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Te Aka Whai Ora

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54-530: Te Aka Whai Ora (English: Māori Health Authority ( MHA ) ) was an independent New Zealand government statutory entity tasked with managing Māori health policies, services, and outcomes. The agency was one of four national bodies that oversaw New Zealand's health system since 2022, along with the Ministry of Health , the Public Health Agency , and Te Whatu Ora . They replaced a system in which

108-826: A claim with the Waitangi Tribunal challenging the Government's dissolution plans. In late February 2024, the Government passed urgent legislation disestablishing the Māori Health Authority by 30 June 2024. Te Aka Whai Ora (the Māori Health Authority) is a statutory entity responsible for ensuring that the New Zealand health system meets the needs of Māori. It will work in partnership with the Ministry of Health and Health New Zealand to achieve

162-443: A farewell ceremony at Waitangi to bid the independent Crown entity farewell. The ceremony was also attended by former associate health minister Peeni Henare . The organisation's responsibility for managing Māori health outcomes was reassigned to iwi partnership boards. Many former Te Aka Whai Ora staff returned to the community health sector. Ministry of Health (New Zealand) The Ministry of Health ( Māori : Manatū Hauora )

216-465: A general geographic region, or merely gave a waka name. Initiatives like the Iwi Helpline are trying to make it easier for people to identify their iwi , and the proportion who "don't know" dropped relative to previous censuses. Some established pan-tribal organisations may exert influence across iwi divisions. The Rātana Church, for example, operates across iwi divisions, and

270-414: A generally recognised territory ( rohe ), but many of these overlap, sometimes completely. This has added a layer of complication to the long-running discussions and court cases about how to resolve historical Treaty claims. The length of coastline emerged as one factor in the final (2004) legislation to allocate fishing-rights in settlement of claims relating to commercial fisheries. Iwi can become

324-748: A group), Ngāti Poneke (Māori who have migrated to the Wellington region), and Ngāti Rānana (Māori living in London). Ngāti Tūmatauenga ("Tribe of Tūmatauenga ", the god of war) is the official Māori-language name of the New Zealand Army , and Ngā Opango ("Black Tribe") is a Māori-language name for the All Blacks . In the southern dialect of Māori, Ngāti and Ngāi become Kāti and Kāi , terms found in such iwi as Kāti Māmoe and Kāi Tahu (also known as Ngai Tahu). Each iwi has

378-528: A larger role in health purchasing. The department remained actively involved in policy (as opposed to purchasing). In 1947 the department assumed responsibility for the administration and operation of psychiatric hospitals after the Mental Hospitals Department was abolished and became the division of mental hygiene at the department. By the 1970s problems had appeared in the health system. The high growth rate in hospital expenditure

432-674: A parliamentary bill called the Pae Ora (Healthy Futures) Bill , which created the new public health entities and strengthened the Health Ministry's stewardship role. This bill passed into law on 7 June 2022. On 1 July, the Pae Ora (Health Futures) Act came into effect; with Health New Zealand, the MHA, and the Health Ministry's Public Health Agency assuming the district health boards' former provision of healthcare services. In March 2024,

486-449: A particular hapu may have belonged to different iwi at different times, the tension caused by the social and economic power moving from the iwi down rather than from the hapu up, and the fact that many iwi do not recognise spouses and adoptees who do not have kinship links. In the 2006 census, 16 per cent of the 643,977 people who claimed Māori ancestry did not know their iwi . Another 11 per cent did not state their iwi , or stated only

540-438: A prospective vehicle for ideas and ideals of self-determination and/or tino rangatiratanga . Thus does Te Pāti Māori mention in the preamble of its constitution "the dreams and aspirations of tangata whenua to achieve self-determination for whānau , hapū and iwi within their own land". Some Tūhoe envisage self-determination in specifically iwi -oriented terms. Increasing urbanisation of Māori has led to

594-532: A single Ministry funded services through 20 district health boards (DHBs). Riana Manuel was appointed to be the first Chief Executive, which has been a permanent agency since 1 July 2022. In late November 2023, the incoming National-led coalition government announced plans to abolish Te Aka Whai Ora and return to a single integrated health system. The Government's plans to abolish the agency drew criticism from health professionals and Māori leaders. In mid December 2023, Lady Tureiti Moxon and Janice Kuka filed

