Power of Potential

MATT SHAND, JOURNALIST

A year on from the formation of Te Aka Whai Ora, Chair Tipa Mahuta speaks about the challenges of changing the paradigm when it comes to Māori health in New Zealand.

Providing a Māori-led approach to health has proven to be a political hot-potato, with much of Te Aka Whai Ora’s initial year spent juggling politics with gaining better health policies for Māori.

“Te Aka Whai Ora had a political birth,” chairperson Tipa Mahuta said.

“It has taken up a lot of oxygen having these political conversations, but we cannot wait another generation to justify why this moment, of having a Māori Health Authority, should happen.

“I grew up in the era of the eighties, and this idea of Te Aka Whai Ora has been coming for a long time. It was really a case of when will New Zealand be ready for it.”

That time, it seems, has not yet fully crested, with the National Party leader Christopher Luxon promising to disband Te Aka Whai Ora if elected. Mahuta does not get involved in party politics, instead choosing to focus on the opportunity afforded her.

Looking at health statistics in New Zealand, it becomes evident Māori have been let down by the health system, exasperated by the flow-on effects of colonisation. Māori die at twice the rate of non-Māori from cardiovascular disease. Māori children have a mortality rate of 1.5 times that of non-Māori, and on average Māori die seven years earlier than non-Māori.

It is a significant challenge for Te Aka Whai Ora to overcome and one that will require more than an election cycle to complete.

“It is time for Māori-led solutions because nothing else has made a difference for our people,” Mahuta said.

She says the first two years of Te Aka Whai Ora’s life will be critical for achieving benefits for Māori, and there has been a need to hit the ground running.

“We have been busy reaching milestones,” she said.

“In our first six months we responded to the need for more services designed by and for Māori. We have made commissioning decisions to increase funding for Kaupapa Māori and, in November, launched Te Pae Tata with Te Whatu Ora and have created 11 iwi-Māori partnership boards who will represent whānau in the design and delivery of health care.”

Te Aka Whai Ora wants to put the culture and context of Māori health back at the forefront of health care.

“Modern medicine recognises that people are grounded in their cultures and contexts, and caring for them well requires we understand that context,” she said.

“For Māori, ensuring good care means incorporating mātauranga Māori and te ao Māori, which offers opportunities to improve care for a diversity of whānau.”

An area where this was highlighted was in the vaccination response towards Covid-19, where Māori- or iwi-led initiatives had much higher uptake from the Māori community.

“The lesson from Covid-19 was the responsiveness of the community and opportunities for communities to lead their own service,” she said.

“If you want to meet the outreach you need to go through that door. We want whānau to be as well protected as possible, which means keeping people up to date with all immunisations. Our system contains many barriers for whānau Māori accessing immunisations, and Te Aka Whai Ora is working with Te Whatu Ora to implement new recommendations from the immunisation taskforce.”

One of those recommendations is the expansion of the vaccinator workforce so it is diverse and reflects the different communities it serves.

Empowering Māori providers to lead the way in schools, marae and drive-through centres in remote communities is seen as a key measure.

“The talent is there,” Mahuta said. “Some of the problem is in the way medicine is taught. This is not a problem unique to Māori communities, but if there is a resurgence of Māori in the health workforce it will have flow-on effects for Māori health.

Te Aka Whai Ora Te Pitomata – Power of Potential grants were launched in April and look to support Māori health care workers to study across five health categories, including midwifery, allied health, nursing, medicine and health management.“

Research conducted in November told us previous students need more financial assistance for course and living related responses, as these costs have risen over the past few years,” Mahuta said.

“This grant will support people to realise their potential and ensure, long term, the workforce is aligned with the needs and aspirations of our people.”

Reflecting on the past 12 months, Mahuta says she remains focused on the opportunity Te Aka Whai Ora can bring to New Zealand and right some historical wrongs.

“We have a unique position,” she said. “We have the capacity to put things in the right place and we have the ability to hold the system to account, to commission and direct policy and strategy with Māori at the heart.

“In time we will have capacity for our great intentions, but for now we are learning to walk before we run.

“Our biggest achievement to date has been the ability to influence, in a very short time, some significant policy shifts and really start to drill down into the equity space. In a few years, we’ll be flying.”