'Stop playing party politics with our people's health' - National's plans to scrap Te Aka Whai Ora worry Māori health providers
Friday, 13 October 2023
Māori health providers and Health Coalition Aotearoa (HCA) have raised concerns around how Māori health would be impacted without Te Aka Whai Ora, the Māori Health Authority.
National’s health spokesperson Dr Shane Reti has said his party plans to disestablish Te Aka Whai Ora, if elected to government.
At a political panel in August, he said: “I do not believe that centralising authority and decision-making to Wellington, and telling people in the north of Hokianga what is best for them is right and correct.”
Reti said they would instead have a strong Māori health directorate inside the Ministry of Health.
“A Māori health directorate within the Ministry would be strategic and not operational. Iwi-Māori Partnership Boards will be the regional operational entities.
He said under former minister Tariana Turia, the Māori health directorate was powerful and created the enduring He Korowai Oranga – Māori Health Strategy.
“The Māori Health Authority had nearly two years in transition and now one year operational. These three years have produced little, if any, tangible outcomes.”
However, Māori health experts say that the authority hasn’t been given a chance to work.
HCA said that the disestablishment of the Māori Health Authority posed a grave threat to the health and wellbeing of tangata whenua.
It called on all parties to retain Te Aka Whai Ora as a Māori-led independent Crown agency advocating for and commissioning services and policies to improve the health of Māori and address unacceptable inequities and institutional racism.
“Policies to scrap the entity – after just over one year in existence – are politically motivated, without regard for the years of evidence, planning and collaboration that underpin it,” said HCA board member Grant Berghan.
“Stop playing party politics with our people’s health. It will take 20 years to turn back the damage this will do.
“We’ve been striving to set up a commissioning agency like Te Aka Whai Ora for the last 20 to 30 years. That is the vehicle that will enable Māori, by holding the pen, and having an influence over Te Whatu Ora, to make a difference,” he said.
HCA co-chair Dr Lisa Te Morenga said disestablishing Te Aka Whai Ora would weaken Māori advocacy for better control over the alcohol, tobacco, vaping and unhealthy food industries whose products disproportionately harm Māori.
“Māori communities and health providers have an especially strong interest in there being greater control, regulation, and limits on the power of commercial organisations.
“That voice can get lost when we’re a few hands raised in this big machine that is Te Whatu Ora.”
Frana Botica, general manager of Ngāti Whātua health provider Te Hā Oranga, agreed that the entity “meant that we have a louder voice and the needs of whānau we’re putting on the table are being heard”.
She said the entity “has not been given time to undo years of under-service and under-delivery of equitable health outcomes for Māori.
“However, whilst still in their infancy, they have already facilitated the highest level of engagement and communication between the Crown and Māori health providers that we have experienced, ever.
“The disestablishment of Te Aka Whai Ora will potentially be a step backwards and a step in the wrong direction if the specific focus on improving Māori health outcomes and achieving equity is removed,” Botica said.
The entity was established following recommendations from the Waitangi Tribunal and an independent Health and Disability System Review and dismantling it would be contrary to upholding Te Tiriti obligations, Botica said.
The Tribunal’s Hauora report said that the primary healthcare framework failed to recognise and properly provide for tino rangatiratanga and mana motuhake of hauora for Māori.
The failure had contributed to “the inequitable health status of Māori, who, on average, continue to have the poorest health status of any ethnic group in New Zealand – despite the Crown investing some $220 billion in the health system since 2000”.
Tia Ashby, the chief executive of Te Hau Ora O Ngāpuhi, said Te Aka Whai Ora meant that Māori rights were finally being recognised.
“We’ve had inequitable health outcomes for a very long time and this was the first opportunity for the health system to recognise the gaps in service delivery,” she said.
“Contracts that were previously given to us were more of a master-servant relationship whereby they’ll say we’ve got some money, this is what you’ll deliver on,” said Ashby.
She said Te Aka Whai Ora has enabled frontline hauora workers, who know the needs of whānau and communities, to deliver tailored services in ways that meet their needs.
“One thing that’s not helpful is when people say this is racist, but actually it’s the existence of health disparities between Māori and non-Māori that are racist,” she said.
Ashby said a centralised Māori entity is important because of the partnerships and collaboration opportunities it provides, especially where there may be fewer resources in semi-rural areas.
“We’re all trying to tackle such complex issues in the community,” said Ashby. “It’s a huge job to try to co-ordinate all those moving pieces, and it helps if parts of the whole operation have a central figure that helps make sense of these changes.
“And it keeps us safe.”