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648-480: A situation where a significant percentage do not identify with any particular iwi . The following extract from a 2000 High Court of New Zealand judgment discussing the process of settling fishing rights illustrates some of the issues: ... 81 per cent of Maori now live in urban areas, at least one-third live outside their tribal influence, more than one-quarter do not know their iwi or for some reason do not choose to affiliate with it, at least 70 per cent live outside

702-585: Is the public service department of New Zealand responsible for healthcare in New Zealand . It came into existence in its current form in 1993. The organisation was founded in 1901 as the Department of Public Health in 1901, and was renamed to Department of Health in 1922. The Ministry of Health's origins can be traced back to the Department of Public Health, which was first established in 1901 at

756-541: The 1999 election . In December 1999, the separate government health service purchasing entity, the Health Funding Authority , was merged with the Ministry of Health. Critics were anxious as to how the Ministry would perform as a funder, as they commented that the Ministry had in the past only performed as a policy organisation. However, supporters of this move stated that they believed this would make these agencies more accountable. In February 2001,

810-728: The Māori King Movement , though principally congregated around Waikato / Tainui , aims to transcend some iwi functions in a wider grouping. Many iwi operate or are affiliated with media organisations. Most of these belong to Te Whakaruruhau o Nga Reo Irirangi Māori (the National Māori Radio Network), a group of radio stations which receive contestable Government funding from Te Māngai Pāho (the Māori Broadcast Funding Agency) to operate on behalf of iwi and hapū . Under their funding agreement,

864-533: The New Zealand Medical Students' Association submitted a letter criticising the proposed dissolution and urging Prime Minister Christopher Luxon , Reti, and Māori-Crown Relations Minister Tama Potaka "to demonstrate their commitment to Māori health leadership." On 14 December 2023, Lady Tureiti Moxon and Janice Kuka filed a claim at the Waitangi Tribunal , challenging the Government's plans to dissolve Te Aka Whai Ora. They claimed that

918-549: The New Zealand government response to the COVID-19 pandemic . In April 2021, the Sixth Labour Government announced that DHB system would be abolished and replaced by three new entities: a centralised agency called Health New Zealand , a Māori Health Authority (MHA) to fund Māori health services, and a Public Health Agency to centralise public health work. In October 2021, the government introduced

972-496: The original migration voyages ). These super-groupings are generally symbolic rather than logistical. In pre-European times, most Māori were allied to relatively small groups in the form of hapū ( ' sub-tribes ' ) and whānau ( ' family ' ). Each iwi contains a number of hapū ; among the hapū of the Ngāti Whātua iwi, for example, are Te Uri-o-Hau , Te Roroa , Te Taoū , and Ngāti Whātua-o-Ōrākei . Māori use

1026-413: The 2023 election campaign. On 15 December, Waatea News reported that Te Aka Whai Ora's chief executive Riana Manuel had met several times with Health Minister Reti and Associate Health Minister Matt Doocey . While Reti confirmed that the Government would proceed with its plans to dissolve the organisation, he reaffirmed the Government's commitment to continue working with iwi-Māori partnership boards on

1080-549: The Department of Public Health. Under the Health Act 1920, major organisational changes were mandated. Seven separate divisions were created within the department, each headed by its own director. The department was renamed the Department of Health in 1922, dropping the word public. The structure remained relatively static even when the Social Security Act 1938 was passed where the New Zealand government took

1134-640: The Fifth Labour Government also launched the "New Zealand Primary Health Care Strategy" (PHCS) with the goal of improving public access to primary health care and reducing health inequalities. By 2008, the Primary Health Care Strategy had succeeded in reducing fees for doctors' and nurses' visits in "higher need areas" and for patients aged over 65 years. In addition, consultation rates increased across all age, socio-economic, and ethnic groups in New Zealand. As part of

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1188-487: The Fifth Labour Government established District health board (DHBs) in 2001 as subsidiary organisations of the Health Ministry. They were responsible for providing and funding health services within a defined geographical area. At the time of their dissolution in July 2022, there were twenty DHBs. They were also responsible for running hospitals and funding some health provisions in their respective areas. Funding for these DHBs

