The health system Aotearoa deserves

Riana Manuel is the chief executive of Te Aka Whai Ora.

OPINION: Māori children have a mortality rate one-and-a-half times the rate of non-Māori children, Māori die at twice the rate of non-Māori from heart disease, and Māori die on average seven years earlier than non-Māori.

The statistics are clear.

Māori have been let down by our health system for too long, and Te Aka Whai Ora is here to make a difference and drive much-needed change.

A year since establishment, we have built a team of committed health professionals, made significant investments in the Māori health workforce and are addressing the chronic underfunding for Māori providers.

But we are young. And there’s more mahi do. Lots of it. And we’re not shying away from this challenge. The cost to Māori and wider Aotearoa is too great if we stop this momentum.

The opportunity to lead an organisation focused on improving health outcomes for those most in need is both a privilege and daunting task.

It’s been over 30 years since I started my journey working in the health sector, but it’s taken us over 180 years to get to this point where we are finally addressing decades and decades of a system that has failed Māori.

We have seen throughout the Covid-19 pandemic that when iwi, hauora (health) providers and other Māori organisations are supported nationally and given the opportunity and resources to develop their own solutions, they mobilise quickly, reach deep into their communities and achieve effective results.

More recently, the benefits of a national Māori health agency were demonstrated in the response to Cyclone Gabrielle.

Te Aka Whai Ora acted quickly to support the iwi, hapū and hauora Māori providers working on the ground in the affected communities with dedicated resources (including funding and clinical personnel) and ensured they were well linked into the national response.

For instance, one of our hauora partners, Turanga Health, personally checked in on over 1000 individuals in Tairāwhiti after the cyclone. It then partnered with Te Aka Whai Ora to provide te ao Māori psychosocial solutions for whānau affected by the severe weather events.

It offered whitiwhiti kōrero, wairua and rongoā services, and community resilience and capability building activities. It also held kaumātua days to help connect people from across the rohe to receive much needed mirimiri, romiromi, hiki wairua packs, and develop neighbourhood phone trees.

Based on many experiences like these, we are confident that our approach – where solutions are delivered by hauora Māori providers – will work.

Establishing a new organisation is a complicated task and we are proud of the work that has been undertaken by our team over the past 12 months. We have had to build our waka, while navigating some big challenges, and we have delivered in many areas.

In our first six months, we responded to the need for more services designed by and for Māori. We have made commissioning decisions to increase funding for kaupapa Māori providers and late 2022, launched Te Pae Tata (NZ Health Strategy) in partnership with Te Whatu Ora.

The release of a recent report into our performance highlighted a number of areas we need to make progress on.

It is pleasing that, as this report was done at a point of time – just 10 months into our establishment, we have already completed many of its recommendations, and the others we welcome.

While primarily targeted at Māori populations, what is often overlooked is that the diverse and innovative models of care supported by Te Aka Whai Ora are open to all New Zealanders where available in their local communities.

We are extending the current reach of the health system, expanding choice of services and adapting the way care is delivered. Many non-Māori access services are already delivered by hauora Māori providers.

Providing Te Aka Whai Ora with a significant direct commissioning budget doesn’t just enable us to drive system improvements for Māori and develop hauora Māori-specific strategies and services. It also helps the Crown meet its obligations to Māori as a partner under te Tiriti o Waitangi and strengthens Māori-Crown relations.

I know myself, all the staff at Te Aka Whai Ora and all our partners in the health sector are committed to delivering transformational change for the health and wellbeing needs of whānau Māori now and into the future.