Right track for Māori health services . . .

A109 Light Utility Helicopter flight with mayor Gisborne City from the air in November 2023.

Opinion

An email to Health Minister Shane Reti from Rob Campbell, the outspoken former chairman of Te Whatu Ora - Health NZ, was published on the NZ Herald website yesterday.

He started by saying Reti’s public comments about wanting to apply real focus to improving Māori health service access and outcomes, and to devolve control, funding and delivery to iwi and hapū, were “very much in line with what is required”.

He then sounded  a note of caution about the advice Reti will get from the Ministry of Health, which had a record of “repeated failures . . . to effectively oversee and direct health service operations over many years, which is a significant cause of current deficits in Māori health experience”.

Leaving business consultants to develop and implement the Pae Ora legislation that established Health NZ and the Māori Health Authority, with limited input from iwi, hapū and Māori health services, had compounded this situation. “Subsequently, the ministry has failed to be adequately supportive of Te Aka Whai Ora (Māori Health Authority) in terms of its funding and authority to act.”

Campbell said Reti had identitifed a fault in the Pae Ora structure, which had been a major challenge: “It does not properly take into account and involve the deep and broad experience and expertise in health service funding and delivery which has been built up within Whānau Ora.”

With a greater degree of independence, Te Aka Whai Ora could build on the success of Whānau Ora and integrate it better with other social agency support.

A vocal opponent of National’s plan to abolish the Māori Health Authority, Campbell wrote that despite “excessively early” review conclusions of issues with the new authority, it had “established a highly skilled and motivated independent team” which would be wasted if it was integrated with wider structures and mandates.

Devolution of health service delivery was the right direction for all, including Māori. The Iwi Māori Partnership Boards which Te Aka Whai Ora had established were “an ideal mechanism for this”.

“They must be retained but have the additional funding and support they need to be effective, and must have the autonomy to develop their own relationships with Whānau Ora and associated central and local government agencies involved in the wider determinants of health.”

Reti was right that current structures — although still in evolution — were too centralised and cumbersome, especially for primary health services.

“The best option will be to supercharge that evolution alongside of a similar supercharge of Te Aka Whai Ora and its Partnership Boards working alongside Whānau Ora.”