"The economy is one of the major players in reviving oranga [wellbeing] for our people – when our people are living in warm whare, when we have a strong economic base as whānau, hapū and iwi that we start to see some different decision-making and behavioural changes.
"Let's fix hospitals, let's make sure primary health is better, let's make sure our people have better access to screening, diagnostics, etc, but we also have to push hard on te reo, that we get whakapapa sorted out for all our people."
Manuel said the MHA would ensure "reo is a focus, mātauranga is a focus, rongoā is a focus, that we reclaim our atua stories, our pūrākau [mythology traditions] and we use these as methods of healing for our people in the same way we do Panadol, chemotherapy and so on".
From July the MHA will become the funder of 155 kaupapa Māori providers around the country. Manuel is promising to cut bureaucracy.
"Most of them have up to about 100 different contracts, which means 100 different reporting and monitoring mechanisms – you have to employ people just to do those jobs.
"We want one, two, maybe three contracts with really clear outcomes … We want longer contracts so we're not doing these one-year contracts where you've got no ability to plan or maintain a workforce."
Although the system was being centralised, iwi and communities would be involved in setting boundaries for 'localities' and making three-year plans.
Manuel said existing Māori advisory boards would gain more teeth as partnership boards.
"Iwi-Māori partnership boards will look to sign off on those plans – and that's the lever they have.
"If you are not seen in your community to be working in a [way] that includes education and local government and all the kinds of people who can really make a difference … then probably your plan is not going to get there.
"If you haven't had a strong relationship with the mana whenua, with iwi and with hapū, then you're probably not going to get sign-off on your planning."
A registered nurse, Manuel said the MHA also has more immediately health-focused goals.
Some goals would be assisted by new online technology.
"An audiologist can do an entire assessment of your ear using a scope and a technician based close to you."
Wāhine needed access to self-screening cervical services and mammography closer to home.
"In Thames the other day we had the opening of a mammography service where the DHB had put the very first mammography suite inside of one of our kaupapa Māori providers.
"It's just moving resources, it's not adding to the pūtea, it's being really clever about where we put those resources and making sure they get closer to people who need it."
She said workforce was also an essential focus: "We need more Māori in hauora."
Māori-led Covid-19 responses had seen kaimanaaki (support workers) vaccinating and screening, and Manuel wants more micro-credentialing to extend their skills, taking pressure off nurses who in turn could ease the pressure on doctors and nurses.
Mobile services needed boosting, especially for isolated rural whānau, who would need better broadband.
"Gone are the days of just going to a clinic."
Technology would also allow the MHA to spread staff across the country, not just at the headquarters in south Auckland.
"My preference is if you live in Taranaki, or you live in the Tairāwhiti, we have all of this technology and we can talk to each other and have hui and be together without moving our people around."
Manuel cautioned that transformation would take a long time.
"A lot of what we do now will make probably not a lot of difference to those of us sitting in the taumata of this age, but it will make so much difference for our babies … our tamariki mokopuna will inherit a better system than we did.
"It's taken us 182 years to get to this point so we all accept it won't happen overnight."
Local Democracy Reporting is Public Interest Journalism funded through NZ On Air.
