Monique Jonas (Pākehā) and Anneka Anderson (Kāi Tahu and Kāti Māmoe) for Ki Te Pae Tawhiti NZ Health Reform Collective.

When Minister of Health Dr Shane Reti presented the Pae Ora (Disestablishment of Māori Health Authority) Amendment Bill to the House for its first reading, he said it was needed “not just to support an election mandate but to undo an ideology that was struggling to produce tangible results.” Dr Reti did not name that ideology, but spoke of the need to shift power out of  Wellington and enable “the delivery of care as close to the home and the hapū as possible.” But if centralisation is the ideology under attack by the Coalition Government, it is unclear how decentralisation will be achieved by transferring the functions of Te Aka Whai Ora (Māori Health Authority) back to Te Whatu Ora (Health New Zealand) and Manatū Hauora (the Ministry of Health), as the new Pae Ora Amendment Act does. Many commentators perceive a different target for this and other Coalition Government priorities for their first hundred days in office: the undoing of substantive mechanisms for enacting the Treaty relationship between Māori and the Crown.

All three coalition parties (National, ACT and New Zealand First) campaigned on disestablishing Te Aka Whai Ora and it was included in the Government’s 100-day plan. The Pae Ora Amendment Bill was heard under urgency and passed before the 100-day mark. The use of urgency prevented public scrutiny and participation in select committee processes, measures that the government saw as unnecessary given their electoral mandate. It also thwarted an urgent Waitangi Tribunal hearing into whether the disestablishment constitutes a Treaty Breach (Wai 3307). In their application to the Tribunal, Janice Kuku and Lady Tureiti Moxon noted that the only commitment to Māori health in the Coalition Government’s 100-day plan was to disestablish Te Aka Whai Ora. They suggested that this policy was the culmination of a campaign to create “a false impression of special treatment of Māori as a means to gain votes.” The reading of the Bill brought impassioned rhetoric from opposition parties, with Labour’s Peeni Henare calling the government’s Māori policy agenda “regressive” and the Green’s Hūhana Lyndon proclaiming a “gross breech of Te Tiriti o Waitangi.” Whilst Dr Reti insists that the Coalition Government is “committed to improving Māori health outcomes”, the dismantling of Te Aka Whai Ora without a clear replacement strategy makes this prospect seem doubtful.

Te Aka Whai Ora was established in response to the Health and Disability System Review and the Waitangi Tribunal’s landmark judgement Hauora (WAI 2575) as a vehicle for tino rangatiratanga (sovereignty) and mana Motuhake (self-determination) for Māori. The agency had powers to fund and plan health services and stood as a partner to Te Whatu Ora, an advisor to the Minister and a monitor of the whole of system’s progress towards meeting the aspirations and rights of Māori to good health and good healthcare. During the election campaign, National, Act and NZ First highlighted the findings of a review to suggest that Te Aka Whai Ora was not fit for purpose. The review of its first year of operation found that difficulties recruiting and securing resources had contributed to delays in commissioning services. While the Crown and “mainstream” health services have failed for many decades to provide health services that achieve positive Māori health outcomes, authority will now return to those same agencies to make decisions for Māori. If there is a commitment to urgently deliver better services for Māori, as Dr Reti suggests, surely this is not the path to take.

Dr Reti has made much of his intentions for the Hauora Māori Advisory Committee within his Ministry of Health. Advising can be a powerful way of exerting influence, but it is not the same as exercising power. Te Aka Whai Ora gave Māori a Treaty-based authority to plan and provide health services. This authority has now been returned to the government by an act of government and with no input, let alone partnership, from its Treaty partner. Whilst the Coalition Government promises that Iwi-Partnership Boards will play an important role in local provision of services, plans for how this will be achieved have not been announced. Under the former Labour Government’s plans, the members of the Hauora Māori Advisory Committee would have been nominated by Iwi-Partnership Boards and Hauora Māori stakeholders from July 2024. This prospect has been withdrawn: now the Minister will appoint members. Under the Pae Ora (Healthy Futures) Act, the Minister was obliged to seek and consider the advice of The Hauora Māori Advisory Committee about specific matters such as ministerial directions and letters of expectation to Te Aka Whai Ora. If the Minister did not agree with advice about a matter that required public notification under the Act, the disagreement had to be disclosed. The Amendment Act dissolves those ministerial obligations and restricts the Committee to providing advice sought by the Minister. These changes reduce the standing and independence of the Committee and the Minister’s accountability regarding its advice. Whilst it is possible that plans will be unveiled that revive the prospect of substantive power-sharing between government and Māori, the strong signals are that this government is moving at pace in the opposite direction.

Te Aka Whai Ora’s demise has occurred on one front of the Coalition Government’s overall campaign against  co-governance and “race-based initiatives”. The National-NZ First coalition agreement confirmed that the government would not take itself to be legally bound by UNDRIP (the United Nations Declaration on the Rights of Indigenous Peoples) and suspended He Puapua, the work programme initiated to give effect to New Zealand’s UNDRIP commitments, particularly regarding Māori tino rangatiratanga. The Waitangi Tribunal has agreed to hear another urgent claim about the Coalition Government’s policies to reduce the prominence of Te Reo Māori in the public sector. Several further claims have been taken to the Waitangi Tribunal concerning the Smokefree Amendment Act 2024, which repealed measures designed to prevent tobacco harm. This barage of actions in the government’s first months in office have spurred leaders in Te Ao Māori and allies to reassert the binding, non-negotiable commitment that Te Tiriti o Waitangi generates for government. The kotahitanga and resolve displayed at Turangawaewae, Rātana, the Iwi Chairs Forum and Waitangi this year suggest that ACT’s Treaty Principles Bill, and any other developments on the horizon that jeopardise Treaty responsibilities will be met with staunch, legislated and righteous opposition.