Te Runanga o Aotearoa NZNO April Hui
Friday 17 April 2009; Brentwood Hotel, Wellington
Hon Tariana Turia, Associate Minister of Health

The other day I received an unexpected surprise in the post.

One of my former nursing colleagues sent me a slide when I was known as Nurse Woon of Whanganui Hospital.

It immediately transported me to another time, many years ago.

In those days, up until 1965 at least, if a nurse married she was expected to leave the hospital to become a housewife. The thinking was that once married, a young woman would be no longer interested in a nursing career.

And so when I married my husband, George, that signalled an end to my nursing career.

And yet, over four decades later, I can still remember the pleasure of that role; the sense of satisfaction that came with knowing we were making a difference.

It is perhaps best captured in a thought from African American writer, Maya Angelou, “I’ve learned that you shouldn’t go through life with a catcher’s mitt on both hands. You need to be able to throw something back”.

Occasions like today, are vital to keep us focused on the ball; to sustain the energy and optimism that is required to fuel our momentum; to stimulate us to continue to throw something back.

It is vital that we all continue to believe that we are making a difference; that what we are doing is worthwhile.

And so I commend Te Runanga o Aotearoa for your part in supporting the Maori nursing and healthcare workforce.

Your role is fundamental for the growth and strength of the workforce. The efforts that you make on behalf of registered nurses, midwives and healthcare workers enable them to do what they do, to enhance wellbeing, to create whanau ora.

I am told you have the largest Maori healthcare workforce with a membership of some 2718.

But of course, that number is but a fraction of the lives you influence.

The leadership you provide in health and nursing policy and nursing education and professional development, has the capacity to change lives, to shape futures.

Every act to improve the wellbeing of another, sends forth a ripple of hope to others.

Every time you stand up to advocate, to speak out against an injustice, to draw attention to ongoing disparities, you are shaping history to come.

You are restoring that same courage that our tupuna had, that we can stand on our ground, and be healthy, well, independent, and able to make our way in life

That is what we want most for our people – the attainment of whanau ora.

The challenge of course is to know that what we are doing, is making the difference; that what we are doing counts.

Yesterday, I understand that the Ministry of Health reported back on the Whanau ora Health Impact Assessment report.

The health impact tool is a way of understanding the positive and negative impact that policies have on Maori – it is a key means of being able to assess what difference such policies make in the reduction of poorer health outcomes for Maori.

The focus of health impact assessment should be the concept of ‘whanau ora’ – how whanau Maori can achieve our maximum health and wellbeing.

I am extremely interested in being able to understand the value of the activities that are captured under the heading of Maori health development.

What is the cost in terms of Maori health outcomes, from the creation of 21 DHBs and the organisational clutter of divided funder and provider roles?

How has the health bureaucracy impacted on the development of Maori health providers, on Maori health workers?

What costs can we attribute to the administration overload of the health sector?

How has the establishment of primary health organisations advanced outcomes for whanau ora?

And perhaps most significant of all, how has access increased at the whanau level? What is the difference that we can measure from the greater involvement of Maori providers in the health sector?

It is now well over six years since I launched He Korowai Oranga: Maori Health strategy in conjunction with the former Minister of Health. At that launching in Wellington, I said,

“If Maori are to have healthier lives and fulfil their potential, then all the factors that affect health need to be addressed. We can do this by providing integrated health and social services, with multi-disciplinary teams assisting individuals and their whanau to make their choices.
He Korowai Oranga challenges us to create environments where whanau can shape and direct their own lives”.
There have been many changes and structural reforms since I made that statement, but just as I retain that same belief in the value of healthcare workers that I did as a young nurse in Whanganui; I also retain that same belief in the principles that drove He Korowai Oranga.

In fact, if anything, the more that I have seen the fragmentation and conflict emerging in the component parts of the health system, the stronger my belief in the need for integrated services to achieve whanau ora.

And so I am absolutely delighted that the focus of this April hui is to build strategic alliances with other members of the Maori health professionals to improve the health and wellbeing of all people.

I commend you for reaching out across the Board of Te Runanga, to also welcome kaumatua, kaimahi, nurses, community health workers, Te Ropu Rangahau a Eru Pomare, Te Kete Hauora and Maori staff from across NZNO.

But my challenge to you all, is don’t just stop there.

Whanau wellbeing is not just about an investment in the whanau as a concept rather than the treatment of an individual.

The goal of whanau wellbeing and resilience will not just be realised in the health domain exclusively.

The commitment to build whanau capability can be advanced from initiatives in education, social services, health, employment, housing, justice or other community developments. Conversely, a sector by sector, agency by agency approach can only ever be partially successful.

You will be aware that I am keen to encourage us all to be ‘possibility focused’ on how we can collaborate and work together, to achieve the difference we so urgently require to lift outcomes.

What I mean by being possibility focused – is that instead of measuring the ill-health status of our people; totting up the expenditure on youth residences and prisons; reeling off the disparity data on underachievement; we instead consider the possibilities of a whanau centred approach.

What are the indicators of whanau ora that will result in change?

How can the money that is currently being spent by the state on health outcomes, be better configured to accord with whanau realities?

How can we facilitate positive relationships within whanau by recognising the inter-connectedness of health, housing, employment, education, justice, social innovation and lifestyle as elements of whanau wellbeing?

What are the key principles to achieve whanau capability? What are the skills and knowledge required across the workforce to build whanau resilience?

These are but some of the questions I want us to consider, together, as we work to achieve progress, not just in increasing nursing capacity and capability; but importantly in whanau ora.

I am absolutely clear that improving pay parity for those nurses working in the non government organisation sector is a vital step in this journey, and I will be keen to hear from you, what progress has been made in this regard.

Finally, the aspiration for whanau ora is not just a topic for this April hui; a one day wonder. It is a constant conversation that we must continue to have when we return to our home base; when we gather in our offices; when we go home at night.

It’s a topic we must toss around, and as Maya Angelou would remind us, every now and then throw it back out to the universe.

I look forward to hearing your thoughts and in doing so, thank you once again, for all the efforts you give out, to support and sustain the Maori nursing and healthcare workforce Tena tatou katoa.

ENDS

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