Latest news with #HealthyFutures)Act2022
The Spinoff
2 days ago
- Health
- The Spinoff
Tribunal hears what was lost when Te Aka Whai Ora was taken
In a major Waitangi Tribunal hearing, Māori health leaders laid bare the consequences of the government's decision to disestablish Te Aka Whai Ora. For many, it wasn't just policy – it was personal. At the end of last month, the Waitangi Tribunal wrapped up its hearing regarding the disestablishment of Te Aka Whai Ora, or the Māori Health Authority. An urgent inquiry as part of the wider Health Services and Outcomes Kaupapa Inquiry, the hearings took place over the space of a week and saw dozens of expert witnesses provide their insights into the state of Māori health in Aotearoa. Established through the Pae Ora (Healthy Futures) Act 2022 under the previous Labour government, Te Aka Whai Ora was an independent government agency charged with managing Māori health policies, services and outcomes. It was pitched as a pivotal step towards addressing the long-standing inequities in hauora Māori, grounded in a Tiriti partnership model. Its disestablishment on June 30, 2024, came less than two years into its operation. 'Te Aka Whai Ora was a once-in-a-lifetime opportunity to not only change Māori health outcomes, but to also change the health system,' said indigenous rights advocate and business leader Chris Tooley in his submission. But its beginnings were far from simple. Witnesses explained how the authority was required to be built from the ground up: no existing systems, no legacy staff or infrastructure, and no meaningful transfer of Crown power. In contrast to Te Whatu Ora, which inherited the resources and staff of the former DHBs, Te Aka Whai Ora was expected to function as an equal partner with a fraction of the funding, infrastructure or political support. Its disestablishment was a political decision, witnesses argued, driven not by evidence or performance, but by ideology. 'The fallacy of neutrality that our public health system treats everyone equally and fairly – it's not true,' said public health expert Elana Curtis. 'If you belong to white British colonial culture, then the health system will tend to produce better outcomes for you than someone who doesn't align with those values or that worldview.' The tribunal itself was not unfamiliar with the issue. A year earlier, it was forced to abandon its urgent inquiry into the government's planned disestablishment of Te Aka Whai Ora when the coalition government introduced repeal legislation under urgency, stripping the tribunal of jurisdiction. That legislation went through without consultation with Māori, and without input from the authority itself. Later, the tribunal would find that the process was a breach of te Tiriti. In the latest round of hearings, witnesses were clear: the authority was beginning to show real promise. A 'new whare' grounded in tikanga and data, commissioning services by Māori, for Māori, at scale. 'We must bring back Te Aka Whai Ora – otherwise we will be continuing to swim in the crap of colonialism,' said submitter Maia Honetana. Witnesses also argued the disestablishment has weakened existing structures. Iwi Māori Partnership Boards (IMPBs), destined to work in tandem with Te Aka Whai Ora, have been left adrift, they said. Some remain in name only, others have shifted focus to service provision, and several are now competing for the same limited funding. At least one board has said that its current funding is set to expire in June 2026, raising concerns about the long-term viability of the model. The effects are also being felt in clinical spaces. In renal care, the Māori renal health taskforce has been disbanded, and national forums where inequities were previously discussed have gone quiet. 'Equities seemed to be at the forefront of discussions, and that's now gone,' said Kidney Health New Zealand board member John Kearns. The Crown's position is that the current settings – including IMPBs, the Hauora Advisory Committee and residual provisions in the Pae Ora Act – uphold its Tiriti responsibilities. But several experts rejected that claim, describing the reforms as cosmetic without genuine devolution of power. 'Until the Crown devolves power and resources to these bodies, they are a toothless tiger who give an illusion that the Crown is honouring te Tiriti,' said claimant representative Maia Te Hira. Rawiri McKree Jansen, formerly chief medical officer at Te Aka Whai Ora, put it more bluntly: 'We aren't getting anywhere with this approach.' Throughout the week, witnesses called for a return to Māori-led design – not symbolic oversight, but meaningful authority over strategy, funding and service delivery. Many cited the importance of retaining evidence-based equity tools, including the use of ethnicity as a population-level health marker. Without these, several argued, the system will continue to fail Māori by default, not design. 'The fact that we are dying so prematurely, the fact that we have so much morbidity – when you start to do something like Te Aka Whai Ora and then take it away after 10 months, it's not OK,' said Elana Curtis. 'None of this is just or fair.' Crown engagement during the hearings was limited. Its only witness, deputy director-general of Māori health John Whaanga, had his written brief withdrawn just days before he was due to appear. Whaanga did appear, however, citing active cabinet deliberations about sector reform, while Crown counsel said officials were not authorised to discuss future reforms. No alternative model was presented. Claimants argued that the absence of a replacement plan was itself a breach of te Tiriti. In their closing submissions, they noted that the Crown had offered no justification for dismantling Te Aka Whai Ora, and no path forward since. 'This isn't a system failing by accident,' said Māori health leader Lady Tureiti Moxon, one of the lead claimants. 'It is a conscious decision to return to Crown control and institutional racism.' The tribunal's findings are expected later this year. What remains is a growing record of what Te Aka Whai Ora was, what it represented, and what was lost when it was taken away.
