Yesterday the Pae Ora (Disestablishment of the Māori Health Authority) Amendment Bill was passed by the Government under urgency.
As the name of the new legislation suggests, the Māori Health Authority - Te Aka Whai Ora will be disestablished on 30 June 2024. In a Cabinet Paper that accompanied the Amendment Bill, the Minister of Health Dr Shane Reti noted that the Māori Health Authority's functions would be redistributed within the public health system, that joint decision-making provisions would be repealed, and that there will no longer be co-commissioning of health services. The paper stated, however, that some functions of the Māori Health Authority would continue; for example, the commissioning of kaupapa Māori services will become a responsibility of Health New Zealand - Te Whatu Ora.
Dr Reti has indicated that, by the end of March, the Health Sector (Transfers) Act 1993 will be used to transfer functions, assets, liabilities and staff of the Māori Health Authority. The transfers will primarily be to Health New Zealand - Te Whatu Ora, with a small number to the Ministry of Health - Manatū Hauora.
While the Amendment Bill "takes a narrow focus on the changes needed to disestablish the Māori Health Authority", there are a number of changes to the Pae Ora (Healthy Futures) Act 2022 (Pae Ora Act) that are worth noting, which we set out below:
- Health New Zealand has amended objectives - Health New Zealand's objectives now include "to achieve the best possible health outcomes for all New Zealanders", and "to ensure planning and service delivery respond to the aspirations and needs of the population".
- Health New Zealand's functions have been amended to include providing accessible and understandable information to the public about "the performance of the publicly funded health sector". Additionally, Health New Zealand must have systems in place for the purpose of engaging with Māori in relation to their aspirations and needs for hauora Māori, and enabling the responses from that engagement to inform the performance of its functions.
- The duties of the Board of Health New Zealand now include ensuring that it has systems and processes in place so that it has the capacity and capability to understand kaupapa Māori services, cultural safety and responsiveness of services.
- Heath New Zealand has additional obligations to Iwi-Māori Partnership Boards (IMPBs). In particular, Health New Zealand must take reasonable steps to support IMPBs (for example, by providing information and administrative support), and must engage with IMPBs when determining priorities for kaupapa Māori investment.
- IMPBs will no longer have the function of agreeing to locality plans. However, IMPBs will be required to work with Health New Zealand to develop priorities for improving hauora Māori.
- While the Hauora Māori Advisory Committee will remain, its composition and functions have been amended. All of the members of the Hauora Māori Advisory Committee will now be appointed by the Minister after consulting the Minister for Māori Development. Also, when developing a health strategy, the Minister must have regard to any advice from the Hauora Māori Advisory Committee. The current members of the Hauora Māori Advisory Committee will continue to hold office.
- Under the Pae Ora Act, localities were required to be determined by 1 July 2024, and locality plans were required to be developed by 1 July 2025. Those dates have been amended to 1 July 2029 and 1 July 2030 respectively. However, in the Cabinet paper accompanying the Amendment Bill, the Minister advised that work on localities will stop pending further legislation - stating "With the disestablishment of the [Māori Health] Authority I do not intend to progress localities".
We will keep a watching brief on any further developments in this area.
