The Tihei Takitimu Iwi-Māori Partnership Board (IMPB) is urging the government to adopt a “programme reset” as a constructive alternative to the proposed amendments to the Pae Ora (Healthy Futures) Act 2022.
In a submission to the Health Select Committee, the Board argues that its current legislative functions in needs analysis, monitoring, and strategic commissioning are critical for driving local solutions that are patient-centred and responsive to whānau needs. The proposed amendments would be a “backward step” that disregards the significant progress already made and operational issues that could be quickly resolved. The Board’s submission highlights the unique position IMPBs have to address the disproportionate rates of high-priority health conditions and barriers to care faced by Māori. Rather than diluting the impact of IMPBs, the Board believes a reset would enable and catalyse success by leveraging the momentum and knowledge they’ve already established.
The proposed programme reset focuses on four key areas:
- Capturing Lessons Learned: The Board has been working to identify opportunities and challenges to success and seeks to continue advocating for whānau on issues that matter to them, with solutions that leverage the best of the health system. This advocacy needs to happen both nationally, and on-the-ground in the region.
- Accelerating Innovation: A review of health services would aim to identify gaps and overlaps based on whānau needs and priorities, and a plan to resolve them. The Board has already demonstrated this approach by commissioning research that linked improved health for working-age Māori with significant economic gains for the Hawkes Bay region.
- Removing Barriers to Effective Delivery: The Board has identified several systemic barriers to their effectiveness, including a lack of proactive local health data, limited visibility over where health funds are being invested, and issues with accountability for delivery across the system.
- Collaborating on ‘Big Issues’: The submission proposes working with the Hauora Māori Advisory Committee on significant issues that will have the greatest impact on Māori health outcomes nationally, and resourcing the development of people, services, and systems for greater impact at the coalface.
Tihei Takitimu has already built a new entity from the ground up, establishing deep capabilities and trusted relationships with whānau across the Te Matau a Māui/Hawkes Bay district.
Board Co-Chair, Kerri Nuku says that the trust Tihei Takitimu has established is linked closely to its direct influence and focus towards achieving better patient outcomes within the region.
‘A message we hear regularly from whānau has to do with how often they are surveyed and by different organisations asking the same things, without any real manifestation of change. With the IMPB’s their experience is different, especially with our mandate to influence better outcomes,’ she says.
The Board’s first Community Health Plan published last December consolidated important achievements and identified 23 priorities that matter to whānau. Due to some of the systemic and operational barriers these priorities are still waiting to be addressed, but the Board’s been able to build constructive relationships with the Regional teams focussed on planning, funding and outcomes, and has found some innovative workarounds to ensure whānau voice is heard.
As an example of its innovative approach, the Board collaborated with the New Zealand Institute of Economic Research (NZIER) and HBREDA to explore the links between health and productivity in the region.
The resulting report revealed that improving the health of working-age Māori could lead to a potential productivity gain of $122 million per annum and add 1,800 workers to the region. It also highlighted that working-age Māori are not accessing essential care early enough, leading to more serious conditions.
Co-Chair, Lewis Ratapu says that this type of localized, evidence-based approach is exactly what the IMPB is mandated to do: advise and determine where regional investments should be made. However, as the Minister says, we need to get the basics right, especially for delivery on the ground.
“We’re asking the Select Committee to consider the insights we have gained and approaches we have made, and enable and strengthen IMPBs like Tihei Takitimu to continue their regional work programmes, without either legislative or operational barriers that compromise better health outcomes for whānau.
“Without this dual national and regional focus, stark inequities in Māori health across Te Matau a Māui/Hawkes Bay will persist and the government’s intentions to put patients first will be lost.”
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