Māori health providers are in a ‘state of suspension’ after Te Aka Whai Ora, the Māori health authority, was disbanded.
Wheturangi Walsh-Tapiata, mātaiwhetū of Te Oranganui in Whanganui, says hauora Māori providers are waiting to see if the changes deliver the benefits proposed under Ta Aka Whai Ora.
“We are all holding on tightly to each other as a group of health care providers, trying to support each other, understanding the situation and providing excellent practice so that, where possible, these changes do not impact our whānau and we can still walk alongside them to achieve their whānau ora goals.”
She said the arrival of Te Aka Whai Ora had immediate benefits for Māori healthcare providers.
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“Previously it seemed that the hospitals were in charge.
“With Te Aka Whai Ora we were a community working in partnership with other parts of the health system. That meant we had a voice.
“For the first time in my career in Hauora I felt there was a strong focus on Māori, challenging and trying to correct the inequalities in the system.”
This ranged from data and contracting to public health and what was happening in hospitals, to social involvement and how providers were coordinated.
According to Walsh-Tapiata, hauora providers are now in limbo.
“We are waiting to see whether there will be ongoing developments for hauora Māori, particularly in an environment where we are feeling the impact of cost of living on whānau, and on our ability to survive and create our own solutions.”
Walsh-Tapiata said having a specific organisation that represents the needs of Māori brings multiple benefits and advantages.
The first victory for providers was the award of their own relationship manager.
Te Oranganui mātaiwhetū Wheturangi Walsh-Tapiata says Māori need to be on alert as the government implements the latest health reforms. Photo / Bevan Conley
“Before that we had gotten to the point where we only had an email to connect us to the system. In addition, that manager’s focus was on supporting hauora Māori providers and ensuring we had positive whānau hauora outcomes.”
The second major step forward was an online forum.
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“All of us as hauroa Māori providers could now meet regularly to keep up to date with all the changes that were happening, to understand different parts of the system, to hear regularly from the CEOs of Te Aka Whai Ora and Te Whatu Ora and to share what we know.”
The coalition government’s focus was on the “needs of everyone” rather than the needs of Māori or disadvantaged communities, Walsh-Tapiata said.
“We will do our utmost to ensure that ‘the needs of all’ also apply to Māori.
“We must remain strong, have a clear vision for the kaupapa and continue to work with our whānau to find solutions.”
When asked whether Māori would hold the Coalition government to account if health disparities for Māori were not reduced, Walsh-Tapiata said the changes would be questioned if they did not deliver for Māori.
‘We must be alert’
“Governments come and go, and it is always important that we can adapt to the changes and key strategies of the government of the day, and find ways to benefit our whānau.
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“It is up to us to continue to provide our whānau with the coverage we have had so far.
“But we will also have to be alert.
“We all need to keep our eyes and ears open to the conversations coming from the government.”
Walsh-Tapiata said her biggest fear was that the country would return to an old system that didn’t work for Māori.
“We must look at opportunities that benefit our people, and we relish the opportunity to showcase examples of excellence that can strengthen government thinking or promote alternative ways of doing things.”
In terms of practical changes, Walsh-Tapiata said providers such as Te Oranganui now operate on integrated 12-month contracts rather than the multi-year contracts they previously had.
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“Now that we have met all the conditions of those contracts and shown that we are delivering change for our whānau in our communities – which are often isolated, rural and very Māori – the optimist in me expects we will be back on multi-year contracts within a year.”
‘There is no doubt that New Zealand must improve the health of the Maori’
Health Minister Shane Reti says improving health “for Māori and everyone” remains a priority for the government.
“There is no doubt that New Zealand must improve the health situation of Maori,” he told Local Democracy Reporting.
“The roles and functions of the authority have now been transferred to Health New Zealand and the Ministry, and I have made it very clear that that process must be done properly to improve outcomes and health needs.”
Health Minister Shane Reti says solutions that work for Māori will “substantively come from Māori”. Photo / RNZ / Angus Dreaver
It is believed that many former Te Aka Whai Ora staff have returned to health care.
In February, Reti said merging the functions of the Māori Health Authority and transferring staff to the public health system would retain the expertise needed to improve health outcomes “for all New Zealanders, including Māori”.
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The government believed that decisions should be taken closer to the community, to the family and to the hapū.
“Local circumstances require local solutions rather than national bureaucracies.
“This means that solutions that work for Māori will be Māori in content, as two-thirds of Māori are seen by mainstream providers.
“Māori involvement in the design and delivery of services for Māori is likely to lead to more effective services, reaching more people who need them.”
Reti said the 2024 government budget includes “record investment” in health care, including cost-saving funding for hauora Māori services to maintain current service levels.
Iwi Māori partnership boards are said to play an important role in the planning and delivery of health care in their communities.
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“Local ownership of health care, particularly primary and community services, is good for everyone and a priority for this government.”
According to Te Oranganui mātaiwhetū Wheturangi Walsh-Tapiata, the Iwi Māori Partnership Boards and the Hauora Advisory Group are seen as crucial change agents in the country’s health system.
Both groups would liaise directly with the Minister of Health to determine the strategic direction of the new health system and ensure the voice of Māori is included in the changes.
Walsh-Tapiata said staff at Te Aka Whai Ora, which had merged with Health New Zealand and the Ministry of Health, would be committed to serving Māori.
‘A spark from within’
“They will be a spark within the new system. They will ensure that Māori representation continues and I hope they will have a strong voice so that ka whawhai tonu mātou – we can continue to address the challenges and the needs on behalf of our people.”
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In a farewell video last week, Te Aka Whai Ora CEO Riana Manuel said staff would continue their work to improve health outcomes for Māori from their “new home”.
“We still have mahi to do within our new waka. We will be known as Hauora Māori Services.
“We will continue to strive for a fair health system that supports Māori to grow and thrive.”
LDR is a local journalism organisation co-funded by RNZ and NZ On Air