1242-531: The Government's decision to pass legislation dissolving the Māori Health Authority prior to the scheduled Waitangi Tribunal hearing on 29 February as disrespectful. In response, Prime Minister Christopher Luxon and Dr Reti said that the agency's dissolution was part of the National-led government's 100-day plan. Luxon stated "we’ve campaigned on it. The New Zealand people supported it." On 15 May, several Māori health providers including Te Puna Ora o Mataatua,

1296-584: The Government's plans to dissolve the agency constituted a breach of the Treaty of Waitangi . On 18 December, the Government filed a memorandum of counsel opposing Moxon and Kuka's claim. The Government conceded that it had no alternative plan to address poor Māori health outcomes and that it had not consulted Māori according to the principles of the Treaty. The Government also conceded its plans to dissolve Te Aka Whai Ora had been motivated by political expediency during

1350-728: The Health Ministry proposed slashing 180 jobs following a cost-saving directive from the National-led coalition government . In early April 2024, the Public Service Association expressed concerns that proposed job cuts at the Health Ministry would lead to the closure of the Suicide Prevention Office and other specialist roles. The PSA's statement was disputed by the Minister for Mental Health Matt Doocey , who said he had not been briefed about

1404-431: The Māori Health Authority as a new Crown entity. The bill passed its third reading on 7 June 2022. On 1 July 2022, the MHA formally came into existence as a new entity. The MHA's interim chief executive Riana Manuel stated that the new organisation would work alongside Health NZ. While it would have its own commissioning powers and work with Māori health providers, Manuel clarified that the MHA would also have oversight over

1458-480: The New Zealand Government allocated NZ$ 22 million from the 2021 New Zealand budget to the commissioning of the interim Māori Health Authority. On 19 May 2022, the government allocated a record sum of $ 13.2 billion from the 2022 New Zealand budget to facilitate the establishment of both the MHA and Health NZ over the next four years; with $ 11.1 billion being allocated to cover cost pressures from

1512-598: The Ngāti Hine Health Trust, Te Kohao Health and Papakura Marae challenged the Government's decision to abolish Te Aka Whai Ora in the High Court , alleging breaches of the Treaty of Waitangi and the New Zealand Bill of Rights Act 1990 . On 1 July 2024, several former Te Aka Whai Ora board members and senior executives including chair Tipa Mahuta and founding chief executive Riana Manuel gathered for

1566-468: The PHCS programme, the government encouraged the development of Primary Health Organisations (PHOs) to provide some primary health care services at the local level and to transition health care services from fee-for-service arrangements to capitation funding for health professionals who are members of these organisations. By early April 2003, 34 PHOs had been established throughout New Zealand. In addition,

1620-552: The advice of the Central Board of Health. The Department of Public Health assumed responsibility for the provision of Māori health services between 1906 and 1909, when Māori medical health services were returned to the-then Department of Native Affairs . In 1910, the Public Health Department resumed responsibility for the control of Māori health. In 1911, a Māori Nursing Service was established as part of

1674-494: The allied New Zealand First leader Winston Peters had advocated abolishing Te Aka Whai Ora in order to eliminate "separatism." The Health Minister Shane Reti also confirmed that the Government would disestablish the MHA and return to a single integrated health system. To dissolve the agency, Cabinet must first approve of the dissolution and Parliament has to repeal Section 17 of the Pae Ora (Health Futures) Act 2022. The National-led government's plans to abolish Te Aka Whai Ora

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1728-565: The bones" — literally to the burial-areas of the ancestors . Māori author Keri Hulme 's novel The Bone People (1985) has a title linked directly to the dual meaning of bone and "tribal people". Many iwi names begin with Ngāti or with Ngāi (from ngā āti and ngā ai respectively, both meaning roughly ' the offspring of ' ). Ngāti has become a productive morpheme in New Zealand English to refer to groups of people: examples are Ngāti Pākehā ( Pākehā as

1782-568: The closure of the Suicide Prevention Office. Doocey said he had spoken with the Director-General of Health to ensure the Office would remain open. Doocey reiterated that mental health and suicide prefention remained a priority for the New Zealand Government. The directorates and business units of the Ministry include: Medsafe carries out medical regulatory functions within the Ministry. The former National Health Board (NHB), which

