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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Click here to read the full submission

The report, “Health and productivity opportunities: Assessing the economic value of addressing priority health conditions in Hawke’s Bay working-age Māori”, was commissioned jointly by Hawke’s Bay Regional Development Agency (REDA) and the Tihei Tākitimu Iwi-Māori Partnership Board.

Produced by NZIER economists Sarah Hogan and Tom Dunn, the report is thought to be the first in New Zealand to consider the critical links between Māori wellbeing and regional economic development. Māori make up 29 per cent of Hawke’s Bay’s overall working population and play a vital role in the food and fibre sector industries, along with regional recovery.

“The research shows that Hawke’s Bay’s working-age Māori aren’t accessing health care early enough, for a variety of reasons, which leads to more serious primary health conditions,” Lucy Laitinen, REDA’s CEO says.

“One of the reasons it’s so difficult for Māori to access health services is because they largely work in agriculture, forestry, and fishing with little or no flexibility in their working hours. They also earn less than the regional average. These are among the issues driving the relatively low use of preventative care which leads to the high rate of ED visits.’’

Tihei Tākitimu Iwi-Māori Partnership Board co-chair Lewis Ratapu says the report provides the wider community with a burning platform to think about and act differently in how health services to Māori are delivered. We need to invest more effectively and deliver services targeting mental illness and addiction, diabetes and cardiovascular disease so Māori can lead happier, healthier lives, provide for their whānau and continue to make a productive contribution to the local community.

Ratapu hopes the collaboration with REDA ensures health stays on the agenda for local regional leaders – the Matariki Governance Group – as it considers its priorities over the coming year. He noted the Regional Recovery Plan identified a need for 2,500 extra people to deliver the recovery programme over the next three years and with co-ordination needed to address current and future workforce requirements.

“We will be actively encouraging and facilitating a joined-up approach to addressing this issue, including exploring alternative health service models with large local employers, iwi, hauora Māori and health service providers and local and central government working together to trial different options for Māori that suit their needs, Ratapu says.

The research only further highlights the importance of Māori health to Hawke’s Bay’s future. This issue is not going to go away, especially as the working-age population of Māori is expected to grow to 43,540 within the next two decades.

Together as a community we have to improve Māori health now,” Ms Laitinen says.

NZEIR Health  Productivity Opportunities