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Turia: Toitu Hauora Maori 2030 Summit 2014 – Mauri Oho

Hon Tariana Turia
Associate Minister for Health

Thursday 27 March 2014

Toitu Hauora Maori 2030 Summit 2014 – Mauri Oho
Silverstream Retreat, Lower Hutt

Ka rere atu nga mihi ki te hau kainga, te tangata whenua, Te Ati Awa, tena koutou katoa.

I want to thank the staff and board of Te Rau Matatini and the Henry Rongomau Bennett Foundation who have organised the event and in particular, Trish Davies, the CEO of Te Rau Matatini, and Roma Hippolite, the chair of the Te Rau Matatini Board. Tēnā kōrua.

As I stand here this morning, in this beautiful retreat bordering on the banks of Te Awa Kairangi, I am thinking of another river which runs through my veins, which lifts me up and stills the racing heart.
Nga Wai inuinu o Ruatipua era
Nga manga iti o honohono kau ana
Ka hono; ka tupu; hei awa
Hei Awa Tupua.

Those of the drinking fonts of Ruatipua
The small streams which run into one another
And continue to link and swell until a river is formed
The Awa Tupua

Less than 24 hours ago, Whanganui iwi initialled the Deed of Settlement in a historic agreement with the Crown in relation to our river claim, WAI 167.

For the descendants and hapu of Tamaupoko; Hinengakau and Tupoho, the legislation will put into law what we have always known – that the river is an integrated living entity, from the mountains to the sea. It has its own voice; its own mana; and is absolutely connected to our health and wellbeing as a people.

Mai te kahui maunga ki Tangaroa
Ko au te awa; ko te awa ko au.

Our claim has carried the weight of history stretching back to the first petitions in 1873 and involving the talents and genius of leaders such as Hikaia Amohia, Titi Tihu, Hekenui Whakareke and so many others who fought for a better tomorrow for us all. Twelve years ago, my cousin, the late Te Atawhai Taiaroa told our people

“The negotiations will probably be long and complex so I ask we all stay focused work together and support each other. What we are about to embark on is the fulfilment of the work that our tupuna began all those years ago. Now it is up to us to leave our mokopuna with a legacy that they can be proud of”.

As our iwi prepared to travel to Parliament, the news came in of one of our beautiful songbirds, a daughter of Kaiwhaiki, had lost her struggle for life. A young woman in her 40s with so much of life left to live.

Both these events have filled my mind as we travelled here this morning.

Hauora Maori is in its purest form, a story of life and death.

It is about understanding what keeps us well; which is it that sustains our life-force; keeps us whole.

I wanted to start my korero this morning from the basis of te awa tupua because it encapsulates for me so much about what we define as the spirit, the essence of our health.

When we are ill we go to the river. When we have important work, we go to our awa to karakia. The river cleanses us; it revives and restores the essence of who we are.

When I spoke at your hui two years ago, I started by reminding us all about the meaning of Toitu – enduring; untouched; kept pure; protected.

I linked it to the legacy of one of our tupuna Tinirau who left us the challenge; toitu te kupu; toitu te mana; toitu te whenua.

And so as we look closely at the Maori health leadership in this room and beyond – we must ask ourselves – how well does our long term health outlook embrace our language, our land; our culture? In this sense, it is wonderful to see the hui includes a focus on life and language as expressed by Hana O’Regan.

Thirty years ago this month, Te Hui Whakaoranga was born. The hui, led by Dr Paratene Ngata, was the first national Maori health hui held in modern times. Other key contributors included Dr Lorna Dyall, the late Professor Eru Pomare, and Professor Sir Mason Durie.

And I want to just mihi to Sir Mason, the chair of the Henry Rongomau Bennett Foundation committee and one of our great leaders. His thought leadership has widened our vision on so many levels and I want to personally thank you, for the difference you have made in encouraging us all to yearn for a better life. To believe in ourselves that we can do and can be.

The 1984 hui was a highly significant milestone - it set an agenda for Maori health leadership; it gathered together close to three hundred people from across whanau, hapu and iwi; the health sector, and Government agencies to collectively establish a foundation for change.

Out of the hui came a recognition that culture was important and valuable – and wait for it – the breaking news realisation that Maori worldviews had a place in health provision.

That hui, therefore, must be recognised as setting the platform for the transformation of the health landscape from a ‘one-size-fits-all’ approach to a more inclusive and diverse health system, informed by a Maori cultural context.

And now we find ourselves, thirty years on, planning for Māori health leadership up to the year 2030.

We have made significant progress in Māori health since Te Hui Whakaoranga.

We have seen a flourishing of Māori participation in the health sector at all levels. At the time of the hui in 1984, there were few Māori providers and minimal health service provision by iwi, there are now more than 270 Māori health providers delivering a wide range of programmes in child health, mental health, health promotion, disability support, midwifery and public health.

