Māori health experts say Te Aka Whai Ora hasn't been given a chance to work

Wednesday, 16 August 2023

Peeni Henare is an associate health minister, responsibile for Māori health.

Māori healthcare workers say Te Aka Whai Ora, the Māori Health Authority, hasn’t been given a chance.

The authority could close in a few months, with all parties on the political Right – National, ACT and NZ First – campaigning to shut it down if they win October’s election.

Their opposition gained steam when the Government released a highly critical assessment of Te Aka Whai Ora earlier this month.

This review, which ministers received in May, raised a number of concerns.

Its key issues were:

Recruitment problems. The report said the new authority hadn’t been able to hire enough staff to do its job. This had led to leadership changes and instability in its early days. “Te Aka Whai Ora staff have significant workloads and are struggling with forward planning,” the report said.
An underspent budget, with fewer health services commissioned than hoped. Key projects that had been funded in Budget 2022 “will not be fully achieved”, the report said.

Lance Norman is a Māori health expert, currently leading health efforts at WOCA.

Planning issues. The report said there was no central “implementation plan” for how Te Aka Whai Ora would scale up.

The review started in March 2023, with consultants interviewing Te Aka Whai Ora senior leaders across five weeks.

At the time, Te Aka Whai Ora was 8 months old. It started work on July 1, 2022, as part of the Government’s wide-reaching health reforms that merged the country’s iwi health boards and 20 district health boards.

Whānau Ora Commissioning Agency health director Lance Norman said the Māori Health Authority had been over-scrutinised and was facing the same challenges as the rest of the health system.

“I’ve never, ever heard of a review being done after eight months,” he said.

“Just as they got some momentum going in January, February and March, someone came to do a review and said ‘actually, you suck at what you were set up to do’,” he said.

Dr Shane Reti says National would close Te Aka Whai Ora.

Working in the Māori health sector, Norman said he saw a lot happening in April, May and June as Te Aka Whai Ora worked towards its one-year anniversary. “By the time they got to June 30, they had actually caught up on a lot of those start-up challenges they had during the first nine months,” he said.

In Budget 2022, Te Aka Whai Ora received $300 million for four years of operations. The total new spending for Māori health made up just 2.3% of the overall healthcare budget.

Norman said it wasn’t surprising that a small agency in its start-up phase had struggled to find staff, given the larger Health NZ/Te Whatu Ora had the same issue.

“When you’re so small, you only have 2% of the budget, it’s pretty hard to just target that component of the healthcare system and say that’s not working,” he said

National Party health spokesperson Shane Reti said Te Aka Whai Ora had avoided scrutiny, rather than being over scrutinised.

“Labour’s bureaucratic health restructure has cost taxpayers half a billion dollars, and for there to be no plans or details for a whole year on how to better improve Māori health is shocking,” he said.

“No other public service would be allowed to operate like this.”

Māori Health Minister Peeni Henare said the organisation had achieved a lot during its first year and pushed back against the suggestion he cut it too much slack.

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One concern from this year’s review was that an excessive number of parliamentary questions, ministerial and Official Information Act requests had distracted staff from their core tasks.

Henare said it was important to keep the public service accountable, but he questioned the motivation of many of these requests.

“I do think that, certainly coming to an election year, Māori issues and kaupapa Māori initiatives like Whānau Ora come under unfair scrutiny,” he said.

He also defended the progress of Te Aka Whai Ora so far. He said there had been “amazing outcomes”.

“We were never going to turn all of this around in one year, we’ve got a long game to play,” he said.

The Iwi Māori Partnership Boards had been set up, Henare said, leading to a boost in tamariki Māori immunisation rates over the past year.

He also said there had been improvements in mental healthcare, with Māori health providers brought in to help in the Cyclone Gabrielle recovery.

With Te Aka Whai Ora now into its second year, Henare refused to set a benchmark for what success would look like by July 2024.

“We've been clear as a government not to set a target in that manner. We need to see these results improve,” he said.

He only set a more general goal, of Te Aka Whai Ora reducing the number of Māori appearing in emergency departments.

“We will continue to monitor that and I’m confident we can turn those numbers around,” he said.

“I'm hopeful that our country, and in particular our Māori communities, have seen the work that we've done here and want to see it continue.”

The authority was set up last year, with the goal of addressing the inequity in health outcomes between Māori and non-Māori. These inequities are shown in life expectancy, with current statistics showing a Māori pēpi born today is expected to die 7.5 years earlier than a non-Māori peer.

ACT leader David Seymour has promised to abolish Te Aka Whai Ora, calling it an example of “racial discrimination”.