Health partnerships under threat
Local chair slams Nats’ plan to abolish iwi-Ma¯ ori boards
National’s threat to gut Ma¯ori health partnership boards would lock in poorer health for wha¯nau, says the head of Taranaki’s board. Iwi-Ma¯ ori partnership boards were set up under last year’s health reforms, and Te Whatu Ora — Health New Zealand needs their agreement to sign off local health plans.
National’s health spokesperson Dr Shane Reti said if his party wins the election, the partnership boards will lose that influence and be demoted to the same level as any other local health sector group.
“An iwi-Ma¯ori partnership board will be collaborative at the provider level along with every other major stakeholder. That includes hospitals, that includes all of the NGOs, every major provider of community care.”
Taranaki’s board is Te Punanga Ora, and its chairman Te Pahunga Davis said National’s plan left him “shattered”.
“It’s like one step forward, 10 steps back.”
Davis also served on the previous iwi relationship board which advised the Taranaki District Health Board on Ma¯ori health.
“For 21 years under National, under Labour, we got nothing, no movement. The lifespan remained the same, the health determinants for Ma¯ ori were poor and remained poor.”
“It was lip service at best . . . You could design a health strategy and people would look at it and say, ‘Oh, yeah’, and carry on doing what they were doing. If we have a reversion to that, things will remain the same.”
In 2022, the Pae Ora Act set up iwiMa¯ori partnership boards and the independent Ma¯ori health authority Te Aka Whai Ora to work in parallel with the health ministry and Te Whatu Ora.
Reti has long promised to scrap Te Aka Whai Ora and said the partnership boards would lose their powers because they had made no difference to Ma¯ori health.
“Show me one outcome that’s better — because I’ll be very, very outcomes-focused.”
Davis said that was just political posturing.
“We’ve been going [for] five minutes. What sort of changes can you make in five minutes, for the huge moves needed? Of course there’s not going to be a momentous shift right away — we’re not even started.”
He said there had been a “gigantic shift” in Ma¯ori having a legislated say in decisions about what services they get.
“The opportunity for community voice and community involvement in the design of the system — that has been amazing.”
“We have more say in establishing priorities and getting agreement on potential service to localities.”
Labour’s Ma¯ori health spokesperson Peeni Henare recently warned that the newly enhanced voice for Ma¯ ori under the Pae Ora Act “is seriously at risk”.
“All it takes is a majority in Parliament — and Act and National have both said this kaupapa our people have fought so hard for [would be] gone,” he said in August.
Davis said doing away with partnership boards would face significant resistance.
“It’s legislated 15 iwi-Ma¯ ori partnership boards, but there are more than 70 iwi sitting in behind them. I think that’s a long road.”
He said it was unclear how a National-led government would organise the health system at a regional and local level.
“It could be fraught. I don’t know what Reti is talking about, and I don’t think he knows what he’s talking about either.”
Reti said National hadn’t yet decided on its preferred regional health structure, but partnership boards might get a single seat at a local decision-making table.
Davis said whatever government is elected will face the same marked disparities in Ma¯ori health that have persisted for over 100 years.
A Ma¯ori pe¯pi born today is expected to die 7.5 years earlier than a non-Ma¯ori with the same birthday.
Ma¯ori health status trails nonMa¯ori across almost all chronic and infectious diseases, as well as injuries, including suicide.
Mortality rates are also higher for Ma¯ori at nearly all ages. The cardiovascular disease mortality rate is twice as high for Ma¯ ori as it is for nonMa¯ori, and cancer mortality rates are 1.5 times higher.