Elements we are building from
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What we need to achieve
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The Southern health system needs to reflect Te Tiriti relationships, partnerships and Māori leadership at multiple places and points in our system, not just a singular Crown-Iwi partnership with a DHB or Health NZ regional office. Supporting genuine Māori partnership, leadership and influence within the health system is a fundamental point of change. Services for Māori should focus on Pae Ora. The Pae Ora framework identifies that health futures for Māori involves whānau ora (healthy families), mauri ora (healthy individuals) and wai ora (healthy environments). This framing should provide a reference point for how localities and systems of care may be designed to improve outcomes for Māori. Relationships with Māori must uphold the principles identified in the Waitangi Tribunal Health Services and Outcomes Kaupapa Inquiry (Wai2575). Wai 2575 identified principles, which can be applied to guide the Southern system and create new types of relationships and connections as it moves forward: |
Tino rangatiratanga – organisations across the health system should work with Ngāi Tahu, potentially through the Iwi Māori Partnership Board, to identify the best way forward. Māori leadership should also function across localities as this is where local Māori have a good understanding of their own issues and what may work to address inequities.
Partnership - true partnership, which is not partnership in which Iwi Māori are asked to 'sign off' decisions that have already been made. Māori want to have a view of funding, data, available resources/services and to have oversight of actions to ensure needs and inequities are being addressed. Māori want to see action on decisions and to monitor performance. |
Active protection – a priority is the workforce and its development, with a focus on recruiting more Ngāi Tahu into roles; and Ngāi Tahu kawa and tikanga in all models of care (the New Dunedin Hospital is an excellent example of where this should happen).
Equity – requires funding, resources, and training to support Iwi Māori to take up the new leadership roles identified within the health reforms, for example in areas such as legislation, finances, data analysis, population health and service development. These can only be achieved with further investment in Iwi Māori governance capacity, workforce development and services for Māori. Options - whānau should be able to see and access a range of health and disability care options. This requires the provision, and adequate resourcing of, kaupapa Māori health and disability services. It also means that all services are culturally safe, and are inclusive of hauora Māori models of care |
Unacceptable inequities regarding the right to a quality of life and length of life exist for Māori in the South.
This is highlighted in the amenable mortality data for the region, when examined by ethnicity. Amenable mortality (premature deaths under age 75 that could potentially be avoided, given effective and timely healthcare) from 2014 - 2018 for the Southern DHB region showed that the rate for Māori is higher than that of non-Māori from 25 years of age, and particularly in the 60-74 year age bracket, where the rate is 2.2 times higher. |
Fundamental change is required across our health system to address inequities such as this.
This strategic briefing is based on reframing the Southern Health system’s relationship with Māori from one of ‘engagement’ to one of ‘leadership’. This reframe encourages and enables Māori to provide leadership across the system to guide how it responds to improving health outcomes for Māori. This leadership will be essential in the development and resourcing of focused solutions for Māori going forward.
A new structure that empowers Māori is a critical element of the health reforms. The Southern system can begin to work with Māori leaders in the ‘leadership paradigm’ even whilst the Iwi Māori Partnership Boards are under development.
The key message here is ‘do not delay’. There is no need to wait, and this work can begin while the system is transitioning.
This strategic briefing identifies priority actions where Māori leadership is vital.
These include:
This strategic briefing is based on reframing the Southern Health system’s relationship with Māori from one of ‘engagement’ to one of ‘leadership’. This reframe encourages and enables Māori to provide leadership across the system to guide how it responds to improving health outcomes for Māori. This leadership will be essential in the development and resourcing of focused solutions for Māori going forward.
A new structure that empowers Māori is a critical element of the health reforms. The Southern system can begin to work with Māori leaders in the ‘leadership paradigm’ even whilst the Iwi Māori Partnership Boards are under development.
The key message here is ‘do not delay’. There is no need to wait, and this work can begin while the system is transitioning.
This strategic briefing identifies priority actions where Māori leadership is vital.
These include:
- Establishing localities and service systems in localities that work for Māori
- Developing pro-equity systems of care – implementing and monitoring those systems
- Connecting consumer and community voice with service development
- Reframing funding to support Māori outcomes
- Workforce development
- Strengthening the data system and its governance