Scoop
30-04-2025
- Health
- Scoop
Nearly 400 Doctors Call For Caution And Care In Health Workforce Reform
Press Release – NZ Women in Medicine While NZWIM supports efforts to streamline regulatory processes, it stresses that reform must be part of a wider strategy to address workforce shortages, staff wellbeing, and the sustainability of healthcare services. The New Zealand Women in Medicine (NZWIM) Charitable Trust is urging the Government to rethink aspects of its proposed health workforce regulation reforms, warning that patient safety, professional standards, and cultural obligations must not be compromised. NZWIM, the country's only pan-professional medical organisation which represents women working across all stages and fields of medicine, submitted detailed feedback on the Ministry of Health's 'Putting Patients First' consultation released in March 2025. While NZWIM supports efforts to streamline regulatory processes, it stresses that reform must be part of a wider strategy to address workforce shortages, staff wellbeing, and the sustainability of healthcare services. 'We agree there are opportunities for improvement, but any regulatory change must prioritise patient safety, uphold Te Tiriti o Waitangi obligations, and maintain strong professional standards,' says Dr Orna McGinn, Chair of NZWIM. 'Changes alone won't fix workforce shortages, and deregulation could put patient care at risk.' Key concerns raised by NZWIM include: The lack of evidence underpinning proposed changes and the document's framing, which appears to favour deregulation without considering the risks. The undermining of cultural safety training, despite its vital role in providing effective, equitable healthcare in Aotearoa. Leading and biased survey questions that limit meaningful consultation and undermine public trust. Premature government announcements that suggest decisions have been made before the consultation process has properly concluded. NZWIM recommends a collaborative approach to future reforms, aligned with the Pae Ora (Healthy Futures) Act 2022, to create a unified regulatory framework that strengthens public safety, centres equity, and honours Te Tiriti o Waitangi.
Scoop
29-04-2025
- Health
- Scoop
Nearly 400 Doctors Call For Caution And Care In Health Workforce Reform
The New Zealand Women in Medicine (NZWIM) Charitable Trust is urging the Government to rethink aspects of its proposed health workforce regulation reforms, warning that patient safety, professional standards, and cultural obligations must not be compromised. NZWIM, the country's only pan-professional medical organisation which represents women working across all stages and fields of medicine, submitted detailed feedback on the Ministry of Health's "Putting Patients First" consultation released in March 2025. While NZWIM supports efforts to streamline regulatory processes, it stresses that reform must be part of a wider strategy to address workforce shortages, staff wellbeing, and the sustainability of healthcare services. 'We agree there are opportunities for improvement, but any regulatory change must prioritise patient safety, uphold Te Tiriti o Waitangi obligations, and maintain strong professional standards," says Dr Orna McGinn, Chair of NZWIM. "Changes alone won't fix workforce shortages, and deregulation could put patient care at risk." Key concerns raised by NZWIM include: The lack of evidence underpinning proposed changes and the document's framing, which appears to favour deregulation without considering the risks. The undermining of cultural safety training, despite its vital role in providing effective, equitable healthcare in Aotearoa. Leading and biased survey questions that limit meaningful consultation and undermine public trust. Premature government announcements that suggest decisions have been made before the consultation process has properly concluded. NZWIM recommends a collaborative approach to future reforms, aligned with the Pae Ora (Healthy Futures) Act 2022, to create a unified regulatory framework that strengthens public safety, centres equity, and honours Te Tiriti o Waitangi.
