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Launch of He Korowai Oranga – Māori Health Strategy

Hon Tariana Turia

Associate Minister for Health


Friday 20 June 2014

Launch of He Korowai Oranga – Māori Health Strategy
Grand Hall, Parliament Buildings, Wellington

Ki a koutou Ngāti Toa, Te Ātiawa, Ngāti Kauwhata, Rangitāne, ngā iwi o te motu katoa.

Tēnā koutou, ā, tēnā tātou katoa.

I am so happy to welcome you here to your House, in the spirit of Puanga / Matariki.

There could be no better time to be launching He Korowai Oranga than at the Māori New Year.

During the season of Puanga, our people came together, to cling to one another and prepare for the cold months ahead. It is a time which connects us to land and sea, to food-harvesting and weather patterns, the rising of the star constellation, the new moon.

In this special season then, what better thing to be doing than considering our health and wellbeing; as the foundation for our future.

As many of you may recall – in fact some of you were here with me at the time with me - He Korowai Oranga was launched here in Wellington in November 2002.

The launch of this strategy, that placed whānau at the centre of public policy, meant so much to our people.

He Korowai Oranga grew out of extensive consultation across the length and breadth of the country. We looked at the current picture of Māori health and what changes we needed to make to see improvements.

Our eyes were firmly fixed on tomorrow.

We chose the concept of a korowai deliberately. A korowai is a cloak that is worn for warmth and protection - but it also represents honour, tradition, pride and our connections to our whakapapa, to our ancestors.

The ultimate honour for those who have passed on, is that their casket is covered with a korowai; a measure of manaakitanga, keeping a loved one warm in their last journey.

In drawing upon the concept of he korowai oranga, we know that the learning and knowledge of our tupuna is being applied to today’s situation. It represents taonga tuku iho, a treasure handed down from generation to generation.

E kore au e ngaro he kākano i ruia mai i Rangiātea.
I will never be lost, the seed which was sown from Rangiātea

And so what was that treasure; the source for our vision?

The vision of He Korowai Oranga, Whānau Ora, has been pivotal in our transformation from a focus on disease and illness to a desire for health and wellness.

In its introduction, He Korowai Oranga signalled a radical change of approach to health care in New Zealand. No longer would health be driven by a preoccupation with individuals and with disease.

It is with the greatest joy that I know that Whānau Ora has helped us shift focus towards the collective health of families. I do have to say, however, although there was so much enthusiasm for the concept of Whānau Ora back in 2002, it had to wait until a new government in 2008, before the full potential of the transformation could be realised. I think it is so sad and such a waste of those years.

There is another significant feature of He Korowai Oranga. And that is the challenge to Government to help create an environment that enables whānau to shape and direct their own lives to meet their own aspirations.

In doing so, we must be alert to the disparities that have characterised the picture of Māori health for too many decades and successive generations.

You will all know too well the research that reveals that Māori life expectancy is considerably lower than that of non-Māori and that Māori health status remains unequal with non-Māori across almost all chronic and infectious diseases as well as preventable unintended and intended injuries.

It is right that here in the Grand Hall we have Professor Sir Mason Durie and Dr David Jansen present with us - two towering figures in our story of health.

They have shed such light upon the environment in which health professionals have operated. They have diligently documented the fact that Māori receive fewer referrals, fewer diagnostic tests, and less effective treatment plans from their doctors than do non-Māori patients. What a sad story.

They have told us that tāngata whenua are offered treatments at substantially decreased rates and prescribed fewer secondary services such as physiotherapy, chiropractors and rehabilitation.

We must ask ourselves is that right? Is that fair? Is it just?

And if we find the answer lacking, we must have the courage to speak up, not just for ourselves and our families; but for the growing generations who come after us.

What we know is that He Korowai Oranga has been Government policy now for over a decade and in 2014, we should be proud that it has been a catalyst for increasing Māori participation across the whole of the health system. This includes well established iwi-partnership boards that contribute to local decision making with DHBs.

We must, however, avoid the risk of complacency.

We can never assume that today’s givens will remain tomorrow’s priorities.

We must be vigilant, absolute in our determination that as long as there are inequities; as long as there are disparities and entrenched deprivation; as long as there is the long-standing impact of institutional racism – then Māori health must remain of the utmost priority.

