Te Tiratū Iwi Māori Partnership Board (IMPBs) is voicing concerns two weeks after Health Minister Simeon Brown announced proposed legislative reforms to the Pae Ora (Healthy Futures) Act 2022.

IMPB says the reform plans to remove its decision-making authority by reducing its role to a consultative.

Co-chair Hagen Tautari argues that the proposed changes undermine the intent of Pae Ora, which will weaken community-led health leadership, falling short of the Crown’s obligations under Te Tiriti o Waitangi.

“Te Tiriti is a constitutional foundation. Reforms must reflect the Crown’s enduring duty to uphold Te Tiriti obligations in both law and practice, not through policy alone.”

Although IMPB is criticising the proposed reform, it also supports Minister Brown’s back-to-basics approach, putting patients first and stating the goal of timely, quality healthcare for all Kiwis.

While IMPB has criticised the proposed reform, it supports Minister Brown’s back-to-basics focus on patient care and timely, quality healthcare. In a letter to the Minister, IMPB offered feedback and solutions, backing reforms that strengthen national oversight and equity provided they are properly resourced and do not undermine the unique, community-based role of IMPBs.

“Partnership is not a principle to be referenced in policy, it is a constitutional obligation that must be upheld in law and practice,” said Tautari.

“The voices of our whānau are strongest at the local level, where services are delivered, where the gaps are being identified by Whānau Voice and where IMPBs are making a real difference.”

Tautari also sees a risk that the proposal could centralise decision-making in Wellington, undermining decades of progress in improving health outcomes for the highest-need group in Aotearoa’s health system.

“Equity comes from working alongside whānau, listening to communities, and enabling local solutions. The reforms must protect that,” Tautari said.

The proposed reform

In mid-June, Health Minister Simeon Brown announced that Cabinet had approved the amendments to the Pae Ora (Healthy Futures) Act 2022.

“After years of bureaucracy and confusion, the health system lost its focus. The previous government scrapped health targets, centralised decision-making with no accountability, while every single health target went backwards, meaning patients waiting longer for the care they need.

“These changes are about improving health outcomes by making sure the system is focused on delivery, not bogged down in doing the same thing twice. That means better care for patients through a more connected, transparent, and effective health system,” he said.

The Minister confirmed there were also going to be changes to strengthen the Hauora Māori Advisory Committee (HMAC) and clarify the role of iwi-Māori Partnership Boards.

“Local IMPBs will continue to engage with their communities but will now provide advice directly to HMAC. That advice will then support decisions made by the Minister and the Health NZ board.

“These changes are about one thing, putting patients back at the centre. We’re rebuilding a health system that delivers real outcomes, not just organisational charts.”

RNZ curated a list of changes included:

• Establishing a new statutory purpose to ensure all patients have access to timely, quality healthcare.
• Legislated health targets to lock in accountability and ensure New Zealand’s health system is measured and managed.
• Requiring all health strategies give effect to these targets.
• Stronger governance and financial oversight within Health New Zealand.
• Making the delivery of health infrastructure a core legislated function of Health New Zealand.
• Establishing a permanent infrastructure committee to carry out functions related delivery of physical health infrastructure by Health New Zealand.
• The director-general of health (or delegate) able to attend Health New Zealand board meetings to support monitoring.
• Ensuring simplified board appointment rules that select the best person for the job, based on skills and delivery.
• Clarifying public service integrity rules apply to the Health New Zealand board, CEO, and staff so patients know they’re held to the highest standards.
• Removing audit requirements for the NZ Health Plan, aligning with other Crown entity requirements.
• Repealing the Health Charter and Sector Principles to reduce red tape and make things clearer for everyone.
• Enhancing the role of the Hauora Māori Advisory Committee (HMAC) to provide advice to the Minister and the board of Health New Zealand, that will be taken into account at the national level.
• Clarifying and streamlining iwi-Māori Partnership Boards (IMPBs). IMPBs focus will shift away from local service design and delivery, to engaging with communities on local perspectives and Māori health outcomes.

The Amendment Bill will be introduced to Parliament in the coming weeks.

Additional reporting by RNZ.