Māori participation in health at the policy and governance levels has also increased significantly, with increased Māori leadership and input at senior management levels across the health sector.

So the question we must ask is not who are our Maori leaders – but how is that Maori leadership being demonstrated? What is the nature of our leadership and how is it being experienced?

I came across a comment the other day from the Dalai Lama which made me think more deeply about the qualities we look for in Maori health leadership:

The planet does not need more successful people. The planet desperately needs more peacemakers, healers, restorers, storytellers and lovers of all kinds’.

It reminded me of the challenge my great friend Irihapeti Ramsden issued after the box-office success of the movie, Once were warriors. She asked us to reclaim our proud history as "Once were gardeners, once were astronomers, once were philosophers, once were lovers".

And so as we look to the horizons for Maori health and wellbeing, let us look at the widest possible interpretation of hauora. Let us look critically and carefully from every angle.

We must keep close scrutiny on the health system to ensure that it responds competently and consistently to whanau, hapu and iwi across the lifecycle experience.

And I want to say to ourselves – we must not sit by when we see issues occurring that we know are not right. To be silent could imply consent.

We must remember the vision of thirty years ago – indeed the promise of Te Tiriti o Waitangi – to carve out a future we can proud our children will inherit.

Let us ask ourselves – why do we not support the voices that challenge change?

We need revolutionaries – not people sitting noho puku, nodding agreement yet their stomachs churning inside.

And as we move into election fever – I want to remind us – we must not rely on politicians to make the changes – to be enduring and effective, the change must come from the people.

I say to our whānau at home all the time – ask not what others can do for us; ask ourselves, what we can do on our own.

I am really hot about the message that if we willingly abdicate our responsibilities to anyone else, all that happens is we lose sight of our dreams, our aspirations, our potential – and who would ever want to sign up to that.

We must be whānau driven; whānau focused to make the change we want to see.

We must ensure while there are many different tributaries that may define the pathway of care our people need, that there is one focus – and that is on whanau outcomes.

Just as te awa tupua is an integrated, indivisible whole, so too must we consider that while there are many pathways leading forward, the most enduring outcomes will come when all aspects of our lives are integrated as one.

Emerging priorities for Māori health might therefore also include an emphasis on the environment and its impact on health, including issues such as access to safe and healthy homes and food, education, economic independence and work.

Dealing with the impact of climate change and events such as earthquakes could also be part of the picture. Our whanau have many life events to deal with – success is most likely when all the issues are brought together in a holistic and integrated way.

Within this, we should be convinced that strong Maori leadership is an important driver of change.

That leadership must be aligned with the needs and aspirations of whanau – and we must be prepared to appreciate leadership resides within us all and comes in many forms – including the diversity represented in the words of the Dalai Lama and Irihapeti Ramsden.

As leaders in Māori health, you are well poised to nurture and advance whānau development. Whanau, as a vital source of identity, security, and strength, are also a powerful source of motivation for change.

If there is one thing I would hope might come out of this hui, it is the recognition of the fact that it is developing whānau leadership that will empower whānau to become champions of their own health and wellbeing.

And that will be demonstrated as enduring; untouched; pure; protected- Toitu Maori.

We must consolidate the gains- within Whanau Ora for instance we have witnessed some amazing whānau transformations and we must work hard to embed these as part of our expectation for the future.

Building on from this success, the scope and direction of Whānau Ora has shifted to supporting whānau to build the capability and capacity to set goals, plan for their futures and deal with any issues confronting them. This involves building leadership at the whānau level, as well as recognising, reinforcing and building on existing whānau strengths.

The new model for the future delivery of Whānau Ora will see the establishment of three non-government organisations that will operate as commissioning agencies for the North Island, South Island, and a Pacific focused agency. Two of the three commissioning agencies have been announced in the past month, these include Te Putahitangi o Te Waipounamu, and Pasifika Futures.

The commissioning agencies will recruit local-level whānau centred initiatives to best support whānau goals and aspirations.

Finally, I want to encourage you to take advantage of these two days with the amazing talents within this hui, to dream even bigger about the vision of healthy futures for our people.

How will we achieve the goal of Mauri Oho – our vibrant lifeforce? What will it take – and how do each one of us contribute to that goal?

At the end the Hui Whakaoranga, three directions were agreed:
• the incorporation fo Maori health perspectives into the delivery of health programmes;
• increasing the professional Maori health workforce and
• developing Māori health provider organisations.

I guess the question for all of us in moving forward is whether we have now reached a point where we sign off on those three directions as having been achieved, or at least being a work in progress.

And I wonder if it is timely to widen our gaze to bring whanau within sight – to ensure we have done everything possible to develop strong leadership, create a shared vision and demonstrate collective action.

Nō reira, tēnā koutou, tēnā koutou, tēnā tātou katoa.


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