Health Minister Shane Reti has successfully scrapped the Māori Health Authority and next on his hit list is ceasing work on health ‘localities’, one of which is in Wairoa.
In Cabinet papers Reti stated ‘localities’, when introduced in 2022, were intended to allow the specific needs and aspirations of a particular community to be identified and met, with robust engagement with the community concerned. This was to be seen as a response to abolishing local DHBs.
“The aim was to support localism and encourage integration between public services that can address wellbeing outcomes for communities,” he said.
“In practice, implementation has been slow and there is a lack of clarity for communities and the health workforce. Additionally, a primary function of the locality arrangements was to provide a mechanism for iwi-Māori partnership boards and the Māori Health Authority to exercise joint decision-making with Health New Zealand. With the disestablishment of the Authority, I do not intend to progress localities. I have instructed Health New Zealand to stop work on localities pending further legislation.”
Around May 2022 Wairoa was selected as a Locality Prototype, to test how it can plan for, and deliver, health and social services in a different way that better meets the needs of Wairoa people.
The locality approach to planning had been set up as part of the health reforms with Wairoa’s Locality, Tihei Wairoa.
Nigel How, chairman of Wairoa Taiwhenua, contract holder on behalf of Tihei Wairoa Locality Prototype told BayBuzz how scrapping of localities would impact the delivery of health services in Wairoa.
“At this early stage, our understanding is that, as the Wairoa Locality is a prototype, the decision by the Minister to stop work on further development of the localities programme does not change the contractual obligations between Health New Zealand/Te Whatu Ora and the locality prototypes,” How said.
He said one staff member was employed by the Wairoa Locality Prototype and that person remained under contract.
“This is a time of uncertainty, and it is encouraging that Minister of Health, Dr Shane Reti understands the value of listening and responding to the needs of community and whānau, and of local decision-making in the delivery and coordination of local services,” he said.
“In the meantime, Tihei Wairoa will continue with our contracted work on behalf of and for our wider community.”
Abbe Anderson, national director of commissioning, Health New Zealand, told BayBuzz the Government had been clear that community involvement in health-service planning remained essential.
“The stop work means that Health New Zealand/ Te Whatu Ora has stopped work on defining further boundaries or assisting additional locality groups to become established,” Anderson said.
“The twelve prototypes are fulfilling their contractual requirements, with most in the middle of coordinating local service delivery in response to community priorities that they have previously identified. Health NZ continues to support this work to its completion including documenting lessons learned to inform future direction.”
To BayBuzz, that sounds like: ‘And then they’ll be axed’. In the meantime, how the Government intends to provide for sorely needed local input into local health service delivery — to say nothing of accountability — remains a mystery.
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