Māori Health Authority would fix inequity of Covid response, submitters say

The Covid-19 vaccination rollout has faced criticism for its outcomes for Māori. Photo / Alex Burton

The inequity of the Government's Covid-19 response could have been addressed had the Māori Health Authority already been in place, submitters into legislation behind the groundreaking entity say.

Māori health organisations were among the more than 4000 submitters on the Pae Oranga bill, which will also establish Health NZ and disestablish the country's 20 district health boards.

John Tamihere, speaking on behalf of Te Whānau o Waipareira Trust, said their organisation having to take the Ministry of Health to court in order to get vaccination data for Māori were examples of why an independent Māori-focused entity was essential.

"This legislation is the first legislation in our history that will elevate us into some form of equilibrium," Tamihere said.

Ministers behind the legislation have made similar statements, that a Māori Health Authority would address the health inequities on display in the Covid-19 response, which has seen Māori vaccination rates lag well behind and Māori disproportionately impacted in case rates.

Speaking in the House in October during the bill's first reading, Health Minister Andrew Little said: "If ever there was any evidence about the problems and the challenges we have with the current health system, you've only got to look at the current Covid pandemic and, actually, the roll-out of the vaccination campaign."

The National Hauora Coalition, one of the claimants to the Waitangi Tribunal's health inquiry in 2019 and which at the time suggested such an authority, said lessons could be learned from the vaccine rollout, including allowing the authority to commission services and shift funding to communities that most needed them.

Chief executive Simon Royal said in his submission they also wanted greater accountability to Māori through the legislation, the authority to be directly involved in developing health strategies, and a stronger Te Tiriti o Waitangi clause.

The language also needed to change from "reducing inequities" to "removing inequities", he said.

Health Coalition Aotearoa also submitted that the legislation needed to strengthen its language around Te Tiriti, giving the Māori Health Authority "equal footing in the law with Health New Zealand and equitable funding to undertake public health impact analysis, without Ministerial direction".

Chair Professor Boyd Swinburn said in their submission they also wanted to see the "80 per cent gap" explicitly addressed, the concept that socioeconomic factors such as housing, transport and the food environment, along with commercial drivers of like alcohol, tobacco and unhealthy food, play much larger roles than healthcare.

"The new health agencies need a mandate to influence the wider causes of health and disease as well as weaving wellbeing measures into the whole system," Swinburn said.

"Public services and policy across Government need to work together as a united team to really make a difference to health."

The health reforms under the Pae Oranga bill, announced in April last year, will see New Zealand's 20 DHBs scrapped and replaced by one new centralised Crown entity, Health New Zealand.

The Māori Health Authority is to be the lead commissioner of health services targeted at Māori and "act as co-commission for other health services accessed by Māori, working jointly with Health NZ to approve commissioning plans and priorities".

Its formation comes after years of outrage from those working in the health sector about inequities and breaches of Te Tiriti o Waitangi, and was recommended by the Waitangi Tribunal in 2019 and the Simpson review last year.

Submissions to the Pae Ora Legislation Committee continue.