Election 2023: Expert pleads with parties to give Māori Health Authority a chance

Grant Berghan.
Grant Berghan. Photo credit: Health Coalition Aotearoa

By RNZ

The centre right parties' plans to dump the Māori Health Authority will be a massive step backwards in trying to improve Māori health outcomes, a man who has worked in the sector for years says.

A group representing 45 health-related NGOs and 75 individual public health academics and professionals says scrapping Te Aka Whai Ora, the Māori Health Authority, would pose a grave threat to Māori health and wellbeing.

Health Coalition Aotearoa, which works to reduce the harm from tobacco, alcohol and unhealthy food, is calling on all political parties to keep Te Aka Whai Ora as a Māori-led, independent Crown agency.

Board member Grant Berghan (Ngāpuhi, Ngāti Wai, Te Rarawa) said dumping the agency now would be a huge step backwards in the fight to overcome inequities in Māori health.

National, ACT and New Zealand First have made it clear they intend axing the entity if they form a new coalition government.

Last year's Pae Ora Act set up the independent Te Aka Whai Ora to work in parallel with the Ministry of Health and Te Whatu Ora to improve outcomes for Māori.

Marked disparities in Māori health have persisted for over 100 years under the previous single health authority system.

A Māori pēpi born today is expected to die 7.5 years earlier than a non-Māori born at the same time.

National wants to scrap the authority and replace it with a Māori health directorate within the health ministry.

Its potential coalition partner ACT has also promised to abolish Te Aka Whai Ora, with leader David Seymour calling it an example of racial discrimination and saying services need to be provided on need rather than on ethnicity.

Berghan said it had taken five years to get the information and the background work to set up the Māori Health Authority, but now political parties wanted to differentiate themselves from Labour so had decided to scrap it.

"I think it would be a really bad move."

Progress in terms of improving Māori health outcomes would go backwards, he told Morning Report. It would take at least 12 months to get rid of it and then much longer to establish its replacement. It would be back to the "same old same old" and he feared Māori health outcomes would continue to be inferior to Pākehā.

Berghan, who has worked in Māori health for 35 years, said its establishment was the most exciting thing he had seen in his career. It was intended as "a gamechanger" and he saw it as the best opportunity in his lifetime to make a real difference.

It needed at least five years to properly embed itself, he said.

"What we do need to do is get behind it and allow it to be properly set up."

An independent report into the Māori Health Authority, released in August, criticised aspects of its timeframes and performance but was defended by the government, with associate minister of health Peeni Henare saying it had made some progress but there were "areas of improvement".

When questioned about the report, Berghan said it was "ridiculous" to hold a review so soon after the agency started, and it needed to be remembered three political parties had already committed to its abolition so it had been difficult to attract experienced staff.

"There were issues in terms of recruitment and so on, but my whole view it was a very cynical [move] - come on, eight months after the establishment of an agency and it comes under review."

Regarding National Party health spokesperson Dr Shane Reti's promise to "ramp up" cultural competency training for the sector and have a strong Māori health directorate inside Te Whatu Ora, Berghan said that would be hugely different to what was beginning to happen now.

Before the Māori Health Authority was established, it had been very hard to get the traction staff needed to improve Māori health outcomes, he said.

"One of the reasons for that was it was really challenging to hold the system to account for Māori health outcomes.

"So there was a lot of rhetoric but in terms of the action it wasn't forthcoming over decades of work on Māori health."

RNZ