Labour will not re-establish the Māori Health Authority, Te Aka Whai Ora, if it wins the election and will instead take a devolved approach by funding Māori health providers directly.
Over the weekend, Labour MP Willie Jackson commented on the coalition government’s disestablishment of Te Aka Whai Ora.
Jackson and Labour leader Chris Hipkins confirmed on Tuesday its reintroduction “is not a priority” for the party.
Jackson says the new approach to addressing Māori health inequities follows discussions with Māori health providers who considered Te Aka Whai Ora “not the best approach”.
“What we are going ahead with will be the devolvement like you haven’t seen before. And that’s the most important thing for Māori health providers.”
Hipkins says the approach is about removing barriers Māori health providers may have faced when seeking adequate funding and resources.
“So, trying to get that resource directly to the frontline and Māori health providers without the need for a central government agency overseeing that.”
From structural reform to devolution
Labour established Te Aka Whai Ora in 2022 as part of its major restructuring of the health system, alongside the creation of Te Whatu Ora, Health New Zealand, and the abolition of district health boards.
The authority was intended to give Māori a greater role in determining how health services for Māori were designed and commissioned, and to work alongside Te Whatu Ora to address persistent inequities in Māori health outcomes.
But the National-led coalition disestablished Te Aka Whai Ora in 2024, arguing a separate Māori health authority created unnecessary bureaucracy and duplication and that Māori health needs could instead be addressed through the wider health system.
Its disestablishment was described as “a sad day for Te Tiriti o Waitangi” by former Labour minister Peeni Henare.
Now, 10 weeks out from the election, Labour says it does not intend to rebuild the structure it created.
‘Don’t want another disestablishment in the future’
Hipkins says there is reluctance among some of those involved in establishing Te Aka Whai Ora to go through the process again, only for another government to dismantle it.
“We have heard from a lot of the people who are involved in establishing Te Aka Whai Ora, that putting their heart and soul into establishing a Māori Health Authority, only to then have it dismantled in the way that it was after the election, isn’t an experience that they want to repeat.”
“So there’s a real concern amongst all those involved, that if they went through that process again, the same thing would happen. A future change of government would result in that being disestablished.”
However, any legislation or structural reform introduced by one government can ultimately be repealed by the next.
That was put directly to Hipkins on Tuesday, with reporters questioning whether the same logic could apply to other Labour policies, including its commitment to restore fair pay agreements.
“You’ve always got to focus on getting the balance right,” Hipkins responded.
“Yes, there will be some things where in time you hope that you’ll be able to get your opponents on board. I think given the strength of their opposition to this, I don’t think we’ll ever get the other side on board on a Māori Health Authority. I hope once the fair pay agreements are in place, they’ll see the value of them.”
Jackson says repeatedly rebuilding and dismantling the health structure would be unfair to Māori health providers.
“You set it all up and you put everything in place, and these guys just dismantle it at the drop of a hat.”
Rather than restoring the authority, Labour says it wants to strengthen direct funding to Māori providers and expand the role of existing structures.
Hipkins pointed to Iwi Māori Partnership Boards, which were also created through Labour’s 2022 health reforms and survived the disestablishment of Te Aka Whai Ora, as one mechanism Labour could build on.
“The Iwi Māori Partnership Boards are a good model, and we’d certainly look to do more in that area.”
‘Te Aka Whai Ora was never a political experiment’
Labour’s stance is not backed by everyone.
Te Kōhao Health managing director Lady Tureiti Moxon has expressed disappointment with Labour’s “significant retreat” from its previous position on Māori health self-determination.
“Te Aka Whai Ora was never a political experiment. It was a structural response to structural inequity.
“We are calling not just for its reinstatement, but for a stronger, independent, Māori-governed health entity with statutory protection, secure long-term funding and accountability to whānau rather than political cycles,” she says.
Labour is instead proposing a devolved approach that would provide funding directly to Māori health providers, a solution Jackson says responds to calls from many communities.
“It’s no good having a set up and it’s not funded and resourced properly. These providers, I know, need to be resourced and funded properly and that’s what’s going to happen.”
Moxon says devolved funding is important but believes that, without independence, it risks becoming tokenistic and creating further problems.
“Mana motuhake in health is not about separatism, it is about effectiveness. When Māori design, commission and deliver services for our communities, outcomes improve.”
“That is evidence-based. That is practical. That is what equity requires. Māori having the authority to design and determine solutions for our own communities.”
“Māori providers have the expertise, relationships and capability to deliver. What we require is the authority, resources and political courage to do it properly.”
