The Māori Health Authority is all but gone, so what will replace it?
The Māori Health Authority is all but gone, so what will replace it?
The bill to disestablish the authority will have its final reading this morning under urgency as the health minister paints 'a different dream' for meeting the health needs of Māori
Mōrena, and welcome to The Bulletin for Wednesday, February 28, written by Anna Rawhiti-Connell.
In today’s edition: Chris Bishop sets housing affordability target; serious issues revealed in report on Accredited Employer Work Visa scheme; Alice Snedden has more Bad News; but first, the final stage of the bill to disestablish the Māori Health Authority is set to pass this morning
Bill to disestablish Te Aka Whai Ora set to pass this morning
On July 1, 2022, a new era was heralded for the health system as Te Whatu Ora and Te Aka Whai Ora came into being. At the time, there was an acknowledgment of the challenges ahead and the time it would take for the reforms to ease well-documented strain and crisis within the health system. There was also hope. Te Whatu Ora has since its original name deemphasised, with primacy now given to the English version, Health NZ. Te Aka Whai Ora, the Māori Health Authority (MHA) will cease to exist, with the final reading of the bill to disestablish it planned for this morning. Stewart Sowman-Lund reports on a charged day in the House. Opposition parties held little back in expressing their anger at the move and the use of urgency to get the bill through. This morning, Shanti Mathias explains what urgency means in the parliamentary context, why its used and why its use is being criticised.
Smokefree laws also on the slate for repeal this week
Toby Manhire spoke to the then-freshly appointed heads of both entities, Margie Apa and Riana Manuel, in July 2022. Manuel, Te Aka Whai Ora’s chief executive, said the MHA would address the inequities and failures exposed during the pandemic and throughout the Wai 2575 Waitangi Tribunal claim inquiry. The 2019 Waitangi Tribunal report into health services for Māori was described as a game-changer by Te Aka Whai Ora board member Dr Mataroria Lyndon in a story on The Spinoff last December last year. It recommended the creation of a Māori health authority, a recommendation that also came from the health and disability system review report in 2020. Both shone further light on a system that results in Māori dying on average seven years earlier than non-Māori, dying at twice the rate of non-Māori from cardiovascular disease and being more likely to be diagnosed and die from cancer. The smokefree laws introduced by the previous government are also on the slate for repeal this week. Modelling published on NZ Doctor late year suggested those laws would save thousands of lives, particularly by reducing the heavy burden smoking places on Māori.
‘A different dream’
As far as how the Tribunal’s substantive findings and the well-documented inequities will be addressed, health minister Dr Shane Reti has yet to provide a lot of detail. Speaking to reporters before heading into the House, Reti said he wanted to wait until he was in the House before laying out his vision, saying he liked oratory and “adding context and contour to the statements I'm going to make”. He did talk to a few details saying the funding for Māori health would remain the same. In the House, he went on to say, “While the particular version of the dream that the Māori Health Authority laid out is coming to an end today, I want to paint a different dream, one that will be outcomes driven, providing greater devolved decision-making that will deliver care as close to the home and the hapū as possible.”
Te Aka Whai Ora signs off
As far as detail goes, Reti said Te Aka Whai Ora's “staff and functions will transfer mostly to Health New Zealand, with a few to the Ministry of Health". He said it wasn’t “simply a rehoming of the Māori Health Authority within Health NZ and the Ministry of Health” and that there will be fewer funded positions transferred across, citing unfilled roles currently being covered by “expensive consultants.” The authority itself posted something of a sign-off on social media and its website yesterday with Manuel thanking staff and hauora Māori partners. The statement said that “work to transition our kaimahi is expected to be completed by 31 March, and our organisation will be officially disestablished by 30 June 2024.” Te Aka Whai Ora Chair Tipa Mahuta says she has full confidence that the mission to improve Māori health outcomes will endure. “Te Aka Whai Ora originated from the self-determination of whānau, hapū and iwi, and the advocacy of rangatira and Māori leaders from across the motu.”
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Chris Bishop introduces housing affordability targets
As our Wellington editor Joel MacManus writes, housing minister Chris Bishop “laid out the most unabashedly urbanist vision for New Zealand we’ve ever seen from a cabinet minister. In a speech to the Wellington chamber of commerce yesterday, Bishop labelled the housing crisis “state neglect on an industrial scale” that has “shattered the Kiwi dream”. Bishop also set a target of having homes costing three to five times household incomes, which is far lower than they are now throughout most of the country. Speaking to RNZ’s Checkpoint last night, Bishop is setting a 10-20 year time frame for the target, saying a crash “tomorrow” would “cause enormous economic and financial instability to people”.
MBIE bosses dismissive of concerns raised by Immigration NZ
As Stuff’s Glenn McConnell reports, a review conducted by the Public Service Commission of the Accredited Employer Work Visa scheme found that migrants were being exploited under the scheme by “unscrupulous employers” and Ministry of Business, Innovation and Employment (MBIE) leaders were “dismissive” of exploitation concerns raised by Immigration NZ officials. Immigration advocates were disappointed by the limited scope of the review, saying the whole system “needs a good look at”.
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Bishop's stated ambition that houses should cost 3-5 times the median wage is all very well.
But how does the government intend to get there when (a) it is actively driving real incomes down for low and middle income people, (b) continuing to fuel the housing speculative bubble with tax cuts/billions in corporate welfare to landlords, no capital gains tax, (c) not pushing a massive public housing build programme, and (d) not reinstating the incentives that worked such as low interest loans from State Advances and capitalising the family benefit.
Instead, he pushes the free market myth.
If his "different dream" is so great, why not reveal it BEFORE repealing the existing arrangement and hear the views of those most directly affected? The fact that he refuses to discuss in advance reveals a complete lack of interest in providing an effective alternative. This is just political theatre and it's going to harm people