Horowhenua leads health reform in iwi-driven pilot
Horowhenua is one of the first regions to benefit from the health reforms starting on July 1, thanks to existing models of co-operation between local iwi and health providers.
Health Minister Andrew Little and health professionals were in Taitoko Levin last week to announce nine locality network pilots that should help improve how healthcare is delivered, especially in areas where this has been poor for a long time.
The locality network, which should be in place nationwide by late 2024, will take over from the DHB structures from July 1, provided the legislation goes through Parliament smoothly before then.
Health New Zealand and the Māori Health Authority have worked with local initiatives already present on the ground, to pick the first nine pilots.
Horowhenua covers 32,000 people of whom 31 per cent live rurally, 38 per cent of whom are deprived economically, with 27 per cent identifying as Māori.
“The local DHB MidCentral has been a leader in locality planning,” Little said.
“This is one reason why Horowhenua was picked in the first batch. Practical locality processes have already been used here. I have seen local initiatives that show community leaders are fully engaged in seeking innovative approaches to future health services here, such as the proposal for a health hub.”
He also pointed to a local initiative for a nurse-led medial practice in primary healthcare in Levin.
He said the health reforms will mean everyone has a fair chance of getting good healthcare, no matter where they live or who they are.
The locality approach will cover manageable areas and a locality is “essentially a place-based approach to improving the health of populations, as well as a mechanism for organising health and social services to meet the needs identified by wha¯nau, community and mana whenua. ”
There are three characteristics to a locality. First, it is a partnership with mana whenua, recognising their tino rangatiratanga. Second, the approach supports locally led solutions that take a holistic approach to wellbeing, acknowledging the range of other factors on a person’s health.
Third, the locality approach will join up care across communities and improve integration with different layers of the health system.
“We build on local leadership to achieve a well-functioning health system,” said Little. He acknowledged there will be challenges and that the legislation to enable this still needs to go through Parliament.
“Our system fails many,” said Interim Health NZ Board member Dame Karen Poutasi, who also attended the launch in Te Takeretanga o Kura-haupo¯.
“We trust local communities to be able to lead the tailored approach to healthcare for their communities. We recognise local partnerships and this approach is an unprecedented opportunity where community organisations play a key role. They will ensure actions will be taken along the plan they have developed.”
She said access to health services will be easier and the aim is to eventually deliver more services closer to home.
Muaūpoko Tribal Authority (MTA) CEO Di Rump spoke in behalf of both Raukawa Whānau Ora and MTA.
“We are really excited as the change will be iwi led with whānau at the heart.”
Margie Apa, CEO of Health NZ was there to pledge support for the approach.
“This is a journey which will involve a lot of mahi. We need to work on relationships.”
She felt Levin’s Cultural and Community Centre was an appropriate place to launch the first locality pilot news to the nation.
“We are a whole people, not compartmentalised. We need to focus more on preventions rather than on fixing up serious health issues. The community voice is at the heart of this and we will work at removing barriers.”
She said while the emphasis is on local, some things like the bowel screening programme will continue to be done on a national level.
Little said the localities chosen first up already had a head start.
“Poor health performance was also a key in choosing the first nine pilots. The community was consulted and we have worked with existing providers.”
He said community groups have a voice in this, not just health providers.