two dentists along with twenty GPs as Māori health providers for the Toa Rangatira Rūnanga.   

Tā Matiu Rei, executive director for Te Rūnanga o Toa Rangatira, says the move by the Association of Salaried Medical Specialists (ASMS) would incur considerable costs for patients because the government only pays for dental care up to the age of 18 years.  

Rei claims, “We are not willing to impose significant cost increases on our clients in order to meet the doctor's union's complex demands to extend our doctor’s collective employment agreement to also cover our dentists."

But ASMS Senior Industrial Officer Lloyd Woods says cost wasn't the issue.

"Indeed when his representatives were asked directly at the negotiating table if cost was the problem they said no."

Woods argues the union's move to include the two dentists in the collective agreement provides no threat at all to low-cost public healthcare.

"The only issue of note between the parties throughout the negotiations...is that these doctors working for the Rūnanga want their two dental colleague team members on the same employment agreement. The Runanga has still not given any reasonable explanation for their hard line in refusing dentist coverage and the doctors still don’t understand the problem," says Woods.  

Rei claims the expectation from negotiations with ASMS is that his iwi should use their Treaty settlement money to pick up the extra costs.

“We offer low cost and affordable healthcare to our entire community, the majority of whom are not Ngati Toa.  Contrary to popular belief, we cannot legally spend our Treaty settlement monies to directly benefit our clients who are not Ngati Toa,” Rei says.

Woods says the ASMS union has no expectation that iwi authorities fund low-cost public healthcare from their Treaty settlements. 

"We have lobbied for better funding of primary health care for many years," says Woods. 

Te Runanga o Toa Rangatira runs five medical centres and a dental clinic which provides low cost and accessible healthcare to Māori, Pacific and vulnerable people in Porirua and Wellington. 

The Toa Rangatira Māori health provider currently employs twenty doctors and two dentists and most, but not all, are members of ASMS.

“Doctors and dentists are different – they have different expertise and skills and therefore they should have tailored agreements that meet their specific requirements. Certainly, the way they are publicly funded is also very different,” says Rei.

ASMS continues to tout their successful negotiation for collective agreements for dentists and doctors who are employed by District Health Boards (DHBs).

“What they refuse to acknowledge is that we are an Iwi Health Provider.  We don’t receive the same level of funding for health provision as a DHB, and the funding we receive for adult dental care is minimal.”

Rei says the Toa Rangatira Māori health provider is the first to be targeted by the union with the expectation they're loaded with cash from their Treaty settlement to pay any shortfall. 

He says "The last thing we want to do is set a precedent for other Iwi Health Providers to pick up the health tab."  

Rei says the settlement fund is for iwi beneficiaries and comes from breaches of article two of the Treaty of Waitangi. 

However, tangata whenua have rights as New Zealand citizens under article three of the Treaty and those rights mean the public purse pays for health services via district health boards.   

He says the bigger picture is that the rūnanga must balance the needs of their employees, the community and iwi.

“The underlying issue is that adult dental care needs to be publicly funded so that affordable dental services are readily available to everyone and in every community.”

Woods says that ASMS fully supports and has publicly congratulated the Runanga for including dental care for their patients. 

"We fully agree with Sir Matiu Rei that adult dental health care should be publicly funded so that affordable dental services are readily available.  'Ma pango, ma whero ka oti te mahi', Sir Matiu, the ASMS is only too happy and ready to work with you towards this aim."