Source: Radio New Zealand
Dr Kim Ngawhika – Pouwhakahaere Te Kāhui Hauora o Te Tauihu IMPB. Supplied/Te Kāhui Hauora o Te Tauihu
Iwi Māori Partnership Boards (IMPBs) are concerned their role in the health system will be reduced under the government’s Healthy Futures (Pae Ora) Amendment Bill.
The Health Select Committee released its final report on the bill in November, recommending it be passed. It is expected to have its second reading in the coming months.
Minister of Health Simeon Brown said the changes being made were focused on ensuring a clearer structure that delivered better results, including for Māori, and a key part of this is clarifying the role of Iwi Māori Partnership Boards.
The 15 regional Iwi Māori Partnership Boards were set up in 2022 to ensure the voices of Māori are heard in healthcare decision-making and improve hauora outcomes for Māori.
Te Kāhui Hauora o Te Tauihu covers the top of the South Island, its Pouwhakahaere Dr Kim Ngawhika said currently IMPBs have three main functions: first to provide a whānau voice, second to monitor the health system and third to work with Health NZ in developing priorities for improving hauora Māori.
Under the Pae Ora amendments those functions would be reduced to one, providing a voice for whānau, she said.
“It does kind of put us on the outer as far as partnership is concerned, we’re still there, we’re still going, but is has reduced our responsibility considerably.”
Ngawhika (Kāi Tahu, Kāti Mamoe, Te Arawa) said it feels as if the partnership is being reduced as much as possible without shutting down the IMPBs outright.
“Of course we will adapt, Māori have always adapted, as governments come and go we remain. Our focus for Te Kāhui is our whānau voice.”
Ngawhika said the focus for the IMPB remains on working with whānau and continuing to engage in the health system despite the uncertainty of what the future holds.
When Te Aka Whai Ora, the Māori Health Authority was disestablished the IMPBs took on some of its responsibilities, and the previous Health Minister Dr Shane Reti indicated that they would be empowered to take on a much broader remit. https://www.rnz.co.nz/news/in-depth/514549/how-the-coalition-plans-to-replace-the-quickly-scrapped-maori-health-authority
Ngawhika said there was some great encouragement from Reti in his initial contact with the IMPBs during what was a time of uncertainty.
“There was a lot of work that happened in that time and it was a time of great change too because Te Aka Whai Ora was being disestablished and I think that the Iwi Māori Partnership Boards just put their heads down and got on with that piece of work.”
The Manahautū of Wellington IMPB Āti Awa Toa Hauora, Hikitia Ropata is concerned that the IMPBs will lose their direct relationship with the Minister of Health under the changes, which would see the Hauora Māori Advisory Committee (HMAC) providing advice to the Minister instead.
But as Ropata (Ngāti Toarangatira, Te Āti Awa, Ngāti Raukawa, Ngāti Porou) notes, the members of HMAC are appointed by the Minister.
“So what we want is the opportunity to influence at that really regional, local level. I know there are public servants working hard to try and enable that to happen. But when your legislative framework changes so much, it’s hard to keep the faith in a system when you know you want the best for your people.”
The IMPBs have now been around for three years now and in that time have worked hard to build relationships both with the communities they serve and with Health NZ, she said.
“At the end of the day, I think that IMPBs have a better crack at building trust and getting information from our own people than if health officials go out and try and do it.”
Ropata is also concerned that among the raft of changes the Bill also strips key health sector principles designed to address inequities by removing the requirement for the Government Policy Statement (GPS) to consider any national health strategy.
These strategies, such as the Māori health strategy and Pacific health strategy, provide important evidence and data and Ropata is worried the health system will “lose its compass” without them.
“If we can’t use that evidence and that data for our way forward, how the heck are we going to know where we’re heading, how the heck are we going to achieve better equity for our people in our community? Our people, iwi and Māori people in our local areas, but also everyone.”
The amendment breaks the link between long-term health planning and the political direction of the day, she said.
“Basically, IMPBs could be left monitoring ongoing inequities for the government, but not have it influence what the government aims to do in its government policy statement.”
Te Taura Ora o Waiariki Chair Hingatu Thompson. Supplied/Te Taura Ora o Waiariki
Te Taura Ora o Waiariki, the IMPB for Te Arawa, also expressed concern at the removal of the strategies for groups most affected by inequity, including whaikaha (disabled) whānau.
“Removing strategies for those already struggling to be heard is dangerous. These inequities are avoidable, unfair, and unjust. The amendments make them worse,” said Chair Hingatu Thompson.
Both Māori voices and those of supportive non-Māori organisations have been ignored, he said.
“When you remove evidence, ignore submissions, and downgrade Te Tiriti, you’re left with political ideology interfering with the democratic process. And that ideology is clearly anti-Māori,” he said.
Ngawhika made note that one of the minor changes the Bill makes is a change to its name, switching from Pae Ora (Healthy Futures) to Healthy Futures (Pae Ora). “This is yet another way of silencing our voice,” she said.
Minister of Health Simeon Brown said under the changes IMPBs will continue to do what they are best placed to do: engage directly with their communities, identify local barriers, and provide deep insight into what is driving outcomes on the ground.
“IMPBs will also continue to engage with Health New Zealand at a district level, ensuring community perspectives directly inform how services are delivered in each region.
“For example, Māori children continue to have lower vaccination rates than non-Māori. Understanding the specific local issues behind those rates is essential to improving them, and that insight comes from IMPBs.
“These insights will also be provided to the Hauora Māori Advisory Committee, whose role is being strengthened to provide independent national-level advice on Māori health priorities to the Minister and the Health New Zealand Board. This creates a clear and consistent pathway from local insight to national decision-making.
“This approach will support more effective, community-informed responses to issues such as childhood immunisation and outbreaks, particularly in areas where Māori outcomes can be improved.”
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– Published by EveningReport.nz and AsiaPacificReport.nz, see: MIL OSI in partnership with Radio New Zealand