We owe it to all those who have blazed a pathway ahead of us to continue to demonstrate leadership; express our unique knowledge and exercise our commitment towards developing, delivering, monitoring and understanding the healthcare needs and aspirations of our people.

We can be proud of the gains in health that DHBs have articulated through their Māori Health Plans. First off, we must celebrate the biggest gain of all that our people are living longer.

I am not so misguided to think that the transformation has come about because of the infiltration of He Korowai Oranga across the health system or the all enduring impact of the Whānau Ora approach.

And I am also wary that even with the greatest intentions sometimes the finest crafted plans fail to result in the change that we need in practice.

But I do genuinely and sincerely believe that the liberation of our future as tangata whenua has only been possible because of the way in which whānau and families have become health champions in every environment where they are located.

I want to acknowledge all of the hard work that has been undertaken by DHBs, PHOs, iwi partnership boards, Māori providers and communities and the health sector generally over the last decade to realise the vision of Whānau Ora and improve Māori health.

This is my opportunity to say thank you – thank you for your role in the creation of our korowai taonga – our cloak of wellness.

Last year, I asked the Ministry to meet with some of our expert sector leaders to discuss He Korowai Oranga and whether it was fit for purpose for the future.

I want to mihi to those hauora heroes – our leaders and champions: Professor Sir Mason Durie, Merepeka Raukawa-Tait, Te Mariameno Kapa-Kingi and Dr David Jansen for their advice on this.

And I know that many of you sitting in this hall today have also contributed.

During the process we have been reminded of the enduring features of He Korowai Oranga, and how it can serve us well for the future.

He Korowai is a holistic framework that embraces all factors that contribute to our health and wellbeing. Our wairuatanga, our hauora – recognising also that rongoa Māori is fundamental to Māori health.

It is absolutely about whānau health, the quality of the environment we live in and the availability of access to health care. It must be intimately linked with the Māori disability strategy, Whaia te ao Marama. We have a blueprint for Māori disabled and we must make sure the ideas in that plan translate into action.

In this revised version, I have retained most of the original framework of He Korowai Oranga with one significant change - expanding the overarching aim to “Pae Ora – healthy futures”.

In doing so I am immediately energised by the inspiration of one of my own tribal leaders, Te Rangitakuku Metekingi : Whaia te pae tawhiti kia tata; whaia te pae tata whakamaua kia tina. He was saying to us, pursue the vision of the distant horizon by achieving the goals at hand.

Pae Ora adds two additional elements important to Māori health to He Korowai Oranga: Mauri Ora and Wai Ora.

Mauri Ora is about being person-centred - meeting the immediate and future needs across all stages of life.

Wai Ora urges us to consider not only the immediate health issues that people present with, but the environmental factors that give rise to these issues – such as poverty, education, housing, water supplies and access to healthy food.

He Korowai Oranga also retains Whānau Ora as a central focus.

And if there is one thing I could encourage all of us to think of, as I start to transition to the life outside of this place, this Grand Hall of hope and promise – it would be that each of us takes seriously the opportunity and the importance of leadership.
Every one of us can be a Whānau Ora champion – all we need to do is make that vision happen.

We must all provide leadership and strive towards our collective vision of making healthy futures for Māori people; to believe in it.

How can we work in a way that empowers whānau to believe in their own health and wellbeing and to achieve that and act in a way that continues the focus on the health of the collective as well as the individual?

He Korowai Oranga has always represented a joint collaboration between those who design and deliver support and services, and those who use them.

Our Māori Health strategy challenges us to continue to think beyond the narrow definitions of health and collaborate together across boundaries and across other sectors as we work to improve Māori health.

And I want to encourage the Ministry to be just as bold and courageous as the ideals in this plan demand that to be.

Finally, I want to state the obvious - He Korowai Oranga is your strategy for Māori Health – it is all of our strategy.

May it continue to provide the guidance, the perspective, and the inspiration we need as we work together to improve Māori health.

Thank you again, to everyone who has walked the talk – who have tried to express the aims of He Korowai Oranga in their everyday existence. Our future is literally in your hands, your hearts and in all of our homes – let us wear the cloak of wellness with pride.

ENDS

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