Health Minister Shane Reti fronts the media before the first reading of the Pae Ora (Disestablishment of the Māori Health Authority) Amendment Bill.
Video / Mark Mitchell
Opinion by Health Minister Dr Shane Reti
OPINION
Legislation to disestablish the Māori Health Authority heralds the start of a new vision for Māori health.
It lays the foundation for a future health system focused on health need.
I want to start by reiterating that I believe we all have the same dream for the health system: we all want to address health inequities, we all want to shorten waiting lists, and we all want a workforce that isn’t overstretched and that has the right skills to respond effectively to all our diverse populations.
Even though this particular version of the dream with the Māori Health Authority is coming to an end, as Minister I want to paint a new one, one that is outcomes-focused, driven by need, and with decisions made closer to the home and hapū.
Dr Shane Reti has a dream for Maori Health, similar to American Civil Rights activist Dr Martin Luther King. (AP Photo/Horace Cort, File).
This Government is totally focused on outcomes. The question we ask about any policy is: will it improve outcomes? Will it mean people get better care? Will it mean people get faster care? Will it mean people will get the care that suits their circumstances, including cultural competency?
Under the vision I outlined this week.
* the Hauora Māori Advisory Committee will be retained and supported to do even more
* we will retain iwi-Māori partnership boards and facilitate them to do more to meet local needs
* we will pause localities while their role is reconsidered.
Throughout the debates, members repeatedly highlighted disparities in Māori health outcomes. I acknowledge these disparities and the need to improve them. As I’ve said before, when we focus on need, we very quickly find that it is Māori who have the greatest need in most areas of health.
My dream for the health system isn’t about bureaucratic structures and endless plans and reports; it’s about identifying need and responding to it.
One of the fundamental differences in approach to health is enabled by this legislation: this Government believes that decisions should be made closer to the community, to the home and the hapū. Local circumstances require local solutions rather than national bureaucracies.
The iwi-Māori partnership boards will have a role in planning and delivery of healthcare in their communities. Local input into health services, especially primary and community services, is good for everyone and a priority for this Government.
Key differences from the previous government across all of Health include:
* health workforce as the biggest hurdle
* targets at the forefront of our health policy
* we believe in decentralising as close to the home and hapu as possible
There will be more to say and more thinking to be done. We need to have ways of working that identify and support local solutions to local health challenges. That means using data, measuring progress, and working with people who know their communities best.
Primary and community healthcare is most people’s gateway to the health system. When we get this right, we’ll be supporting New Zealanders to stay in good health for longer wherever they are, whoever they are, and whatever their health needs are.
Reiterating some of the key changes in this narrow piece of legislation – although my vision is much broader – these include:
* Māori Health Authority staff are to transfer to Health New Zealand and the Ministry of Health — this will retain a focus on Māori health and retain organisational knowledge, including any gains that have been achieved.
* uplifting of the Māori Health Advisory Committee into advisory and monitoring roles
* uplifting of iwi-Māori partnership boards, enhancing their relationship with local communities
* pausing of the schedule for localities while we reconsider their place
Soon, we will be outlining our clear health targets to drive improved outcomes, these will be ambitious targets that will take some time and resources to meet.
Finally, I want to again acknowledge the many staff of the authority, who have worked so hard.
Your expertise is essential to achieving this new dream. I know you will be welcomed into Health New Zealand or the Ministry of Health.
For health: we can choose form or function; I choose function.
We can choose activism or actions; I choose actions.
