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Health Minister Shane Reti has a dream for Māori health - move funding and resources closer to the homes and hapū to deliver services to their own communities.
The former Northland GP said his main aim for Māori is to lift the poor health metrics to the same level as non-Māori.
“The dream I have for Māori is to lift pretty much every health metric we have to the level we have for non-Māori,” Reti told the Herald.
“To do that we have to move decision-making and funding as close to the home, as close to the hapū as possible.
“The difference in philosophy on where we want to go and where the Māori Health Authority was going was why was all that funding held in Wellington with a Wellington-knows-best approach?
“I think the hapū probably know what’s best for their communities.
“My dream is to devolve decision making and funding and give to mana motuhake [self-determination], as close to the home and hapū as possible.
“That is basically my over-encapsulating philosophy.”
Reti said Health NZ was working on a framework where that philosophy can be adopted and rolled out nationally.
“We are quickly working through the mechanisms as to what that could look like and what framework this would sit on.”
Reti said the Māori Health Authority, which he is scrapping, was established with good intentions.
“The Māori Health Authority was well intended and I want to congratulate everyone who worked on its inception, but in my view, they were let down by the previous Government at the implementation level.
“If we look at the transition unit that was supposed to help with transitioning the Māori Health Authority and Health NZ, they spent a lot of time looking at HNZ.
“The Māori Heath Authority didn’t even have a budget until they were a quarter into their existence.”
Reti said the millions spent on establishing the Māori Health Authority was wasted.
“They [transition unit] enjoyed the whiteboard diagrams and the org charts but when it came to rolling up their sleeves and actually doing it, I’m not so sure they actually backed what they talked about.”
Reti said former Māori Party leader Dame Tariana Turia had the right approach to devolve funding from bureaucrats with the establishment of the Whānau Ora commissioning agencies.
“I’m interested in an even further level of devolution. Tariana Turia took Whānau Ora down to the commissioning agencies. I’m interested in moving even closer to the home and hapū.
“That is where Tariana wanted to go but couldn’t quite get it over the line.”
‘We will be an outcomes-focused Government.’
Reti said while he understands the public’s uncertainty over some of the new Government’s policies, he believes they will ultimately improve outcomes for Māori in the long term.
“We will be an outcomes-focused Government. If we make that commitment to Māori, then in collaboration with Māori we will lift things like the immunisation rates to protect our tamariki from measles for example.
“And if we put hearts and minds and passion around that, because Māori want that as well. Māori are done with talking and want to be safe and live the best life they can and want a health system that is there for them in a cultural competence context.
“When we frame it in those terms, Māori do want to work with us.”
He even understood why some Māori are feeling disillusioned.
“I do understand that the Māori Health Authority was one dream and I acknowledge there is a grieving that dream is not going to progress, but I want to paint a different dream, a different vision and propose that we can do even more than what a Māori Health Authority was going to do.
“What we want to do, certainly in my domain, in health, is I want to share a different dream. I want to present a different vision that is outcomes-focused, outcomes-based and delivers what the Māori Health Authority never could.”
He said the Government would continue to promote vaping as a way to bring down smoking rates and he would repeal the smokefree legislation.