Te Aka Whai Ora - Māori Health Authority. Photo / Whakaata Māori
Te Aka Whai Ora - Māori Health Authority. Photo / Whakaata Māori
Opinion:
The Ernst & Young report on Te Aka Whai Ora released on Friday is completely flawed and a badly disguised time machine to put Māori further at the back of the queue for health services.
The first issue is, why was only Te Aka Whai Ora being reviewed and not Te Whatu Ora and the Ministry of Health as well?
Te Whatu Ora has $26 billion of funding and Te Aka Whai Ora has only 2 per cent of that funding, and while the former is blatantly failing (e.g. just this week alone, ambulances with patients inside are queuing to get into Waikato Hospital), it is the latter that is under the microscope. There is an obvious bias to only review the Māori side of these significant health reforms and create fodder for certain political parties in an election year.
Secondly, how and why review a newly established entity after only nine months? Most of the targets are annual. They have strengthened their relationships with Māori providers and they have set up an outstanding team from a zero base as at July 1, 2022.
Te Aka Whai Ora has faced some well-publicised challenges.
On July 1, 2022 they had one fulltime staff member, who was the CEO. All other staff were employed in a temporary capacity to allow for potential re-organisation after the entity was formally established.
They had to take existing staff from the old Ministry of Health and District Health Boards. This was a union requirement to protect jobs, which meant everybody was in a temporary or acting capacity for the first three to six months. This was to give the organisation a baseline workforce and ensure continuity for staff.
So in reality, the first six months for Te Aka Whai Ora were predominately spent establishing a permanent workforce.
From January 2023 onward, the newly established executive team has been diligently working to implement the Māori Health Strategy. They collectively launched the New Zealand Health Strategy with Te Whatu Ora and also developed the significant Workforce Development Plan. Workforce is one of the biggest challenges we have in health.
The reality is that the executive team was fully established for three months (January 2023 - March 2023), and then the organisation underwent a significant review from Ernst & Young.
The third issue is the short window of the review. The report will be for a period of about nine months. Māori providers and Māori leaders in health would have seen some significant activity in the periods of April, May and June in 2023. Funding was moved from Te Whatu Ora to Te Aka Whai Ora and subsequently to Māori providers, creating a new space of commissioning for outcomes and implementing Māori models of care that work better for Māori.
The final issue is with Ernst & Young: how this review was conducted and who they interviewed.
Lance Norman.
Interestingly, Ernst & Young ran the transition unit, and for two years received significant consulting fees from the Government to write and implement the transition of our old health system to our new current health system. They had two years to plan for the changes that they then reviewed themselves, and after only nine months of fulltime operations. It would be interesting to see how much money they received for the health transition and how much they received for this current report.
A number of Māori organisations wrote a significant roadmap to improve Māori health and sent this to Ernst & Young for consideration as part of the changes in health required, but the EY transition unit ignored it for some reason.
It was only jointly developed by 100 of the largest Māori Health Providers in Aotearoa, who are at the coalface supporting our Māori communities every single day.
None of these concerns will be addressed, as this review will be used as a political football regarding Māori and the future of Māori health. From the Government’s perspective, this will look like an own goal, and indeed in hindsight, it’s not the best idea to hold a significant review without long-term data and without context for the challenges of the entire health system.
It is timely to remind the naysayers that the Māori Health Authority was established to deal with historic and significant breaches of the Treaty of Waitangi, which has led to significant health disparities between Māori and non-Māori. Disestablishing the Māori Health Authority would revert back to being a significant breach of the Treaty and take Māori health backwards.
Lance Norman is the director of health at Te Whānau o Waipareira and director of health at Whānau Ora Commissioning Agency. He is an accountant and sits on a number of Māori boards.
