The Coalition Government is being urged to urgently implement sweeping changes to the disability system after the Waitangi Tribunal found tāngata whaikaha Māori continue to experience inequitable outcomes, culturally unsafe services and inadequate participation in decisions affecting their lives.
The New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa says the Tribunal’s newly released Hauwhaikaha – the Disability System Report provides compelling evidence that significant parts of the system are prejudicing Māori with disabilities.
The report follows the disability phase of the Wai 2575 Health Services and Outcomes Kaupapa Inquiry, which involved 48 claimants, 13 interested parties and 11 weeks of hearings between 2022 and 2024. The Tribunal found Māori experience higher rates of disability but continue to face inequitable access to disability and health services.
For NZNO Kaiwhakahaere Kerri Nuku, the findings demand more than another Government acknowledgement.
She wants action.
Culturally unsafe care under scrutiny
Central to the Tribunal’s findings is the experience of tāngata whaikaha Māori navigating services that do not always recognise what it means to live simultaneously as Māori and as a disabled person.
NZNO says the report exposes a system in which clinical competency has too often been prioritised without ensuring equivalent cultural safety.
Nuku argues occasional cultural competency courses cannot, by themselves, guarantee culturally safe practice.
The wider Tribunal findings reinforce concerns about fragmentation, barriers to accessing services, inadequate Māori participation and a disability system that has not consistently delivered equitable outcomes for tāngata whaikaha Māori.
For whānau, that can mean navigating a complicated system while simultaneously confronting barriers associated with disability, ethnicity, geography and access to culturally appropriate services.
Tāngata Turi, Kāpō Māori and people with FASD
The Tribunal identified particular concerns affecting several communities, including Tāngata Turi, Kāpō Māori and people with Foetal Alcohol Spectrum Disorder.
Those findings matter because disability is not a single experience.
A Deaf Māori person may face different barriers from someone who is blind or visually impaired, while people with FASD and their whānau can encounter another set of challenges across health, education, disability support and other government services.
The Tribunal found problems extending across cultural safety, workforce capability, rural access and Māori participation.
It also identified inadequate support for tino rangatiratanga and mana motuhake within the disability system.
NZNO wants Māori at the decision-making table
NZNO is calling for the Government to implement recommendations arising from the Tribunal’s consideration of the Māori Nurses Claim, Wai 2713, brought by Nuku and honorary NZNO member Hineraumoa Te Apatu on behalf of Te Rūnanga o Aotearoa.
At the centre of those recommendations is a shift away from simply consulting Māori towards Māori having meaningful influence over how disability services are designed and delivered.
NZNO is calling for viable, co-designed Māori-Crown partnership arrangements and formal Māori involvement in disability system design and delivery.
It also wants stronger Māori participation through governance, co-governance and co-management.
The distinction is important.
Being asked for feedback after a system has already been designed is fundamentally different from being involved in building that system from the beginning.
Cultural safety must be measured
Another significant recommendation concerns accountability.
NZNO wants stronger monitoring of both cultural safety and cultural competency, alongside public reporting of inequitable outcomes experienced by tāngata whaikaha Māori.
That would mean moving beyond commitments on paper and measuring what actually happens to Māori using disability services.
Are services accessible?
Are outcomes improving?
Are tāngata whaikaha Māori receiving culturally safe care?
Are Māori providers adequately supported?
And are inequities narrowing?
Without transparent measurement, NZNO argues it is difficult to determine whether reform is producing meaningful change.
Put Te Tiriti into Crown contracts
NZNO is also backing explicit incorporation of Te Tiriti and equity obligations into Crown service contracts.
That could have significant consequences for organisations receiving public money to deliver disability and health services.
Rather than cultural safety and equity being treated as optional aspirations, contractual requirements could make providers more directly accountable for delivering them.
The Tribunal’s findings have also highlighted longstanding concerns about kaupapa Māori providers being underfunded despite often working with communities experiencing some of the greatest need.
Strengthening Māori-led provision therefore sits alongside wider reform of mainstream disability services.
Who replaces the monitoring role of Te Aka Whai Ora?
One of the most politically significant recommendations concerns the monitoring role previously undertaken by Te Aka Whai Ora, the Māori Health Authority.
NZNO wants that monitoring function replaced, including oversight of health services delivered inside prisons.
The issue goes to a broader question created following the disestablishment of Te Aka Whai Ora — who independently monitors whether the health system is meeting its responsibilities to Māori?
For tāngata whaikaha Māori, the Tribunal’s findings suggest that question cannot simply be left unresolved.
Monitoring is particularly important where people have limited power within institutions, including prisons and other settings where individuals depend heavily on the state for access to healthcare.
A challenge to the Government on cultural safety
Nuku says the report should also force a rethink of political attacks on cultural safety requirements.
Her argument is that cultural safety is not an abstract ideological exercise when failures in culturally appropriate care contribute to people disengaging from services or receiving poorer outcomes.
The Tribunal’s report puts evidence behind a debate that has increasingly become politicised.
The issue is ultimately whether a health professional can be technically competent while still providing care that does not adequately understand or respond to the cultural identity and circumstances of the person receiving it.
For tāngata whaikaha Māori, NZNO says clinical excellence and cultural safety cannot be separated.
A system difficult enough without additional barriers
The Tribunal’s findings paint a picture of a disability system that can already be complicated and fragmented.
For Māori, those difficulties can be compounded by racism, rural isolation, workforce shortages and services that are not culturally appropriate.
That creates consequences not only for individuals but for whānau who frequently become advocates, navigators and unpaid carers within the system.
It also places additional pressure on Māori health and disability organisations expected to bridge gaps left by mainstream services.
The challenge for Government is therefore bigger than changing terminology or commissioning another review.
It is about redesigning parts of the system around the people who actually use it.
The recommendations are now on the table
The Waitangi Tribunal cannot itself redesign the disability system.
That responsibility ultimately sits with the Crown.
And that is where the political pressure will now fall.
NZNO wants the Government to act on partnership, Māori governance, cultural safety, transparent monitoring, Te Tiriti obligations and Māori participation rather than allowing the report to become another document sitting on a shelf.
For Nuku, the findings represent a damning assessment of a system that has had decades to address inequity.
For tāngata whaikaha Māori and their whānau, the question now is no longer whether serious problems exist — the Tribunal has documented them.
The question is what the Government intends to do about them.
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