Māori still waiting for a real health plan from Health Minister Shane Reti - Hūhana Lyndon

Hūhana Lyndon (centre), and Green Party members receive a petition calling on the Minister of Health to restore Te Aka Whai Ora (the Māori Health Authority) at Parliament.

THREE KEY FACTS

• Health Minister Shane Reti promised a “different path” to improve Māori health outcomes, but staff cuts continue.
• Iwi Māori Partnership Boards struggle with inadequate funding, leading some to use private sector resources.
• The Pae Ora legislation and Health Charter remain in place, but current decisions show no evidence of progress

As our Minister of Health, Shane Reti, began the dismantling of Te Aka Whai Ora (the Māori Health Authority) around the start of this year, he unashamedly dared to dream of a better tomorrow for our communities. Little did he know that his actions were prolonging the generational nightmare of health disparity endured by te iwi Māori.

“I want to paint a different dream, one that will be outcomes-driven, providing greater devolved decision-making that will deliver care as close to the home and the hapū as possible,” he said.

A different dream, he said, and yet, in the months since, the canvas he has laid out reveals the same tired story: deep-rooted inequalities entrenched by decisions which erase progress, rather than build on it.

Now, almost 11 months later, hapū and iwi are still waiting to see Reti’s pathway to improving Māori health outcomes. And yet, we see no plan, no health strategy, no annual report to track outcomes. Instead, we sit amid a storm of cuts, slowly crippling our health system, piece by piece.

As a Māori member of Parliament, I sit bitterly disappointed, particularly at the lack of progress in providing any semblance of a plan to address the 7.4-year gap in life expectancy between Māori and non-Māori.

The “lift and shift” of Māori Health Authority staff resulted in job losses. From the day the Government announced its 100-day plan, such job losses have come, one after the other, as the Government barrels on, focused on cutting costs instead of improving health outcomes.

The lack of consideration for hauora Māori (Māori health outcomes) is highlighted by the latest Waitangi Tribunal report, which was released on Friday last week. It pulled no punches in its documentation of the epic failure of this Government in honouring te Tiriti o Waitangi.

In the report, the tribunal documents errors by the coalition Government in undermining the tino rangatiratanga of Māori. Te Aka Whai Ora was something that demonstrated good partnership, supported “by Māori for Māori” approaches with an explicit aim of addressing Māori health inequities.

Research and lived experience show that culturally responsive care leads to better health outcomes for everyone, not just Māori. Te Aka Whai Ora wasn’t an experiment – it was progress. It came from a whakapapa of wānanga and development over 20 years ago. The Waitangi Tribunal saw “Te Aka Whai Ora as an expression of tino rangatiratanga, albeit a limited one, and one specifically set up to address health inequities for Māori, giving effect to the vision of ‘by Māori for Māori’ at the structural level as well as the level of service provision”.

The Waitangi Tribunal recommend the Crown:

• Commit to revisiting the option of a stand-alone Māori health authority.
• Consult extensively with Māori in the development of any alternative plans.
• Always undertakes proper regulatory impact analysis in matters that affect Māori health.

The promises of Reti to take our waka hauora forward bear no resemblance to reality as our understaffed workforce struggles to paddle upstream.

There is no strategy, there is no plan, and there is no clear direction.

The Māori Health Authority was more than a policy initiative, it was a vision of tino rangatiratanga in action, empowering Māori to shape solutions for their own communities. Its loss isn’t just administrative, it’s a real setback for trust, for collaboration, and for the promises of te Tiriti.

To “paint a different dream”, Reti, we don’t need to start again from scratch. We just need a healthcare system which reflects the richness of te Tiriti, honouring both its promises and its people.