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Welcome to the second edition in our regular monthly publication of Healthcare Review – Online. Current users will be familiar with Healthcare Review – OnlineTM as an occasional series, aiming to keep readers informed regarding significant developments in health care delivery.
In this edition we have had the opportunity to bring together the opinions of a number of key figures in Maori health in New Zealand. Together these contributions have helped to identify the issues in providing best care for Maori, to define health priorities for Maori, and to outline the positive and negative impact for Maori Health of the Coalition Health Agreement and the shift to centralised purchasing.
Maori health was very much on the agenda in 1997 with the formation of the Maori Health Commission and the publication of the review of the Ministry of Health by Te Puni Kokiri.
In addition, 1997 saw the implementation of the Coalition Health Agreement which identified Maori health as an explicit health priority of the new Government. Lorna Dyall, Health Consultant and Public Health Lecturer, University of Auckland, offers a stimulating review of the impact of the Coalition Health Agreement on the roles of the different players in Maori Health.
Three contributions from Maori provider groups have highlighted the approaches used to deliver care to Maori in different parts of the country.
Grant Berghan is Chief Executive Officer at Te Hau Ora o te Tai Tokerau. In his contribution he discusses the issues faced by this Maori health service provider, including the need to balance the competitive approach required to build up a client constituency with the need to work co-operatively to maintain good relationships with other providers, both Maori and non-Maori. Grant also reviews areas of good progress in Maori health and notes the key features common to the more successful initiatives.
As Chief Executive Officer of Raukura Hauora O Tainui, Wayne McLean heads the largest Maori health provider group in New Zealand. As a well established health care provider, Raukura Hauora O Tainui also fulfils an important advisory role for other Maori providers. Wayne reviews the organisation and its relationships with other health care providers. In addition, Wayne’s recent appointment as Chairman of the Commission for Maori Health has allowed Wayne to provide Healthcare Review – OnlineTM with his initial thoughts regarding the operation of this new Commission.
In his contribution, Reg Ratahi, Health Manager at Te Whanau o Waipareira, aims to review "best practice" in the management of Maori health. Waipareira addresses Maori needs through a model which is designed and driven by Maori and is based within a business infrastructure. Wai Health is one entity within the overall Te Whanau o Waipareira Trust, which comprises a number of entities covering broad areas in addition to health such as education, social services etc. The comprehensive nature of the organisation allows Waipareira to provide an holistic health service to its Maori community.
From his position as Manager of the Cultural Resource Units at South Auckland Health, Rea Wikaira, addresses the issues associated with providing health care for Maori within a mainstream environment. Support for Maori issues in the CHE is strong, yet barriers to provision of best care still exist and relate to some extent to purchasing and funding approaches.
The perspective of the purchaser on issues in Maori health is presented by Elizabeth Cunningham, Manager of Maori Health, Health Funding Authority, Southern Region. Elizabeth details examples of good progress in Maori health in the South. In addition to the Unit’s role in health care purchasing for Maori for the Southern population, the Maori Health Unit in the Southern Region has been charged with responsibility nationally for the Maori Health Strategic Plan. Elizabeth considers the disparities in Maori versus non-Maori health and raises the option of a goal for health improvement within the plan which is based on a "wellness" model rather than equity with non-Maori.
The contribution from John Waldon, Research Officer, Te Pumanawa Hauora, Te Putahi-a-Toi School of Maori Studies, Massey University is titled ’Maori Health Research Priority Setting’. John brings to Healthcare Review – OnlineTM his experience in Maori health research and offers an interesting view as to how the setting of Maori health research priorities can be guided by the approach adopted in He Matariki: A Strategic plan for Maori Public Health.
While issues surrounding the delivery of health care for Maori are of specific interest in New Zealand, they are also of international importance given the increasing interest world-wide in the delivery of care by and for indigenous peoples which utilise tailored models of health care delivery. Next month, New Zealand will host the third international conference ’Healing our Spirits Worldwide’ which provides a forum for indigenous peoples to discuss the types of issues addressed in this edition of Healthcare Review – OnlineTM. The World Health Organisation, which will be in attendance at the meeting, is becoming increasingly interested in indigenous peoples’ issues and the models of service delivery which they are developing.
Next month’s edition of Healthcare Review – OnlineTM will focus on issues relating to the private and public health sectors. The edition aims to draw together the viewpoints of a number of parties in the private and public sectors. Contributions will assist to outline the issues facing each sector and the potential for and issues associated with these groups working more closely.
