CDHB and Mana Whenua

Purpose

Tangata Whenua and the CDHB are working together to improve the health of South Island Māori.

Background

Health information shows that Māori have the poorest health status of anyone in New Zealand. Evidence of inequalities can be seen in the areas of life expectancy, disease burden and access to health services. This makes Māori health a priority for both Tangata Whenua and government.

The New Zealand Health Strategy talks of “forming effective partnerships at all levels under the Treaty of Waitangi” and asks DHB’s to identify ways they can respond to Māori needs and support Māori health services. As a starting point, it is suggested that DHBs formalise a relationship with Mana Whenua in their region.

In Canterbury the relationship between the CDHB and Mana Whenua (Ngāi Tahu) has been developing over an eight year period. The relationship was made formal in a Memorandum of Understanding (MOU), signed in March 2008. The MOU commits both parties to meet regularly and enables Mana Whenua to participate in CDHB planning, funding and in the delivery of health services.

Roles

‘Manawhenua Ki Waitaha’ represents the seven Ngāi Tahu Rūnanga that are in the CDHB’s district of responsibility. This is the group that has been set up to engage with the CDHB and bring the health priorities of their whānau to the table. They are an elected board of health professionals with the full backing of the Te Rūnanga o Ngāi Tahu (TRONT).

The seven Rūnanga are:

  • Te Hapu O Ngāti Wheke
  • Te Taumutu Rūnanga
  • Te Rūnanga o Koukourarata
  • Wairewa Rūnanga
  • Ōnuku Rūnanga
  • Te Ngāi Tūāhuriri Rūnanga
  • Kaikoura Rūnanga

The CDHB are responsible for providing health care services in the Canterbury and Kaikoura regions. They are committed to reducing health disparities and providing funding and resources for the implementation of health services for Māori.

What happens

The CDHB and Manawhenua Ki Waitaha meet on a quarterly basis. These hui are a platform for Manawhenua to provide advice and guidance to the CDHB regarding issues important to Māori.
The CDHB reports progress on Māori health to Manawhenua Ki Waitaha and collaborates with Manawhenua about health services and initiatives for Māori and also the wider Canterbury community.

Declaration on the Rights of Indigenous Peoples

The United Nations Declaration on the Rights of Indigenous Peoples affirms the right of peoples such as Ngāi Tahu to “the enjoyment of the highest attainable standard of physical and mental health. States shall take the necessary steps with a view to achieving progressively the full realisation of this right.” (Article 24)

What is working well

The open dialogue that has developed between the CDHB and Manawhenua ki Waitaha is a significant improvement to previous relationships between CDHB and Manawhenua. Ngāi Tahu Kaiwhakahaere Mark Solomon said, “Ngāi Tahu has developed a close relationship with the CDHB since the establishment of Manawhenua Ki Waitaha”.

The relationship allows issues to be raised and addressed. An example of this is in The Māori Health Progress Report (1 July 2008- 31st March 2009). It states, “Manawhenua Ki Waitaha has expressed interest and concern over the DHB’s kaumātua capacity. The CDHB will examine its kaumātua capacity later this year and look to grow its capacity in this area in the next fiscal year (post June 2009) in order to improve its pastoral care for Māori patients and to better support our Māori staff culturally”. The kaumātua capacity this refers to is about the lack of Kaumātua available within the Canterbury region.

Although in its early stages, a direct result of this collaborative way of working is the growth in the number of sustainable health services available at marae. Hector Matthews, the Executive Director Māori & Pacific Health, has said this “has given Tangata Whenua greater access to health services”.

This partnership can be seen as an example of:

  • parties meeting regularly and having an opportunity to develop common goals and agreed actions
  • a commitment from both parties to the strengthening the Treaty relationship
  • providing an opportunity for both parties to respond to immediate issues and also be involved in long term planning.

Challenges

The relationship between the CDHB and Mana Whenua Ki Waitaha is still developing and this takes time:

“Some things are not progressing as fast as we may like, but, generational things do take time and we want to make sure that the structures set in place are fundamentally solid. Not just for this generation but for future generations. This is only the beginning” – Dr Matea Gillies.

At a meeting in March 2009 the Chair and CEO of the CDHB met with the Chair of Manawhenua Ki Waitaha to review the first twelve months of the MOU. The key issue to come out of this was the need to support Manawhenua Ki Waitaha to enable the relationship to flourish. Clarity also was needed on how Manawhenua can participate appropriately within the Canterbury DHB.

Documentation

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