8 Apr 2022

Establishment of Māori Health Authority stirs controversy ahead of election year

2:35 pm on 8 April 2022

The new Māori Health Authority to be in place from July could radically improve life expectancy for Māori - but two political leaders want it scrapped.

Selah Hart from Hāpai te Hauora.

Chief executive Hāpai te Hauora, Selah Hart, says the Māori Health Authority will 'right a lot of wrongs' that have been sustained in the current health system. Photo: Supplied

National leader Christopher Luxon and ACT's David Seymour say they would get rid of it if they win next year's election.

But that stance has drawn criticism from some groups on the health front lines, with a number of non-governmental organisations (NGOs)penning an open letter urging the leaders to rethink their plans.

Māori public health organisation Hāpai te Hauora is one of the signatories and its chief executive Selah Hart told Morning Report the leaders' reaction was disappointing.

She said NGOs like hers worked closely with the country's most under-served communities and the Māori Health Authority would "right a lot of wrongs" that had been sustained in the current health system.

"I think [the opposition leaders' stance] is very disappointing because when we all flourish as a people it has amazing consequences for our economy."

She said there had been a "huge disinvestment in the health services" under previous National-led governments.

"The burden of disease, unintended death and all of the other impacts and consequences of underfunding health services, were ... worn by those communities that continue to be under-served and that the system or model is not created for them."

She said the establishment of the Māori Health Authority was a chance for "intergenerational wrongs" to be righted.

"When a health system is broken we need to look at all the parts and actually say 'is it working?'"

Hart said the current health system was not working for Māori people, and therefore it needed to be fixed.

The Māori Health Authority was based on the needs of people who had been underserved for generations, she said.

"This might be a step in the right direction to actually fix some of those wrongs."

National's health spokesperson Dr Shane Reti agreed there were inequities in the health system but said his party did not believe the Māori Health Authority was the way to address them.

"A model that looks like it will fail from the beginning is a model that shouldn't be started," he told Morning Report.

Reti said the new authority was based on "layers and layers of bureaucracy" with a focus on form, rather than function.

"I'm interested in health outcomes," he said, adding that the government's own regulatory impact statement said there would be no benefits realised from the establishment of a Māori Health Authority for the first five years.

"That's not tenable for the hundreds of millions of dollars that are being spent on the Māori Health Authority."

Reti was also critical of the fact that the model would see the Māori Health Authority be both a commissioning agency and the agency for monitoring Māori health inequities.

"It will be monitoring its own purchase of services," he said. "It's a terrible conflict of interest."

Reti said that instead of the authority, there should be a Māori health directorate in the ministry.

"When you involve indigenous peoples, involve indigenous communities, involve Māori, you get better outcomes; but all of that can be done with a very strong Māori health directorate," he said.

"What we oppose is the separation of a health system on anything other than need. Health needs to be predicated on need, not a treaty response, and when you start with that, surprise, surprise, Māori is the top of the need tree for most conditions."

Reti said the long-term drivers that would change Māori health were income, employment, housing and education and a Māori Health Authority would not focus on those areas.

"It's the co-determinants of health that will shift the dial for Māori."

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