The Government’s two very controversial health reforms

Wednesday, 28 February 2024

• The fate of Te Aka Whai Ora, the Māori Health Authority, is expected to be sealed today in Parliament

• Repealing the Smokefree generation law will commence immediately after

• Closing Te Aka Whai Ora and liberalising the smoking law are two deeply unpopular policies amongst the health workforce and Māori health advocates

• What’s your view on these changes? Leave a comment below with your thoughts.

In a few hours, the fate of Te Aka Whai Ora will be sealed. It will be gone by July.

The Government tried on Tuesday night to pass law to close the recently formed Māori health Authority, but long debate and numerous questions from the Opposition meant the debate was paused to Wednesday.

It was expected to take only a few more hours to finally, officially, lock in the first half of the Government’s most controversial health reforms. Work on the second half, repealing the Smokefree generation law, would commence immediately after.

The feedback from Māori and health experts has been clear and scathing.

Closing Te Aka Whai Ora and liberalising the smoking law were two deeply unpopular policies amongst the health workforce and Māori health advocates, who have questioned the motives of the Government and sought to challenge both policies in the Waitangi Tribunal.

“Sadly this is largely an ideologically-driven move, not backed by evidence,” said Dr Rawiri Keenan, a GP and academic from the University of Waikato, about closing Te Aka Whai Ora.

“It is clear that this government has an agenda that is anti Māori, anti-equity and quite simply racist,” he said.

On repealing the Smokefree generation plan, Hāpai Te Hauora, a Māori health advocacy group, has labelled it “anti-health”. Its chief executive, Jason Alexander, said thousands of people - many Māori, given higher smoking rates - would likely die as a result of the bill.

‘The infant needs to get up’ - Repealing the Māori Health Authority

Health Minister Shane Reti, who’s in charge of disestablishing Te Aka Whai Ora, denied his policy was driven by populism or would harm Māori. He said he had “a vision” to improve Māori health outcomes.

Currently, a Māori pēpi born today is expected to die 7.5 years before a non-Māori peer. Te Aka Whai Ora was established to close that gap. The authority formed 18 months ago.

Reti said people would be “pleased” to hear his alternative vision, but in unusual back-and-forths with reporters throughout Tuesday he declined to outline that vision.

He said he wanted to hold his powder, to deliver a grand plan in the grandeur of the House, to give it “depth and volume and the luster” during his urgent debates. He said he had great respect for “oratory”, and so wanted to keep his plan under wraps to premiere it in Parliament.

He said Te Aka Whai Ora had not delivered much-needed results during its first 18 months.

“It’s not that young,” he told Stuff. “This infant needs to get up on its feet and start walking.”

When his plan was finally revealed, it promised many aspects of Te Aka Whai Ora would survive. The Ministry of Health and Te Whatu Ora (Health NZ) would take on the staff and mission of Te Aka Whai Ora, except the chief executive and board.

Iwi Partnership Boards would continue to operate, and to advise the director-general of health. Reti promised to meet regularly with the boards.

Reti said he would set clear targets for improving Māori health - but those targets were not in the bill.

The Iwi Chairs Forum rubbished Reti’s alternative. Rahui Papa, a senior Tainui leader and co-chair of the national forum’s Pou Tangata group, said there had been “no communication” about the alternative.

“There has been no engagement with our whānau, hapū and iwi hauora (health) providers,” he said.

ACT health spokesman Todd Stephenson celebrated the authority’s disestablishment. He called it “divisive”.

“The Māori Health Authority experiment created resentment as it divided up services based on who our ancestors were. It wasted half a billion dollars,” he said.

Reti said the entire Te Aka Whai Ora budget would remain ring-fenced for Māori health.

Rob Campbell, the former chairperson of Te Whatu Ora (Health NZ), told Stuff the authority had never formed a “separate health system”. Before it formed, he said, resourcing to close the Māori life expectancy gap had been “non-existent”.

“The work started from nothing and has been delivered,” he said.

He called Tuesday night’s urgent lawmaking “a tragic farce”.

‘I am ashamed to be in this House’: Use of urgency questioned

Te Pāti Māori fought unsuccessfully to stop the urgent debate, saying Parliament must wait to hear the results of a Waitangi Tribunal hearing that was set to analyse the policy.

Two urgent claims, about Te Aka Whai Ora and the smokefree policies, were scheduled to start at the Tribunal. But the Tribunal cannot consider bills being debated in Parliament.

Te Pāti Māori co-leader Debbie Ngarewa-Packer said the Government had no moral argument to close Te Aka Whai Ora.

“[The] Government puts urgency before it puts the wellbeing of tangata whenua. I am ashamed to be in this House debating this bill. It is not a moment to be proud of, minister,” she said.

“You have gone on and you have conjured up a narrative that Māori deserve to die earlier; we deserve to be unwell; we deserve to have a system that’s designed by you all who have got no experience.”