Taxpayers commonly work hard to earn the money that governments take in taxes. Knowing the effort sacrificed they naturally want governments to spend that money wisely and well.

Value for money from pharmaceutical spending depends on the medicine’s efficacy for treating an accurately diagnosed condition.

The skills going into the discovery and production of medicines do not depend on the country of origin, creed, religion, or race of those involved. Neither do diagnostic skills.

Accuracy of diagnosis is as important in public policy as in medicine.

Average health outcomes for Māori are poor. No one disputes that troubling fact. The critical first thing is diagnosis.

As documented in this report, the dominant political and official diagnosis in current health policy is that racism is a significant cause of those poor outcomes. Overt racial preferences for staffing and delivery are part of the remedy.

Start with that diagnosis. This report evaluates the most authoritative empirical evidence the Ministry of Health could provide in support of the Director-General of Health’s testimony that personal and institutional racism is a significant cause of the poor health outcomes for Māori.

On examination, the supplied material is shockingly silent overall about both causation and significance.

Where there is no serious interest in rigorous evidence-based diagnosis, there can be no serious interest in the quality of the outcome. Taxpayers, Māori and non-Māori deserve better.

The report uses the case of Pharmac to show how the prescribed remedies depart from the principle of equal treatment for equal need, regardless of race or ethnicity.

Those wishing to see better health outcomes for all New Zealanders will have to wait until there is a serious policy interest in problem diagnosis and remedy evaluation.