The Waitangi Tribunal has found the Government’s plans for Māori health following the abolition of Te Aka Whai Ora breached multiple principles of Te Tiriti o Waitangi.
In its newly released Hautupua: Te Aka Whai Ora Māori Health Authority Priority Report – Part 2, the Tribunal examined both the process used by the Crown and what it put in place after the Māori Health Authority was disestablished. The inquiry is part of Wai 2575, the Health Services and Outcomes Kaupapa Inquiry.
The findings are extensive. The Tribunal identified breaches relating to tino rangatiratanga, kāwanatanga and good government, partnership and consultation, active protection, equity and options.
At the centre of its criticism was the way decisions were made.
The Tribunal found there had been no meaningful consultation with Māori when key parts of the alternative health arrangements were developed. It also found Māori had not been adequately informed and that the Crown failed to recognise Māori rights to determine what was best for Māori health.
The report says the Crown had indicated for almost 18 months that an alternative Māori health plan would be developed, but ultimately failed to produce a clear alternative in a timely way. The Tribunal described that as a lost opportunity to advance Māori health equity.
It also criticised the handling of Iwi-Māori Partnership Boards and the Hauora Māori Advisory Board, finding they were not properly included in restructuring decisions and that significant decisions had already been made before Māori were engaged.
The Tribunal concluded Māori have suffered, and will continue to suffer, short and long-term prejudice as a result of the breaches.
Its recommendations are significant.
The Tribunal wants the Crown to revisit the option of establishing a standalone Māori Health Authority, undertake extensive consultation with Māori on Māori health decisions, and ensure future measures addressing long-standing Māori health inequities are grounded in robust evidence and scientific knowledge.
The findings reopen one of the central debates surrounding the health reforms: not only what replaced Te Aka Whai Ora, but how much authority Māori have in determining the design and delivery of a health system intended to address persistent inequities.
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