Ngāti Kahungunu Chairman Bayden Barber says improving the health of his people is fundamental to the future strength of the iwi, as work continues on an independent Kahungunu Health Authority designed to put whānau, tikanga and rangatiratanga at the centre of healthcare.
For an iwi population approaching 100,000 people, health is not simply another government service. Barber sees it as fundamental to whether Ngāti Kahungunu whānau can thrive, participate in their communities and realise the iwi’s ambitions for future generations.
Ngāti Kahungunu has a particularly young population, with an average age of around 26, but Barber says the iwi remains disproportionately represented in major health statistics including diabetes, asthma, cardiovascular disease and cancer.
Those inequities are helping drive one of the iwi’s most ambitious initiatives — the development of its own independent Kahungunu Health Authority.
Primary care is the gateway
Barber has placed particular emphasis on access to primary healthcare.
For whānau, the local doctor is often the first point of contact with the health system. If appointments are unaffordable, unavailable or culturally unsafe, people can delay seeking treatment until their conditions become considerably more serious.
Ngāti Kahungunu says effective general practice therefore needs to be both accessible and affordable, while recognising Kahungunu values and aspirations for wellbeing.
That means cultural competence cannot simply be an optional addition to healthcare.
The iwi wants services designed around the realities of the people who use them.
From government-led health to rangatiratanga
The proposed Kahungunu Health Authority represents an attempt to fundamentally change that relationship.
Ngāti Kahungunu says around half of its people are currently served by non-Māori providers, and the new model is intended to shift greater authority from a predominantly government-led system towards iwi self-determination in health.
The authority is being developed alongside Hauora Māori providers, regional Taiwhenua, Post-Settlement Governance Entities and the Tihei Takitimu Iwi Māori Partnership Board.
Importantly, it is not intended to replace Māori health organisations already working within the public system.
Instead, the Kahungunu Health Authority would operate independently outside it, providing greater freedom to develop new models of care, establish partnerships and mobilise iwi resources.
Health designed by Kahungunu for Kahungunu
The kaupapa began taking shape publicly in 2025 following engagement with whānau, hapū and iwi through the wider Kahungunu 2050 strategy.
The concerns coming back from whānau were broad.
Kaumātua were experiencing loneliness and social isolation. Rangatahi were struggling with mental health. Other whānau were finding it increasingly difficult to access affordable healthcare when they needed it.
The response is an attempt to build something that does not simply treat illness after it appears.
The emerging vision includes stronger access to affordable healthcare, closer relationships between providers and services grounded in Kahungunu tikanga, kawa and values. Whānau feedback has also identified priorities including rongoā, te reo, culturally grounded care, health education and empowerment.
Whānau helping design the system
Central to the next stage is ensuring the new authority is not simply designed by institutions and presented to the community afterwards.
A working group of 25 whānau members who came forward through the wānanga process is helping shape the early design.
The intention is to ensure the structure reflects the aspirations and experiences of those it is ultimately supposed to serve.
Work is also progressing on governance arrangements that bring together expertise from health providers, iwi organisations and PSGEs.
A different measure of iwi success
For Barber, the kaupapa raises a bigger question about how iwi development should be measured.
Economic assets, settlements and commercial growth matter.
But prosperity means considerably less if whānau continue dying younger, living with preventable disease or struggling to access basic healthcare.
That makes health an investment in the future human capital of Ngāti Kahungunu as much as a response to current inequities.
A healthier generation of rangatahi is better positioned to learn, work, lead, raise whānau and contribute to the economic, cultural and social strength of the iwi.
And healthier kaumātua are able to continue passing whakapapa, mātauranga and tikanga between generations.
Rangatiratanga through hauora
The Kahungunu Health Authority is therefore about more than creating another organisation.
It represents an attempt to test what happens when iwi has greater freedom to shape healthcare around its own population, values and aspirations while continuing to hold the public health system accountable for its responsibilities to Māori.
For Ngāti Kahungunu, the argument is that decades of persistent health inequity demonstrate the status quo has not delivered enough.
If iwi development is ultimately about ensuring future generations flourish, then hauora cannot sit on the sidelines. It has to be at the centre.
And for Bayden Barber, that means Ngāti Kahungunu taking a greater role in determining what good health looks like — for its whānau, across its rohe, and on its own terms.
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