Maori health and government policy, 1840–1940

New Zealand has perhaps been the most interesting social laboratory of the "white" Dominions-those settlements where European colonists quickly outnumbered the indigenous peoples. For a time from 1938 until the "great dismantling" of the 1980s, New Zealand possessed the most comprehensive welfare state in the Anglophone world. It boasted the world's lowest (white) infant and maternal mortality and among the best (white) life expectancy. But the test of all colonial societies is not the condition of the colonizers, but that of the colonized, and here also New Zealand was distinctive. There were Maori medical practitioners by the early 1900s, and one of them, Maui Pomare, was Minister of Health in the 1920s. (My university in Melbourne, with the oldest medical school in Australasia (1864) did not produce its first Aboriginal medical graduate until 1989.) For all the shortcomings of Maori health care and status since colonization, the marvel to an Australian historian is that a book can be written at all about Maori health and government policy that begins in 1840. Derek Dow has aspired simply to write a detailed, critical account of Maori health policy for the century from 1840 to 1940, and the book will prove useful to many working on related or more global issues in the history of health policy and administration. It is a record of patchy, sometimes muddled, frequently well-intentioned service provision on inadequate funding, conducted by people in a new world, confronting a clash of culture and history they barely comprehended. It is the story of people struggling to find solutions and strategies, working them out for the first time with no precedents to follow, unconscious of the long-term significance of their actions. At times they see themselves as "smoothing the pillow of a dying race", or they believe that western medicine will win them Maori admiration and submission. Or there is simply a sense of decency and obligation. Remarkably, Maori health was seen as an issue and the first hospitals were established essentially as "charity hospitals" for the Maori rather than the white poor. Dow relates the ups and downs of policy, of funding, of the native medical officers who provided primary health care; and the attempts (often ineffective) to implement infection control and sanitation. He writes with a sharp, dispassionate eye that finds fault where it existed, for this is a frustrating history, where good intentions promised much and practice achieved …