Left with an outdated philosophy
A group of plaintiffs are asking the High Court for declarations of inconsistency in relation to the Bill of Rights Act and Te Tiriti o Waitangi. Chris Tooley represents one of them.
In the Bay of Plenty we operate the largest GP mobile unit in the country, called Rehua Nuku Ora. It’s state of the art. It has its own power and water supply, immunisation facilities, a satellite to access health records and can be redeployed as an emergency response unit in a civil defence emergency.
It is a full-suite GP practice on wheels that goes into rural townships, marae, kura and provides access to our remote communities. If you’re lucky enough to attend kapa haka events in Mataatua, you’ll be able to pop in to the unit to get your vaccinations done.
It works. Every day we catch up with whānau who have not been to the doctors for years and require healthcare treatment and prescriptions or rongoā (traditional Māori medicine) of some kind.
Despite its obvious health benefits, Rehua Nuku Ora was not funded by the Ministry of Health. Its outdated rules and regulations prevented this type of innovation – taking a whānau ora medical platform on wheels – and instead the government of the day transferred health-equity funding to the more effective commissioning model within Te Puni Kōkiri, so initiatives like these could see the light of day.
This is only one example of myriad systematic impediments that hauora (Māori health and wellbeing) partners face. Te Aka Whai Ora was a response to this type of system.
When we think of the sum of all parts: co-design, policy development, procurement, commissioning, training, innovation, service delivery, budgeting, data, capex, infrastructure, research and monitoring etc, Te Aka Whai
Ora was empowered with all these components at all levels of governance, management and operations – working in genuine partnership with Te Whatu Ora.
Te Aka Whai Ora was also able to take a kaupapa Māori world view and approach, which in turn gave more transformative clout to Māori hauora partners and kaimahi (staff) across the sector to deliver healthcare services.
It fulfilled a 40-year struggle dating back to Hui Whakaoranga in 1984, for Māori hauora partners to have autonomy to design and deliver their own healthcare services.
Nowhere in the revised Pae Ora legislation, or suggested revised policies to date, has the weight of these powers Te Aka Whai Ora held been reassigned in another form. Gone.
Last week we filed action in the
High Court against the Crown. This challenges the disestablishment of Te Aka Whai Ora (the Māori Health Authority), both in terms of the process followed and the decision itself.
The plaintiffs are Māori hauora partners Te Puna Ora o Mataatua, Te Kōhao Health, Ngāti Hine Health Trust and Papakura Marae, with support
... for the first time we had an entity with most of the components required to finally address systemic health inequity...
from Pou Tangata, National Iwi Chairs Forum.
We are asking the Court for declarations of inconsistency, both in relation to breaches of the Bill of Rights Act 1990 and Te Tiriti o Waitangi.
Te Tiriti is the foundation of our nation. For hundreds of years, tikanga has been the first law of this land. It remains part of our law in Aotearoa New Zealand to this day. Our Supreme Court has ruled accordingly.
Across the human rights framework, the Bill of Rights or even free trade agreements, there are fundamental obligations that transcend the shifting politics of electoral cycles. Te Tiriti, a foundational platform of our constitutional arrangements in Aotearoa, is no different. Governments of the day cannot contract out of their obligations under Te Tiriti; the partnership obligation remains.
As Tiriti partners, Māori have rights to make decisions over their own affairs. This includes the design and implementation of our own healthcare models. Decades of being refused this right, by successive governments on both sides of the aisle, has resulted in abysmal healthcare services, and outcomes, for Māori.
Te Aka Whai Ora was not perfect, but for the first time we had an entity with most of the components required to finally address systemic health inequity experienced by Māori for a generation.
Yet without any review or evidencebased rationale, and without an alternative blueprint to consider, Te Aka Whai Ora was disestablished. There was no consultation. There was no real alternative. What we are left with is an outdated philosophy that seems to replicate failed historical models; models which review after review have clearly stated should be redesigned.
Moreover due process, namely the select committee process and the Waitangi Tribunal urgent inquiry, were also denied to Māori and the public.
While this Government has raised arguments about too many bureaucrats or ineffective spending as reasons for disestablishing Te Aka Whai Ora, this attempts to mask the campaign of structural disempowerment of Māori.
Rehua Nuku Ora will continue to keep rolling out across our region and serving the healthcare needs of our whānau. But make no mistake, when obligations under Te Tiriti are so blatantly ignored as with Te Aka Whai Ora, we will stand up, like those who have done so before us, and take action.