Health Minister Dr Shane Reti and Health NZ commissioner Professor Lester Levy.
Health Minister Dr Shane Reti and Health NZ commissioner Professor Lester Levy.
Opinion by Rob Campbell
Rob Campbell is a professional director and investor. He is chancellor at AUT, chair of Ara Ake, chair of NZ Rural Land and former chair of Te Whatu Ora.
THREE KEY FACTS
Health Minister Shane Reti promised a “different path” to improve Māori health outcomes, but staff cuts continue.
Iwi Māori Partnership Boards struggle with inadequate funding, leading some to use private sector resources.
The Pae Ora legislation and Health Charter remain in place, but current decisions show no evidence of progress.
When he introduced the bill to disestablish Te Aka Whai Ora, Health Minister Shane Reti explicitly promised that “a different path [will] improve health outcomes for Māori”.
Lyrically, his speech writer typed for him “I say to Māori Health Authority staff to please join me, guide me, and help us together to row a different waka towards better health outcomes”.
I guess the use of the term “row” rather than “paddle” was a clue – this was to be a European-style waka.
Some staff of Te Aka Whai Ora were laid off straight away. Others went in a July cull. Now we learn of further cuts to Hauora Māori staff.
No doubt some left in the voluntary redundancy programme. Reti expressed hope that they would be joining with, guiding and helping him seems to have been dashed. No sign of him fighting for it.
All around the motu Iwi Māori Partnership Boards are trying to do their best with inadequate funding and support and every day it is less obvious who exactly they are supposed to be partnering with and how.
No wonder so many iwi and hapū hauroa groups are just getting on with what they can do with their own resources and combining where they can with private sector services and with Te Whatu Ora where they can find willing staff and resources there.
National Urban Māori Authority chair Lady Tureiti Moxon. Photo / NZME
As Lady Tureiti Moxon recently put it: “We can get to work creating our own spaces in other ways”.
No doubt that will happen as the needs are great and growing and so is the determination. As Lady Moxon also said “We can’t stop here. Because if we give up now, nothing’s going to change”. And no change is a great loss to Māori and Pākehā alike.
Meantime the cuts continue.
The commissioner and his colleagues have their instructions to match costs to funding which was wrongly scoped and estimated by Treasury and the ministry. But that does not address, but compounds the capital deficits obvious in physical asset maintenance and new construction and in technology. The methods are no secret or innovation. Delay capital spend, cut staff, and limit external funding as best you can to meet the target.
The expressed desire to maintain “front line” staff is politically driven.
It is increasingly interpreted to mean medically qualified staff. This ignores the generation of increased demand for medical services increasing as other programmes and services are cut back and hurts those communities most disadvantaged socially and economically the most. That’s precisely where kaupapa Māori services were being most effectively developed.
I was recently asked at a nurses' meeting what I would change back in the current health system if I could only change one thing.
My slightly facetious answer at the time was to recognise that the Government had disestablished the wrong body. It would have been better to disestablish Te Whatu Ora and expand Te Aka Whai Ora.
The more I think about it, and as events proceed, I am becoming stronger in that view.
The coalition may wish it were not so but the Pae Ora legislation is still in place and still commits all involved to “striving to eliminate health disparities, in particular for Māori”. Not much evidence of that in current decisions.
In the process those involved are supposed to be following the principles of Te Mauri o Rongo, the “Health Charter”. That too is still in place.
I doubt either the commissioners or the ministers keep a copy close but if they did consult it they would find it pretty hard to recognise their current workforce actions in the “wairuatanga” section, or in the principle of “Whiria te tangata – we will weave our people together”. But adhering to contractual obligations of this kind seems somehow out of fashion with this Government, especially where Māori are concerned.
Maybe there is a Pae Ora hīkoi looming. It would be fully justified.
