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Turia: Te Matarau 2005 Conference

Provider Innovation. Te Matarau 2005 Conference

The Quest For Well-Ness: Finding The Right Pathway To Well-Being

Tariana Turia, Co-leader, Maori Party

E nga mana, e nga reo o nga iwi kei raro i te maunga tapu o Taranaki, tena koutou.

Anei tenei o nga rahi o Whanganui me Ngati Apa, Nga Rauru me Tuwharetoa hoki e mihi atu nei ki a koutou.

Tena koutou katoa.

As we were driving into New Plymouth last night, the majestic wonder of maunga Taranaki caused me, again, to reflect on our connections.

I thought of our korero, of the clan of maunga from whence Taranaki derives his authority. I recalled the stories of longing when Taranaki cast sideways glances at Pihanga – who was betrothed to Tongariro.

As Tongariro vented his passion and anger, and the molten ash and lava erupted forth, Ruapehu intervened, and told Taranaki to go, lest his role as tohunga of the clan be jeopardized.

As Taranaki turned to leave, Ruapehu cast a rock off his shoulder, Rauhoto, and fastened it to the feet of Taranaki to guide him in his journey. That rock can be seen at Puniho marae, a marae close to Parihaka of the Nga Mahanga people.

There have been many interpretations of our korero. Some focus on the explosion of might between Tongariro and Taranaki, some focus on the isolation and perceived loneliness of maunga Taranaki, cast aside.

I see it differently. Taranaki never departed as an independent isolate – although he went out on his own, he was always guided by Rauhoto, and in this way, had the best of both worlds.

It is with that korero in mind, that I come to your hui focusing on provider innovation and excellence.

The excellence evident here must be celebrated. I want to mihi to the outstanding success of our Maori Development Organisations: Te Roopu Huihuinga Hauora, Tui Ora, Taumata Hauora, Ngati Porou Hauora, Poumanawa Oranga and Poutiri Trust.

I was so disappointed not to be able to join with you at your inaugural awards ceremony last year at Te Papa – where the true talents and distinctive success of all of our MDO and the vast qualities of Maori health providers were recognised.

I think it is really important that we take time to pat ourselves on the back, to celebrate the 240 Mâori health providers contracted to 21 District Health Boards throughout Aotearoa.

Many of these providers have been totally dedicated to the cause for over ten years now, and you have established a quality of service distinguished by our kaupapa and a delivery framework which is distinctively Mâori .

You have experienced a huge range of changes and most of you have managed the transitions well.

You have established yourself as a leading organisation, nurturing and identifying excellence in nursing, management, clinical leadership, health promotion, administration and support services, support work or counselling and community health.

You have demonstrated your respect for mana wahine, rangatira tane, supporting services that actively represent te reo and tikanga Maori, that display innovation, and are committed to quality.

There are of course, still areas for challenge. I want to raise with you, the question as to the focus of the MDO. When the concept of a Maori Development Organisation was first promulgated there was always the thought that it would bring with it a focus on development, not just health.

Sometimes I wonder whether we are just continuing to mirror existing health services, with a brown face attached. Such questions about the effectiveness of the MDO will continue to be raised, until we are confident that the MDO are working with whanau and hapu in a meaningful way.

Turning now to the focus for this hui, Provider Innovation, there are two particular areas I want to look at, which I believe come to me from the korero of maunga Taranaki. The first is a focus on the right pathway to well-being, finding a definition that fits.

The second is that innovation does not have to be seen as synonymous of isolation; breaking away from the fold, moving out from one’s usual ‘modus operandi’, can be an act of liberation.

The Right Pathway to Well-being I was interested to read through some of the abstracts for this conference, and to see the various initiatives that have been introduced to address the ‘burgeoning epidemic of obesity, diabetes, hypertension, hyper-cholesterolemia and ischaemic heart disease’.

When we set off on the path of Whakatataka, we were always very conscious that it should be an action plan in which whanau ora are supported to achieve the fullness of health and well-being, within Te Ao Maori as well as New Zealand society in general.

The plan promotes the development of four pathways to ensure we build on the strengths and assets within whanau and Maori communities to achieve the aspirations of He Korowai Oranga.

Our key expectation was that whanau members must be healthy if they are to make their fullest possible contribution to New Zealand society.

This is great stuff (if I say so myself!) the focus on wellbeing, on opportunities to improve whanau ora, on facilitating Maori aspirations.

So I was interested to re-read the document, particularly the section, ‘Expectations of Government’. I read about how ‘eliminating Maori health inequalities’ will benefit not only Maori, but all New Zealanders.

Government expected that, ‘If avoidable illness is reduced’, costs will also be reduced, not only for hospital services but also for families and employers’.

A few sentences on: “Hardship during childhood has been linked to a number of poor health outcomes, including an increased incidence of obesity and diabetes”.

Just as when some analysts look at the story of Taranaki and focus on the volcanic explosion, or see it as a story of rejection, it has become even more evident to me that in the eyes of the Crown, Maori visions for success are always associated with concepts of failure, a deficit analysis.

In other words, the initiatives are only considered worthwhile as a response to a problem, rather than a means unto themselves.

I wonder at what point will agents of the State ever give expression to the aspirations of whanau, hapu and iwi?

