29 Paenga-whāwhā 2021 | 29 April 2021
The Royal Australasian College of Physicians (RACP) welcomed the government’s health reform announcements as a health system structure seeking to live its commitments to Te Tiriti o Waitangi.
“These reforms speak boldly, and they speak loudly. They say that our health system will no longer tolerate the health inequities experienced by our Māori and Pasifika whānau,” said Dr George Laking (Te Whakatōhea), a medical oncologist based in Tāmaki-Makaurau Auckland and the RACP’s Aotearoa NZ President.
Dr Sandra Hotu (Tainui-Ngāti Maniapoto, Hauāuru-Ngāti Ruanui) a respiratory physician and Chair of the Māori Health Committee agreed, saying “the system architecture announced on Wednesday draws a line under the system as it currently stands.”
“The reforms openly acknowledge there is another way of doing things – and that way is informed and driven by Te Ao Māori”.
Dr Laking and Dr Hotu are positive about the establishment of an independent Hauora Māori Authority.
“The commitment to tino rangatiratanga through the establishment of the Māori Health Authority is long overdue, and its autonomy must be protected through legislation.”
This was part of the expression of Te Tiriti o Waitangi and its principles in the new system structure, Dr Hotu said, and that included not just autonomy, but appropriate fiscal resources as well.
“Māori must be resourced to commission, fund and contract for Māori health outcomes, including in the mainstream health system, because that is where the majority of whānau receive care”.
The Māori Health Authority’s remit to commission services in partnership with the new Health New Zealand entity could inaugurate much-needed shifts in models of care, she said.
“Equitable health outcomes begin where, how and when the system and health practitioners engage with whānau.”
“We need to be looking to Whānau ora, to Te Whare Tapa Wha”, said Dr Hotu.
“Bringing a lens which doesn’t isolate health and health care from all the other things which make up health and ultimately contribute to the vision of pae ora – health and wellbeing for all”.
Both confirmed that equitable health outcomes needed all facets of the system to play their part.
Dr Laking said that while specific implementation and operational detail remained to be seen, he noted that Māori Health Authority should not have to carry the load alone to hold the system to account for Māori health outcomes.
“‘Health equity for Māori is a non-negotiable’ – that’s there in the reforms package, and the independent Māori Health Authority has a leadership role in this space. But this should be a non-negotiable for every person employed in the health sector, as an expression of partnership under a Te Tiriti-based system”.