1836-522: The country's district health boards, and the Public Health Authority , to centralise public health work. The proposed Māori Health Authority was criticised by the opposition National Party health spokesperson Shane Reti , who claimed that it would create a "two-tier system" based on race. Similar sentiments were echoed by National Party leader Judith Collins , who likened it to racial segregation and called for public consultation on

1890-412: The entire health system to ensure equity for Māori. Māori health practitioners Danny De Lore and Reweti Ropiha expressed hope that the new entity would improve Māori health outcomes and combat inequity within the health system. In March 2023, a review of Te Aka Whai Ora identified several issues facing the organisation including recruitment, an underspent budget, and planning issues. On 24 November 2023,

1944-421: The establishment of a Suicide Prevention Office within the Health Ministry to address the country's suicide rate. Key changes include shifting from a mental health service model to a community-based one and supporting people bereaved by suicide. There were also plans to later establish the Suicide Prevention Office as a separate standalone government service. The Ministry of Health was the agency responsible for

1998-485: The following stated goals: The MHA worked alongside Health New Zealand to create and develop kaupapa Māori services and policies. On 21 April 2021, Minister of Health Andrew Little announced plans to create the Māori Health Authority, which would be responsible for setting Māori health policies and overseeing the provision of Māori health services. In addition, Little announced that the government would create two other public health bodies: Health New Zealand, to replace

2052-681: The government announced the interim board members of the Māori Health Authority. The organisation will be headed by co-chairs Sharon Shea (chair of the Bay of Plenty District Health Board ) and Tipa Mahuta (Deputy Chair of the Counties Manukau District Health Board ). Other board members consist of medical specialist and University of Otago Professor Dr Sue Crengle , Dr Mataroria Lyndon, Lady Tureiti Moxon , Fiona Pimm, Awerangi Tamihere, and Dr Chris Tooley (Chief Executive of Te Puna Ora o Mataatua). On 15 March 2022,

2106-506: The growing New Zealand Māori population tried to keep a connection to their culture, family history, spirituality, community, language and iwi . The Victoria University of Wellington Te Reo Māori Society campaigned for Māori radio, helping to set up Te Reo o Poneke, the first Māori-owned radio operation, using airtime on Wellington student-radio station Radio Active in 1983. Twenty-one iwi radio stations were set up between 1989 and 1994, receiving Government funding in accordance with

2160-665: The health needs of the Māori community including mental health. In early February, 700 doctors signed a letter petitioning the Heath Minister Reti protesting the Government's plans to dissolve Te Aka Whai Ora and seeking information on how the Government planned to prioritise Māori health outcomes. Urgent legislation to disestablish Te Aka Whai Ora by 30 June 2024 was introduced into Parliament by Dr Reti on 27 February and passed on 28 February 2024. The governing National, ACT and NZ First parties supported its disestablishment while

2214-574: The incoming National-led coalition government pledged to disestablish Te Aka Whai Ora in its coalition agreement. During campaigning leading up to the 2023 New Zealand general election , the National Party had campaigned on replacing it with a Māori directorate within the Ministry of Health. The allied ACT Party leader David Seymour had also earlier denounced the MHA as an example of racial discrimination and argued that services ought to be provided based on need rather than ethnicity. Similarly,

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2268-719: The largest social units in New Zealand Māori society . In Māori , iwi roughly means ' people ' or ' nation ' , and is often translated as " tribe ", or "a confederation of tribes". The word is both singular and plural in the Māori language, and is typically pluralised as such in English. Iwi groups trace their ancestry to the original Polynesian migrants who, according to tradition, arrived from Hawaiki . Some iwi cluster into larger groupings that are based on whakapapa (genealogical tradition) and known as waka (literally ' canoes ' , with reference to

2322-454: The matter. Her remarks were described by Māori Party co-leader Debbie Ngarewa-Packer as "desperate racist politicking." Ngarewa-Packer also urged Collins to read National's own 2020 election review which advocated making Māori a "priority area". In addition, Associate Health Minister Ayesha Verrall stated that the proposed Māori Health Authority could ensure Māori input in funding and improving Māori health outcomes. In mid September 2021,