Do we really believe the Ministry of Health is meeting its obligations – as we set out in He Korowai Oranga - or have they rejigged implementation of the Strategy and the Action Plan to address the deficiencies of the mainstream direction?

We must always be solution focused and start concentrating on the pathways to success.

It is for this reason that the Maori Party is currently researching the development of a Genuine Progress Index as a measure of overall progress for the nation.

We believe this would be a better measure of our progress than the Gross Domestic Product, GDP, which is the most common comprehensive measure of the accomplishment of a Nation. The GDP is faulty because it adds together the market value of all goods and services despite the fact that some are for positive purposes and some arise out of negative activity.

So if you like, the incidence of heart disease, of motor-vehicle accidents, are all registered in the GDP because they create a need for services – whether or not such an incidence is of any value to the nation.

What I am suggesting today is nothing new. We know well, the drive to follow our treasured aspirations – bowing down, only to the highest mountain. Whaia te iti kahurangi. Ki te tuohu koe, me maunga teitei We must not get distracted by the urge of the Government, the medical profession, the advertisers, the sponsors, the clinical teams to focus only on disease management.

Our calling has always been to nurture our strength, to create unity, to ensure healing and cleansing is part of the journey to make meaningful genuine progress.

Finding the right pathway to wellness, is being committed to strategies based on our whakapapa, that show that they are derived from our kaupapa. This is not always easy.

The Maori Party took over five months in our initial establishment phase, to really consolidate the right pathway for progress.

Our future is based in inanahi, mo tenei ra, mo apopo. We can only advance if we look to yesterday, today and tomorrow. If we hold true to our past, and we are of the present, we will ensure our legacy for the future. In this way, our kaupapa provides us with a purpose that is relevant to the challenges and opportunities of 2005 but also enables us to control our destiny.

Finding the right pathway to wellness for us, has seen us return to revitalise kaupapa such as wairuatanga, manaakitanga, rangatiratanga, kotahitanga, whanaungatanga, mana tupuna and whakapapa, kaitiakitanga, mana whenua and te reo.

These kaupapa are being enacted in our policy, our practice and our organisational arrangements. All it takes is a re-orientation to make sure we are seeing through kaupapa-tinted glasses, rather than the colonized spectacles we may have worn before.

Innovation or Isolation: Strategies Around Self-determination

The second area I wanted to touch on, was the opportunity provided by maunga Taranaki to break out, to ground oneself anew, and to go, where no man has gone before, beyond the frontier.

Innovation is part and parcel of being Mâori. Tangata whenua have a rich heritage of innovation, a heritage driven by cultural necessity and based in our unique natural environment.

We have a proud history of observation, information collection and exploration, and experiences rich in examples of our entrepreneurial spirit.

We have always been first-dressed in the uptake of new knowledge and technologies, with that ‘have a go’ attitude. Right from the history of our tupuna as voyagers in the Pacific, we have shown ourselves to be adept at taking on new challenges, at being flexible, as an industrious people. We have developed the skills for survival, including the intellectual capacity to thrive.

So we can be innovative – of that there is no doubt.

And we can be self-determining: look at all the many examples of our efforts to shape our own destiny – whether it be kohanga reo, kura kaupapa, whare wananga, - our own Maori health and social service providers.

When I think about self-determination – and in particular the right balance between kawanatanga and rangatiratanga, I wonder are we putting too much emphasis on provider development rather than whanau development?

Reconciliation of the kawanatanga-rangatiratanga relationship may mean a period of recovery and restoration for whanau and hapu.

The Crown is deeply involved in all aspects of the lives of tangata whenua. There’s a kind of co-dependency operating.

So my question to all of you here today, is what role do we play in enhancing the entrepreneurial spirit of our whanau, to take responsibility for their own health and wellbeing?

Have we shifted our people’s thinking – or have we just continued to make them dependent on another set of people?

Removing oneself from dependency – just as maunga Taranaki did – can be both liberating and empowering. We need to have faith in our ability, as whanau, to take responsibility for our destiny.

Faith to address whatever is confronting the ability of whanau to participate fully in our children’s wellbeing.

To be responsible for reconnecting to our maunga, awa, moana, marae, tupuna, atua. To respect our obligations to care for, and make decisions about whanau members, whanau resources, and whanau assets. To support whanau to strengthen our collective responsibilities and reciprocal obligations for each other.

Just as Rauhoto firmly reminded Taranaki of his connections to the cluster of maunga from whence he sprang, so too, our whanau can be self-determining, can move out on their own – but always connected and sustained through the protection of hapu and iwi. There is huge potential in our whanau, and I believe in our ability to find our own solutions. And I fervently believe the solutions can be found in our tikanga. They can be found in our korero tawhito, our purakau and our waiata.

They can be found in our kaupapa. We need to look to ourselves and our histories to see how solutions of restoration, healing, reconciliation and development can be used to address issues of whanau development today. I believe that Maori health providers, Maori development organisations, can play a vital role in assisting such development. This indeed would be a brave and innovative demonstration of the kawanatanga-rangatiratanga relationship in action. I know that Te Matarau has both the expertise and the courage to lead the nation towards genuine progress.

Kia kaha tatou ki te whai o koutou moemoea. Kia kaha tatou, ki te tu, kia kaha, kia kaha.


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