The state of Maori health investment: Not all that healthy

The Ministry that governs Maori Affairs, Te Puni Kokiri is under fire after a tribunal released its findings into why Maori health continues to consistently under perform. Te Puni Kokiri was the subject of a damning assessment by the Waitangi Tribunal Health Services and Outcomes Inquiry that found it had systemically abused its responsibilities under the Treaty of Waitangi to Maori. And as the dust slowly begins to settle, the ghosts in the closet from the failings of several successive Governments are starting to emerge.

Te Puni Kokiri was found in breach by the Treaty of Waitangi Tribunal on grounds of having ignored the principles of good governance and active protection.

But it is more than just a breach of two principles that the Ministry should have known about, understood and respected the purpose of. It is also about the billions of dollars over the last 20 years that have been invested into Maori health, about the relationship of Maori on the subject of health and the Crown which is responsible for funding and resourcing, but also setting objectives, and the policies to give effect to those objectives.

In short this is a substantial red flag that has been waved at Maori health. It is one that will unsettle a lot of people in Iwi and hapu, in the Ministry of Health and District Health Boards. I expect that the Minister of Health, David Clark, will issue a media statement or two to fend off the media and answer initial questions. But deep down he must be thinking “how do I undo 2 decades worth of badly invested money and resources? Do I need to set up a Maori Health panel or other body and if so how?”

For me though, some of the problems are staggeringly obvious. This is entirely why we have performance monitoring of government agencies. This is entirely why performance targets exist and when they are not the relevant officials find out why and make sure that they start being met. The fact that such obviously needed monitoring is not happening makes me wonder if there is a larger, more systemic problem in how we govern this country because it is not nuclear physics.

I can totally understand the anger and the frustration that must be coursing through the health workers in the front line. Te Puni Kokiri was meant to conduct reviews on a regular basis of District Health Boards to make sure that they were meeting their responsibilities to Maori. Between 1993 and 2004 only four reviews were carried out despite consistently poor performance outputs, and no mention has been made of reviews since then.

What needs to happen is that the management of Te Puni Kokiri are put on notice. Hire a statutory manager to oversee how those changes that are recommended are implemented and send packing anyone who cannot or will not get with the programme. Maori have every right to feel like they and their whanau, their mokopuna have been failed.

So too, does the New Zealand taxpayer who will rightfully wonder what went on.

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