2376-548: The opposition Labour, Green parties and Te Pāti Māori opposed it. Its functions and staff will be absorbed into the Ministry of Health and Te Whatu Ora . The Government's disestablishment of Te Aka Whai Ora was criticised by several individuals and groups including University of Waikato academic and general practitioner Dr Rawiri Keenan, Māori health advocacy group Hāpaii Te Hauora, the Iwi Chairs Forum and former Te Whatu Ora chair Rob Campbell . Lady Moxon described

2430-424: The previous DHB system and $ 2.1 billion to setting up the two new public health entities. In addition, the government allocated $ 188 million for the Māori Health Authority to commission services and develop partnerships with iwi (Māori tribes). In October 2021, the government introduced the Pae Ora (Healthy Futures) Bill to formally entrench its proposed health reforms. These reforms included formally establishing

2484-430: The purchasing of health services while general practitioners, specialists, and hospitals were tasked with delivering health services. Public services were also turned into quasi-commercial Crown health enterprises (CHEs). In 1993, the Department was renamed as the Ministry of Health . The Labour – Alliance coalition government redefined the role of the Ministry of Health as part of Labour's election promises in

2538-483: The stations must produce programmes in the local Māori language and actively promote local Māori culture. A two-year Massey University survey of 30,000 people published in 2003 indicated 50 per cent of Māori in National Māori Radio Network broadcast areas listened to an iwi station. An Auckland University of Technology study in 2009 suggested the audience of iwi radio stations would increase as

2592-408: The traditional tribal territory and these will have difficulties, which in many cases will be severe, in both relating to their tribal heritage and in accessing benefits from the settlement. It is also said that many Maori reject tribal affiliation because of a working-class unemployed attitude, defiance and frustration. Related but less important factors, are that a hapu may belong to more than one iwi,

2646-591: The tribe has collective assets under management of $ 1.85 billion. Iwi affairs can have a real impact on New Zealand politics and society. A 2004 attempt by some iwi to test in court their ownership of the seabed and foreshore areas polarised public opinion (see New Zealand foreshore and seabed controversy ). In Māori and in many other Polynesian languages , iwi literally means ' bone ' derived from Proto-Oceanic * suRi ₁ meaning ' thorn, splinter, fish bone ' . Māori may refer to returning home after travelling or living elsewhere as "going back to

2700-419: The word rohe to describe the territory or boundaries of iwi. In modern-day New Zealand , iwi can exercise significant political power in the management of land and of other assets. For example, the 1997 Treaty of Waitangi settlement between the New Zealand Government and Ngāi Tahu , compensated that iwi for various losses of the rights guaranteed under the Treaty of Waitangi of 1840. As of 2019

2754-474: Was allocated according to the Ministry's population-based funding formula. In 2018, the government launched the He Ara Oranga inquiry into mental health and addiction. In 2021, this resulted in the creation of Te Hiringa Mahara , an independent Crown entity that promotes mental health and wellbeing. On 10 September 2019, Prime Minister Jacinda Ardern and Health Minister David Clark announced

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2808-501: Was criticised by several health professionals and advocates including anti-smoking advocate Teresa Butler, University of Otago Māori health professor Sue Crengle, Health Coalition New Zealand board member Grant Berghan, and the Royal Australasian College of Physicians 's (RACP) President Dr Stephen Inns. They argued that abolishing the organisation would have an adverse impact on Māori health outcomes. In addition,

2862-557: Was occurring at a time when the economy was slowing down. Thus, the government was unable to sustain funding this growth. This led the health system to undergo a series of changes over a 20-year period from the 1980s. During the 1990s the Fourth National Government attempted to stream-line the system in a series of reforms such as separating the government purchasing and provision of health care services. Four regional health authorities (RHAs) were created to oversee

2916-643: Was set up in November 2009, dealt with issues such as rising costs, increased demand, an ageing population and shortages of staff with a view to improving the quality, safety and sustainability of health care. Health New Zealand exists as a separate Crown agent while the Māori Health Authority exists as an independent statutory entity. Directors-General of Health (Chief Executive) are: The Ministry serves 1 portfolio and 4 ministers. Iwi Iwi ( Māori pronunciation: [ˈiwi] ) are

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