Government ill-informed, hasty when it axed Māori health authority - Waitangi Tribunal

Friday, 29 November 2024

Pae Ora (Disestablishment of Māori Health Authority) Amendment Bill - First Reading

Go back to the drawing board, and this time do better - the Waitangi Tribunal recommends the Government consider reviving a Māori health authority, with better Māori consultation.

It is part of the tribunal’s report, Hautupua, on the axing of Te Aka Whai Ora, a health authority created to bring the patu down on Māori health gaps.

Dumping the authority was based on minimal consultation and official advice, and was “ill-informed”, says the tribunal in its findings.

The Waitangi Tribunal has slammed the coalition Government’s axing of the Māori health authority as ill-informed, bad policymaking and ideologically driven.

It wants the Government to consider bringing back an authority, and do better this time.

The tribunal found the Government breached five Treaty principles when it dumped Te Aka Whai Ora, a health service set up by the previous government to close long-standing health gaps for Māori.

The Waitangi Tribunal has found the Crown has breached five Treaty principles in its decision to disestablish Te Aka Whai Ora/the Māori Health Authority.

Health Minister Dr Shane Reti said removing Te Aka Whai Ora did not mean the Government was turning its back on its aspirations for Māori health.

“It means using resources to strengthen and build key opportunities that will deliver better health outcomes for Māori.”

However, in Hautupua: Te Aka Whai Ora (Māori Health Authority) Priority Report, Part 1, released today, the tribunal found the Government’s process in axing the authority “was a departure from conventional and responsible policymaking”.

The move to disestablish Te Aka Whai Ora was led by Health Minister Dr Shane Reti.

“The Crown did not act in good faith when disestablishing Te Aka Whai Ora as it did not consult or engage with Māori, nor did it gather substantive advice from officials,” the report said.

Consequently the Government made the “ill-informed” decision that Te Aka Whai Ora was not required, despite knowledge of grave Māori health inequities.

It comes after the Government introduced a bill on February 28 under urgency to disestablish Te Aka Whai Ora. It was passed into law by March 5.

The Waitangi Tribunal has recommended the Crown commit to revisiting the option of a standalone Māori health authority.

The tribunal found that Māori “did not agree with the Crown’s decisions but were denied the right to self-determine what is best for them and hauora Māori [Māori health]”.

Instead, the Crown implemented its own agenda – one that was based on political ideology, rather than evidence, and one that fell well short of a process consistent with the Treaty, the tribunal said.

The tribunal said Te Aka Whai Ora was integral to delivering equitable healthcare and services and gave effect to the Crown’s Treaty obligations.

Te Aka Whai Ora should have been left in place until the Government had a replacement, but instead it chose to remove it “in haste”, the tribunal found.

“Te Aka Whai Ora was previously established by the Crown to provide redress for the long-standing failure by the Crown to reflect tino rangatiratanga in our health system.

“The Crown’s unilateral decision to remove Te Aka Whai Ora has effectively taken that redress away.”

Meanwhile, Janice Kuka, one of those who brought the case to the tribunal, said even in Opposition, National had driven an agenda to “undo this critical step towards equitable healthcare” before it even had the reins of power.

Fellow claimant Lady Tureiti Moxon said the Crown “should be ashamed of itself” because of the damage done to Crown-Māori relationships.

“The evidence demonstrates very clearly that the process was driven by a political and racist agenda,” she said.

The tribunal recommended the Government commit to revisiting the option of a standalone Māori health authority; consult extensively with Māori in the development of any alternative plans; and always undertake proper regulatory impact analysis in matters that affect Māori health.

What next for Māori health?

Health Minister Reti said he would now take time to give the report his full consideration.

He said his vision was to move decision-making around resources “closer to homes, so that local people deliver to local communities.

“This is happening through giving further controls to Iwi Māori Partnership Boards.”

The boards launched in 2022, with the job of talking to communities, assessing the state of Māori health and keeping an eye on how the health sector is performing.

Reti said, at a national level, the Hauora Māori Advisory Committee was an “important independent Māori adviser to me”.

The committee was set up in 2022 as well, with the goal of strengthening Tiriti-based relationships between the Crown and Māori. It provides advice to the Minister on any matter he requests.

Anatomy of an axing

The move to dump Te Aka Whai Ora did not come without criticism however, after the Government jumped ahead of legal action challenging the bill, by introducing it to just two days ahead of a planned urgent hearing of the Tribunal in February.

The tribunal has no authority to consider issues before Parliament.

Then, on November 13, Waitangi Tribunal presiding officer Judge Damian Stone directed the Government to release eight documents, without redactions, which show the advice it received and the process it took to close Te Aka Whai Ora.

A Ministry of Health spokesperson confirmed it released a number of documents on November 14, but asked for more for “consultation” before releasing the remaining documents.