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Māori Communities Prepared And Waiting For Health System Reform

This morning the Government announced a proposal for a suite of changes to the composition of the New Zealand Health Sector

These changes are an extension of those announced in June 2020, and look at the reformation of a health system which includes:

- A contraction of power back to the centre with the triumvirate of the Ministry of Health, Health NZ and a Māori Health Authority

Refocus the role of the Ministry of Health as the chief steward of the health system, and lead advisory body to the government.

Creation of Health NZ, to take responsibility for the day-to-day running of the health system, supported by four regional bodies that will ensure local insights and design.

- Creation of a Māori Health Authority which will directly commission kaupapa Māori and te ao Māori-grounded health services, as well as co-commissioning with Health NZ..

- The 12 current Public Health Units will be amalgamated into a single Public Health Service sitting within the Ministry of Health responsible for public health policy, strategy and intelligence.

- The Health Promotion Agency (Te Hiringa Hauora) will move into Health NZ to ensure retention of capability and expertise in population health.

CEO of Hāpai Te Hauora Selah Hart responded to the announcement this morning "The announcement, as with the previous announcements of this potential reform, have been welcomed, but we are looking to see some strong action on the part of this Government. We see ample opportunity within the announcements by the Minister of Health to really solidify the integrity of our health system and move away from the post code lottery of health services, and as Minister Little addressed this morning that even with the $5.6 billion in the 2020 budget, it has not been enough to compensate the 9 years of under investment from the previous government".

Hart says that communities still need to be at the forefront of this change. "Hāpai Te Hauora is New Zealand’s largest Māori Public Health Agency, with a pro-longed history of overseeing successive attempts at centralisation and decentralisation of power, and unfortunately, over more than 20 years, neither response has even dented the inequities faced by Māori. The lesson in this is clear that reformation needs to be about much more than whether power is detracted or contracted, it actually needs to be about who that power sits with, and ultimately it should sit with whānau".

The Governments proposal includes abolishment of New Zealand’s 20 District Health Boards consolidated into on national entity, Health NZ and amalgamations of the 12 Public Health Units into one National Public Health Service which will be situated within Health NZ. Boyd Broughton, GM for Te Rūnanga o Ngāti Whātua Health Arm, Te Hā Oranga says " this is a step in the right direction of recognising our tino rangatiratanga as articulated in Te Tiriti. Māori have never been allowed to imagine what we can do with autonomy, authority and control over the resources for our people’s health and wellbeing. Mr Broughton goes on to say "We are looking forward to the days coming ahead of us"

Janell Dymus-Kurei, General Manager Maori Public Health Leadership at Hāpai Te Hauora responded to the Ministers claims calling the announcement bold, saying "Whilst these long-awaited changes are considered bold by some, they are actually just the natural progression from a failing health system. It doesn’t matter that we as New Zealand have a world class health system, when it is failing its most vulnerable communities, and nothing has helped to curb the alarming health disparities suffered by Māori in New Zealand"

Ms Dymus-Kurei is however, hopeful that these changes will begin to step us towards a more equitable society "We have a wealth of evidence of what has worked for Māori communities, and that is the manifestation of Tino Rangatiratanga, in big ways and in small ways, for Māori peoples. Independent Māori leadership, Māori voice, Māori governance and māori solutions is what is going to really get us working towards those equity outcomes that the Government so desperately want to be seeing in the very near future.

The rollout of the plan is intended to begin in the coming weeks, with the interim Māori Health Authority and Health New Zealand being stood up sometime shortly after 1 July 2021, and by June 2022 legislation will be passed for the new system, which disestablishes DHB and PHUs for the new structures proposed.

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