Iwi Māori Partnership Boards Express Concerns Over Health Bill Changes

The Iwi Māori Partnership Boards (IMPBs) have raised significant concerns regarding their future role in New Zealand’s health system as the government prepares to advance the Healthy Futures (Pae Ora) Amendment Bill. The Health Select Committee issued its final report on the bill in November 2023, recommending its passage. A second reading of the bill is anticipated in the coming months.

Minister of Health Simeon Brown stated that the amendments are intended to establish a clearer framework aimed at achieving better health outcomes, particularly for Māori. A central focus is to redefine the role of the Iwi Māori Partnership Boards, which were established in 2022 to amplify Māori voices in healthcare decision-making and enhance hauora outcomes.

Dr. Kim Ngawhika, Pouwhakahaere of Te Kahui Hauora o Te Tauihu, which represents the top of the South Island, articulated that the IMPBs currently serve three primary functions: providing a voice for whānau, monitoring the health system, and collaborating with Health New Zealand to set priorities for improving Māori health. Under the proposed amendments, these responsibilities would be narrowed to solely providing a voice for whānau.

Ngawhika expressed concern that this change diminishes their partnership role, stating, “It does kind of put us on the outer as far as partnership is concerned.” She emphasized that while the IMPBs would adapt, the reduction in responsibilities feels like a significant step back in their influence within the health system.

The IMPBs have been operational for three years and have focused on building strong relationships within their communities. Hikitia Ropata, from the Āti Awa Toa Hauora in Wellington, highlighted worries about losing direct access to the Minister of Health. According to Ropata, the Hauora Māori Advisory Committee (HMAC) is set to provide advice to the Minister, but its members are appointed by the Minister, raising concerns about regional representation and influence.

Ropata remarked, “What we want is the opportunity to influence at that really regional, local level.” She noted that while public servants are working to facilitate this, significant changes to the legislative framework challenge faith in the system.

The amendments also draw criticism for removing key health sector principles aimed at addressing inequities, essentially severing the link between long-term health planning and government policy. Ropata warned that without access to essential data and evidence, the health system risks losing its direction in tackling inequities.

Chair Hingatu Thompson of Te Taura Ora o Waiariki echoed these concerns, particularly regarding the removal of strategies for marginalized groups such as whaikaha (disabled) whānau. He described the removal of these strategies as dangerous, stating, “These inequities are avoidable, unfair, and unjust. The amendments make them worse.”

As the debate around the Healthy Futures (Pae Ora) Amendment Bill continues, Ngawhika pointed out a minor yet symbolic change in the bill’s name, suggesting it reflects a broader trend of silencing Māori voices.

In response, Minister Brown emphasized that the IMPBs would still engage directly with their communities, identify local barriers, and provide critical insights into health outcomes. He stated, “IMPBs will also continue to engage with Health New Zealand at a district level, ensuring community perspectives directly inform how services are delivered in each region.”

Brown highlighted the importance of understanding specific local issues, such as the lower vaccination rates among Māori children, asserting that insights from IMPBs are essential for improving these rates. He noted that the insights gathered by the IMPBs will inform the HMAC, which is being positioned to offer independent advice on Māori health priorities at a national level.

As the government moves forward with the proposed changes, the future of the Iwi Māori Partnership Boards and their ability to influence Māori health outcomes remains uncertain. The ongoing dialogue reflects a critical juncture in the evolution of health governance in New Zealand, with significant implications for the Māori community.