Election could bring massive change for Māori health services

11:55 am on 12 October 2023
Geoff Milner (Ngāti Pōrou) is at the helm of Ngati Hine Health Trust.

Ngāti Hine Health Trust chief executive Geoff Milner Photo: RNZ/Justine Murray

Māori health services are waiting nervously for the election, after National and ACT pledged to scrap the independent Māori Health Authority.

Ngāti Hine Health Trust chief executive Geoff Milner said the authority, Te Aka Whai Ora, was starting to address serious disparities in health for Māori people.

In his Bay of Islands town of Kawakawa, Māori health services are not just about getting a GP appointment.

Milner said they were involved in housing, justice, relationship counselling, drug and alcohol rehabilitation, feeding whānau, and other wrap-around outreach services.

"We take a whole of person, whole of system, whole of place approach to well-being. And that's our point of difference that both Māori, and non-Māori when they engage with us, absolutely love," Milner said.

Māori health inequity directly costs the health system nearly $40 million annually, according to an Auckland University report this year.

On average, Māori die more than seven years earlier than non Māori. The indirect costs from lost years of life and wages is estimated at $823m.

Poverty, unemployment, poor housing, and geographical isolation were some of the root causes of health inequity in New Zealand - particularly for Māori, Milner said.

Training more doctors - or paying them more - was never going to be the cure, he said.

After only a year, Te Aka Whai Ora was already making a real life difference to people in Northland, because it listened to what the community wanted, Milner said.

The Māori Health Authority had commissioned services such as Kahu Taurima, for the first 2000 days of a child's life, which allowed Ngāti Hine Health Trust to design a process spanning pre- and post-natal care, until a child is five years old.

Since that funding rolled out in July, the trust had set up māmā and pēpē hubs, Milner said.

"I've seen more in the North of the leadership of Te Aka Whai Ora in one year than I've seen of the leadership of the Ministry of Health, or the local district health board, in my seven years of working in the north."

Milner said the Ministry of Health often directed them to make service changes, whereas the Māori Health Authority consulted with local services on the problems they faced and their potential solutions.

In Gisborne, Tūranga Health chief executive Reweti Ropiha said Te Aka Whai Ora had taken "longer to get off the ground than hoped" - but it was early days and he was hopeful it would deliver.

Turanga Health chief executive Reweti Ropiha says people must be the focus of the Covid-19 vaccine rollout.

Tūranga Health chief executive Reweti Ropiha. Photo: Supplied / LDR

"We're not big champions of things just happening in bricks and mortar, we want to get out there to the paddock or the shearing shed or where young mums are," Ropiha said.

"They all require different approaches, not one-size-fits-all, and we think Te Aka Whai Ora would potentially allow some of that thinking in the design space and let us turn the accelerator on."

Since he started with Tūranga Health in 1997, he had seen at least eight major restructurings of the health system.

"We've still got to make things happen, so we'll see what translates on the weekend," Ropiha said.

Pro-Vice Chancellor of Health Sciences at Otago University Peter Crampton.

Otago University public health professor Peter Crampton. Photo: SUPPLIED / University of Otago

Otago University public health professor Peter Crampton said the authority had become "a political football".

"I'm disappointed by that, but I'm not surprised.

"The shaping of political messages has been quite deliberate, especially around messages to do with Māori, and Te Aka Whai Ora has been caught up in that," Crampton said.

He was a member of the health and disability system review panel, which recommended the establishment of an independent Māori Health Authority.

While it was "not a silver bullet", tinkering with the old system was never going to cure "those persistent biases that have disadvantaged Māori for decades", Crampton said.

"Our system as a whole, our society as a whole has been startlingly unsuccessful in properly addressing those inequities and it's for that reason that new, innovative approaches are required - and Te Aka Whai Ora is such an innovative approach."

- Stay up to date with Checkpoint's live election night special with Lisa Owen, Corin Dann, Jane Patterson and reporters around the country from 7pm to midnight on Saturday, running alongside live data and blogging with electorate and party vote results on RNZ's website. RNZ Asia will also be running its own live blog in Chinese.

实时更新报道, 尽在RNZ中文! 本周六下午5点起,以中文实时追踪2023年新西兰大选。各党票数、全国选情 、计票进展与最终结果,第一手资讯尽在 www.rnz.co.nz/chinese,本周六,我们与您一同关注大选。 #2023年新西兰大选 #新西兰大选

Then on Sunday, stay tuned for the Morning Report special from 8am to 10am, examining the results, the drama, and the changes from the night before: with polls this close, exactly who's in government will likely come down to negotiations.

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