Opinion: Empower whanau to take control of health

Ngati Whakaue supporters march to the hospital in support of the axed service. Photo/Ben Fraser

Whenever I hear organisations intend to make positive changes to the way they deliver their social services I get very interested. Especially when announced as "a new expanded service based on the Whanau Ora model". These are organisations that know and understand from time to time services need to be evaluated. Are they still effective, are long term outcomes being achieved and are the service users happy and responding positively to the services provided?

As chairperson of Te Pou Matakana, the North Island Whanau Ora Commissioning Agency since 2014, I have seen firsthand the difference a Whanau Ora service delivery model can make to the lives of whanau. Many of whom have high and complex needs. There are three commissioning agencies: one each in the North and South Island and one for Pacifica people living in New Zealand.

So what's special about the Whanau Ora approach? Very simply the focus is on the support and help whanau need as opposed to what the service provider wants, or is prepared, to offer. Whanau Ora is not about the provider saying "here are the services we have for you". In the past often with a "take it or leave it" attitude.

Whanau Ora designs services around the needs of the whanau. To do this a provider must sit down with whanau, talk things through and co-design and develop services that are appropriate for them. Communication and trust are key to the relationship. You might think "well there's nothing special about that". There is. In the past social service providers have rarely sat down with the users of their services and asked "tell us where we can improve our services to better meet your needs".

Providers themselves have determined the best approach and aligned their services to achieve what they think, and hope, will make a positive difference to whanau. Be it in health, education, justice etc.

This isn't entirely their fault. They do the best they can with the inflexible contracts they have with various government departments and agencies. The contracts are so prescribed there is little or no room for whanau voices to be heard. That is changing rapidly. Whanau have found their voice, often through committed advocates. They expect to be heard and have high expectations that quality services will be provided to meet their needs. And by providers of their choice.

This is why consultation and participation in new service design is fundamental to success. Whanau themselves, those who work daily with them and those who have a vested interest in improving and achieving long-term outcomes cannot sit apart from each other. They must realise that working effectively with whanau means being culturally informed and whanau-centred. That they need to focus their attention on developing collaborative relationships and partnerships that support and enhance services.

I support local solutions to local problems. Even better when Maori identify their own needs and are supported to develop their own unique solutions.

In Rotorua Hunga Manaaki service provider Te Kahui Hauora has provided whanau-centred health solutions, advocacy and cultural support to the Lakes District Health Board for the past 20 years.

They have been leading from the front. As an iwi health provider they have a vested interest in ensuring the best possible health outcomes for whanau. The Lakes District Health Board's move to have clinically trained staff inform new service design and development is a strange call in my view. They do have an important role to play, however, they will never replace skilled, confident and culturally competent iwi members. Members engaged to invest time and effort into listening to whanau and together deciding the best course of action. Research clearly shows that when whanau have had a hand in developing solutions for their own health problems they are more likely to work hard at what is required to achieve the best long lasting results possible.

Whanau Ora is all about empowering whanau to take responsibility and control of their own lives and future. Over time this approach should see whanau enjoying good health, experiencing economic well-being and participating fully in the wider community.

"Not about us without us" is the message Hunga Manaaki supporters delivered this week to the Lakes District Health Board.

Merepeka lives in Rotorua. She writes, speaks and broadcasts to thwart the spread of political correctness.