Ngā whakahoutanga ā-haoura - Health reforms

In Aotearoa New Zealand, people have different levels of health. This is unfair, unjust, and avoidable.  

The system has failed to look after Māori: 

• Māori die at twice the rate of non-Māori from cardiovascular disease. 
• Māori tamariki have a mortality rate one and a half times the rate of non-Māori children. 
• Māori are more likely to be diagnosed and die from cancer. 
• Māori die on average seven years earlier than non-Māori. 

The Waitangi Tribunal investigated claims (Wai 1315 and Wai 2687) dating back to 2005 around longstanding inequity, institutionalised racism in the health system and worsening Māori health statistics.  

Presented by a coalition of Māori Primary Health Organisations, the claimants pointed to the Crown’s inadequate funding and support of Māori providers compared with non-Māori providers.   

They argued that Māori were unable to exercise tino rangatiratanga in the design and delivery of primary healthcare, and that the continued poor outcomes for Māori health point to systemic problems in the primary healthcare sector. 

Wai 2575 Health Services and Outcomes Kaupapa Inquiry Stage One Report, released in 2019, revealed that our primary healthcare legislation and policy breaches Te Tiriti and fails to care for Māori health and wellbeing. 

This was the spearhead for our health reforms and led to the creation of Te Aka Whai Ora. 

A full Health and Disability System Review in 2019-2020, which included DHBs, health providers, communities, and stakeholders, reinforced the Waitangi Tribunal’s findings and set the scene for the major changes needed. 

The review confirmed that Aotearoa has: 

• unacceptable Māori health inequities 
• institutional racism 
• general health systems that have not improved Māori health outcomes, and 
• approaches to design, purchasing and contracting of health services that have worsened inequity. 

To make positive change, the review recommended that we: 

• embed mātauranga Māori (Māori knowledge systems) in our health system 
• invest in kaupapa Māori health services and providers 
• further develop our Māori health workforce, including strategies and funding for Māori providers to increase innovation, and 
• create stronger leadership and direction at the highest system level. 

This is the basis for the health reforms and a generational reset that will mean Māori live longer and enjoy better health for longer.  

The reforms will ultimately improve the health of all New Zealanders and enable pae ora, a healthier future for all.  

The Pae Ora Healthy Futures Act 2022 embeds Te Tiriti to acknowledge te ao Māori, mana motuhake and reflect Māori aspirations. 

It establishes Te Aka Whai Ora - Māori Health Authority to directly address the long-standing inequities in health outcomes for Māori.