Ā mātou whakapapa | Our narrative

We acknowledge the past and those with the vision for change

In 2019, the failings of the health sector to implement Te Tiriti o Waitangi were outlined in the Hauora Report, from the Waitangi Tribunal findings of the Wai 2575 claim. 

This first formal claim concerning the health sector's unjust treatment of Māori, was presented to the Tribunal by a coalition of Māori Primary Health Organisations in 2005.

The grievance pointed to inadequate funding and support of Māori providers by the Crown compared with non-Māori providers, a failure which breaches Treaty principles of active protection, partnership, tino rangatiratanga, and equity.

In particular, the claimants argued that Māori were not able to exercise tino rangatiratanga in the design and delivery of primary healthcare, and that the continued poor outcomes for Māori health points to systemic problems in the primary healthcare sector.

This was the spearhead for reforms

The Tribunal recommended a series of principles be applied across the entire health system, and the Hauora Report became a catalyst to reform the public healthcare system and improve health outcomes for Māori.

This resulted in new legislation, the Pae Ora Healthy Futures Act 2022, and established two new entities on 1 July 2022, Te Aka Whai Ora and Te Whatu Ora to replace, over a 2-year transition, the current 20 District Health Boards (DHBs). This generational reset will protect, promote, and improve the health of all New Zealanders. Significantly, Te Tiriti is embedded in the legislation to acknowlege te ao Māori, mana motuhake and reflect Māori aspirations.

The changes made through these reforms will mean Māori living longer and enjoying better health for longer. 

The facts about Māori health

In Aotearoa New Zealand, there has been different levels of health for people that is unfair, unjust – and avoidable. 

The system has failed to look after Māori:

• Māori die at twice the rate as non-Māori from cardiovascular disease
• Māori tamariki have a mortality rate one-and-a-half times the rate of non-Māori children
• Māori are more likely to be diagnosed and die from cancer
• Māori die on average seven years earlier than non-Māori.

The Waitangi Tribunal investigated claims (Wai 1315 and Wai 2687) dating back to 2005 around longstanding inequity, institutionalised racism in the health system and worsening Māori health statistics. Its Wai 2575 Health Services and Outcomes Kaupapa Inquiry Stage One Report, released in 2019, revealed that our primary healthcare legislation and policy breaches Te Tiriti o Waitangi and fails to care for Māori health and wellbeing.

A full Health and Disability System Review in 2019-2020, which included DHBs, health providers, communities and stakeholders, reinforced the Waitangi Tribunal’s findings and set the scene for the major changes needed.

The review confirmed that Aotearoa has:

• Unacceptable Māori health inequities
• Institutional racism
• General health systems that have not improved Māori health outcomes
• Approaches to design, purchasing and contracting of health services that have worsened inequity.

To make positive change, the review recommended that Te Aka Whai Ora:

• Embeds mātauranga Māori (Māori knowledge systems) in our health system
• Invests more in kaupapa Māori health services and providers
• Further develops our Māori health workforce, including strategies and funding for Māori providers to increase innovation
• Creates stronger leadership and direction at the highest system level.

This is the basis for the health reforms and pae ora, a healthier future for all.