Tauiwi Visioning an Antiracist Health System: New paper

Some would say our health system in Aotearoa isn’t broken—it’s working exactly as designed: privileging Pākehā and disadvantaging Māori. Our new paper published in Sites: A journal of social anthropology and cultural studies is based on three wānanga held with Tauiwi (settler) health workers, activists, and academics in 2021 which asked the simple but radical question: what would a health system look like if it wasn’t racist?

The paper was part of a Royal Society Te Apārangi Marsden research study focusing on Reimaging antiracism theory for the health sector. 

From the three wānanga with Tauiwi senior health practitioners, academics and leaders passionate  about Tiriti and racial justice we identified four key themes. 

1. The importance of honourable kāwanatanga & decolonisation – Te Tiriti o Waitangi (the authorative Māori text) must be at the heart of the health system. That means upholding tino rangatiratanga, resourcing the equivalent of a Te Aka Whai Ora (Māori Health Authority), and sharing power with hapū (Māori nations). 

2. Building antiracism infrastructure – We need more than unconscious bias workshops. Antiracism has to be embedded into every level: policy, regulation, training, evaluation. That means accountability mechanisms, cross-party commitments, and safe spaces for Pākehā to unlearn racism without burdening Māori.

3. Understanding privilege & power – Pākehā need to own our racism, name white supremacy, and white privilege and get comfortable being uncomfortable. Tauiwi of colour reminded us that their marginalisation is compounded by racism within the system too. Intersectionality always  matters.

4. Shared commitment to transformation – We can’t tinker at the edges. Systemic racism is a public health crisis. Change needs radical imagination—radical democracy, relational decision-making, and a critical mass of people pushing inside and outside the system.
   

What would we hear see and feel in an antiracist health system? Trust. Safety. Connection. Healing spaces that honour wairua and whānau. Services designed with hapū. A system that sees people as whole beings—not fragmented clinical cases to process.

The current National-led coalition is tearing down equity infrastructure, but the visions shared in the paper by Tauiwi shows us what might be possible. Te Tiriti o Waitangi offers us a blueprint for honourable relationships and behaviours. Māori never ceded sovereignty. Māori leadership offers Tauiwi direction around antiracist and Tiriti-honouring praxis. Tauiwi have a responsibility to step up—not with saviourism, but with solidarity. This isn’t a utopian dream. It’s a practical, urgent response to a system that is literally killing Māori.

The challenge is clear: do we continue to defend a colonial illness system, or do we commit—hearts, heads and hands—to building something better, together?

Came, H., Kidd, J., Rae, N., Badu, E., Rigby, G., & McCreanor, T. (2025). Tauiwi (settler) visioning an antiracist health system for Aotearoa before the national-led coalition government. Sites: A Journal of Social Anthropology and Cultural Studies, 21(2), 60-82. https://doi.org/https://doi.org/10.11157/sites-id539