After some confusion about Whanau Ora, our columnist visited a provider to better understand the initiative.
This week I went to Mangere to visit a Whanau Ora provider, to see what had so confused the Auditor-General Lyn Provost about this pioneering initiative.
Turuki Healthcare is one of the four Whanau Ora providers in South Auckland, and also holds a slew of other health contracts including those for mother and baby services and rheumatic fever prevention. I can report that I didn't observe groups of well-heeled Maori employing their mates, driving fancy cars and feasting on truffles and champagne, which I had come to expect after so much angry public reaction to this poorly explained project.
Instead, I saw a very sparse waiting room, packed to overflowing with people of moderate means. I met with chief executive Te Puea Winiata in a modest office and was offered a cup of plunger coffee. If she was hiding a room full of gold bullion or something back there, she did it well.
What I did learn from her and her Whanau Ora development manager, Barry Bublitz, is that Whanau Ora is not only a fantastic initiative that deserves our support, but that it requires more funding, and needs expansion to all New Zealand families where there is genuine need.
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The language around Whanau Ora can be confusing and jargony, but in reality it's quite simple. Whanau Ora sees "navigators" enter a home, assess all areas of need, and put the family in touch with the right social services.
One of a navigator's tasks is to ask whanau members to create charts that list their aspirations. I saw some of these charts and they contain the most heartbreakingly simple things you can imagine. "Put kai on the table every night", "get my kids educated" and "have confidence" are the tenor of most.
According to Te Puea, many Maori families have "forgotten how to dream". Members of some of these dispossessed families have never even had a piece of ID. No ID means no bank accounts, no driver's license, no job, no benefits, and no connection with the system. Basic needs can be assisted by Whanau Ora, but it's flexible enough to allow for more: it might pay for someone to sit a driver's license, for example, which will open a whole new door on their life.
One of the reasons Whanau Ora is a bit trickier to "account" for is that it works differently from a traditional healthcare contract. Ordinarily, a provider is paid by a government department to see, say, X number of babies for an hour a week each. Whanau Ora is not as prescriptive. A navigator may go into the home, see a sick baby, drive the mother and child to hospital, sit with the mother who is anxious, take her to the pharmacy on the way home, and help her administer the medication.
That seems like it could be resource-heavy, but Turuki showed me their figures, and what I saw is that hundreds of families are helped by navigators paid generally less than your average parliamentary staffer. Whanau Ora nationwide has cost almost $140 million in five years - about $28 million a year to fund around 200 or so navigators nationally, with around 50,000 people helped - mostly Maori, but also Pasifika families. There is never any justification for wasting taxpayer money, of course, but let's keep any condemnation in perspective: we will spend one whole year of Whanau Ora funding this year just to investigate changing our flag, at a total benefit to no one except the wealthy people on the flag-changing panel.
More importantly overall, Whanau Ora is working in key areas. In the recently released Report on the Performance of General Practices in Whanau Ora Collectives, by the end of 2014, it had made demonstrable strides in areas such as smoking cessation, mammograms, and diabetes management. And that's because families may not seek out doctors, but a navigator - an "aunty" as some describe them - can go into a house and encourage a middle-aged woman to go for a mammogram, and will usually succeed.
It has to be said the National Party has done a good thing in sticking by the Maori Party's vision for Whanau Ora, even though more funding, and more certainty of funding, is required. Let's hope against hope that today's Budget continues and grows the trend. From what I can see, it's the only realistic way to help head-off a massive crisis in the health budget we're on the cusp of being smacked upside the head with.