The disestablishment of Te Aka Whai Ora – the Māori Health Authority – as proposed by the National, ACT and NZ First parties, poses a grave threat to the health and wellbeing of tangata whenua.
Health Coalition Aotearoa (HCA) calls on all parties to retain Te Aka Whai Ora as a Māori-led, independent Crown agency advocating for and commissioning services and policies to improve the health of Māori and address unacceptable inequities and institutional racism.
Policies to scrap the entity – after just over one year in existence – are politically-motivated, without regard for the years of evidence, planning and collaboration that underpin it, HCA board member Grant Berghan (Ngāpuhi, Ngātiwai and Te Rarawa Iwi) says.
“Stop playing party politics with our people’s health. It will take 20 years to turn back the damage this will do.”
The establishment of Te Aka Whai Ora followed recommendations from the Waitangi Tribunal and an independent Health and Disability System Review – which found the health system had failed to recognise and properly provide for tino rangatiratanga and mana motuhake (self-determination) of Māori health.
“This [failure]resulted in the inequitable health status of Māori, who, on average, continue to have the poorest health status of any ethnic group in New Zealand – despite the Crown investing some $220 billion in the health system since 2000”. Waitangi Tribunal, Hauora report
Berghan said both reports recognised what Māori were calling for – an independent health authority designed to ensure fit-for-purpose health services and policies for Māori.
HCA co-chair Dr Lisa Te Morenga (Ngāti Whātua Ōrākei, Te Uri o Hua, Ngāpuhi and Te Rarawa) said disestablishing Te Aka Whai Ora would weaken Māori advocacy for better control over the alcohol, tobacco, vaping and unhealthy food industries – whose products disproportionately harmed them.
“Māori communities and health providers have an especially strong interest in there being greater control, regulation, and limits on the power of commercial organisations – and that voice can get lost when we’re a few hands raised in this big machine that is Te Whatu Ora.
Te Aka Whai Ora has real decision-making power and this creates a stronger platform to have our voices heard and acted on.”
Most submissions on the Pae Ora (Healthy Futures) Bill by iwi, hapu and Māori health providers strongly supported a Māori Health Authority – but argued for it to have greater autonomy and scope.
“We’ve been striving to set up a commissioning agency like Te Aka Whai Ora for the last 20 to 30 years. That is the vehicle that will enable Māori, by holding the pen, and having an influence over Te Whatu Ora, to make a difference,” Berghan said.
Impact of unregulated harmful industries on Māori:
Unhealthy food:
- Sugary drinks and foods are a major cause of dental caries; more than half of 5-year-old Māori children have dental caries.
- Greater exposure to unhealthy food marketing and retail, and less access to healthy food in areas with high Māori, Pacific and low-income populations
- Unhealthy foods increase risk of diabetes which disproportionately impacts Māori resulting in earlier onset and development of complications such as limb amputations, diabetic ketoacidosis; this cuts Māori lives short
Alcohol:
- Māori children more exposed to alcohol marketing compared with other ethnic groups
- Māori experience disproportionately higher levels of alcohol-related harm than other ethnic groups
Tobacco and nicotine:
- Average daily smoking rate remains persistently higher in Māori (19.9%) than Pākehā (7.2%) indicating smokefree interventions are failing Māori
- The rapid rise of vaping in the last 5yrs has hit Māori teens hardest with 22% now vaping daily and 34% vaping regularly; this is highest among Māori girls: 25% daily vaping and 39% regularly vaping.
