Te Aka Whai Ora - Māori Health Authority. Photo / Whakaata Māori
Te Aka Whai Ora - Māori Health Authority. Photo / Whakaata Māori
OPINION
I thought I might read the report on Te Aka Whai Ora which various politicians have been excited about before commenting.
Not something which I suspect all commentators have done, preferring to dip in the find some highlights which suit them, then leaping to the keyboard. I’mglad that I did because while it does provide ammunition for critics to find, I think we have to be a whole lot more mature about such assessments than is now common. There is much in it that is constructive and positive.
For a start, while some critics of Te Aka Whai Ora are quick to label this an “EY” report, that is in itself disrespectful. I would not have employed EY to mark its own homework myself but while they did conduct interviews and other leg work the report is from the Hauora Māori Advisory Committee, which comprises a set of highly respected and experienced Māori.
This composition will change going forward with input from the Iwi Māori Partnership Boards and other Māori organisations but right now it is more than competent for the task.
The board of Te Aka Whai Ora has responded constructively to the report, defending where it thinks appropriate.
For my part, the points they make seem entirely fair. This report was planned from the start and is no surprise, but as the board and subsequent informed comments from the likes of Lance Norman, of Whānau Ora, have made clear, it is very early in the life of the reforms.
Much effort has been on establishing governance and management in Te Aka Whai Ora for a very simple reason – they had none to start with. They have spent less on commissioning services etc than they could have – they had to establish proper procedures first (can you imagine if they had not?).
It is early days. There are equivalent reviews of Te Whatu Ora to check how the initial organisational set-up is going. They have also naturally shown strong and weaker points of progress. Can anyone seriously imagine that such reviews would not exist or find no weaker points? The attention to this review and its critical observations is simply gaslighting.
The report itself finds that where there are deficiencies in achieving some milestones there has been a “prolonged lack of resource, capability and capacity” which has caused this.
Rob Campbell, former unionist and now company director and interim head of mega-DHB Health New Zealand. Photo / Michael Craig
If you think seriously about this it is pretty obvious that the reasons are in the poor planning and preparation made by EY and Manatu Hauora in the initial drafting and scoping. There are two reasons why something can fall short of delivering milestones – one of them and the strongest one in this case is that the milestones themselves were never realistic.
Such deficiencies do not justify a conclusion that either the organisation or its initial leadership are not appropriate and should not be further supported. Nor does the report itself make any such suggestion.
Those outside the system and debates may not realise that the idea of a Māori Health Authority was not dreamed up by the current Government. It was not even invented by EY.
The idea has a long history over decades within Māori korero on health, and was part of the findings in Wai 2575 in 2019. Its current form and powers are a limited version of the vision developed in those earlier discussions.
If you look at the make-up of the Hauora Māori Advisory Committee and the leadership of Te Aka Whai Ora you will not find people who want to lessen the independence and influence of a “by Māori for Māori hauora” part of our national health system. Quite the opposite. The success of Whānau Ora (by no means only but significantly during the pandemic) has strengthened in practice the widespread findings of health research here and globally regarding indigenous delivery of health services.
To be clear, this is true not just in terms of driving relative improvement in health outcomes but also in supporting gross population outcomes.
The current leaderships are committed to this as a long-term goal, they see what is done in early years as partly important now but even more important for generations to come.
You might as well observe that the kindling of a fire is not producing much initial warmth and ignoring the stockpile of logs being prepared to add.
So I suggest that people reading this latest assessment for tidbits of fault actually read it for its full content and full context.
Rob Campbell is a professional director and investor. He is chancellor at AUT, chairman of Ara Ake, chairman of NZ Rural Land, an adviser for Dave Letele’s BBM charity. He is also the former chairman of Te Whatu Ora (Health NZ).
