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Home / Kahu

Minister under pressure as Māori health report nears completion - Rob Campbell

By Rob Campbell
NZ Herald·
2 Dec, 2024 09:03 PM4 mins to read

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Health Minister Dr Shane Reti.

Health Minister Dr Shane Reti.

Opinion by Rob Campbell
Rob Campbell is a professional director and investor. He is chancellor at AUT, chair of Ara Ake, chair of NZ Rural Land and former chair of Te Whatu Ora.
  • Public servants preparing a paper for the Health Minister face a challenging task after Hautupua’s critical report.
  • The Waitangi Tribunal’s recommendations include revisiting a stand-alone Māori health authority and consulting extensively with Māori.
  • Concerns persist about the Coalition’s commitment to Māori health equity and the impact of recent changes.

The public servants I feel really sorry for this month are those who are tasked with preparing a paper for the Minister of Health. They have a task which would make anyone reach for the last memo on voluntary redundancy.

They will have read by now Hautupua: Te Aka Whai Ora (Māori Health Authority) Priority Report Part One.

My guess is that not many ministers will have done so given how clearly and systematically it takes apart the shabby process behind the “disestablishment” and breaches of te Tiriti which the Prime Minister still claims against all evidence they support.

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In Hautupua, the Waitangi Tribunal notes that the Crown had announced an intention “to announce its alternative plans for hauora Māori” this month. That’s the document which the officials must be working on.

The tribunal has tried very hard to be fair to what that document may have to say.

But it had better be pretty good, if only because the tribunal will join many others in reading it very carefully for whether it tells the truth about what has been done for hauora Māori over the past year, what the ongoing plans are, and how they match Crown obligations.

The tribunal has offered some guidance in its three recommendations which have not yet had much attention:

  • Commit to “revisiting the option of a stand-alone Māori health authority”;
  • Consult extensively with Māori on any alternative plans;
  • Undertake “proper regulatory impact analysis in matters that affect Māori health”.

Imagine drafting a paper which adopted those sound approaches for the current Cabinet. Of course, if you believed in a neutral public service offering free and frank advice you would have no problem.

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But this is after all a month in which many suspend reality for unfounded beliefs like Santa Claus.

Pharmac chief executive Sarah Fitt, left, and chairwoman Paula Bennett at the Health select committee hearing, Photo / Mark Mitchell.
Pharmac chief executive Sarah Fitt, left, and chairwoman Paula Bennett at the Health select committee hearing, Photo / Mark Mitchell.

Hautupua notes that when the Coalition announced its plans in January 2024 it undertook to “continue to promote the exercise of tino rangatiratanga by hapū and iwi towards achieving health equity for Māori”.

Progress on this may be expected in the report imminently due. No, I’m not breathless with anticipation either.

After all, under questioning by Green MP Huhana Lyndon yesterday on the scrapping of Te Rautaki Whai Oranga, the rōpū Māori advising Pharmac, the Associate Health Minister expressed the view that he had no interest in such advice, only “the voices of all New Zealanders”.

Crown counsel in August confirmed that the Coalition would “progress the Minister of Health’s vision and plans for Māori health over the next 12 months following the disestablishment”.

The Minister was undertaking “targeted engagement with health entities” leading into the report we now expect.

Now a reasonable person might, and the tribunal did, expect that one would have a “vision and plan” before shutting down Te Aka Whai Ora, but such is how the Coalition “rolls” as the Prime Minister puts it.

We have also learned to be a bit cynical about “targeted engagement” as a means of consultation after tobacco and other exercises.

It seems to mean “talking to people who agree with us or feel obliged to agree with us and ideally have funded us”. But I guess whatever that means has now been completed and the report drafting is on.

When I talk with or read reports from “health entities” or health workers, especially Māori kaimahi, I struggle to hear of the innovative new approaches to Māori health equity based on tino rangatiratanga by hāpu and iwi which have been promised.

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Rob Campbell, former chairman of Te Whatu Ora. Photo / Michael Craig
Rob Campbell, former chairman of Te Whatu Ora. Photo / Michael Craig

I do hear of jobs lost, funding limits, confusion of accountability and direction. There has been the odd self-serving claim by the Minister about some funding which is inadequate and usually just repurposed.

I certainly have not seen the over $500 million that was claimed to have been wasted made newly available to Māori health entities, or even to the Iwi Māori Partnership Boards which are trying to do the best they can with inadequate resources and unclear roles.

I would love to be wrong but I reckon the report the officials must be completing about now will not only be hard to write, but hard for anyone to swallow.

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