By Māori, with Māori and for everyone ...

According to the Pae Ora Bill's Health sector principles (Sect. 7), how can the intent and functions of the listed principles be undertaken and executed without explicit Māori decision-making authority, matauranga Māori, kaupapa Māori services and "lived experience" if they are not embedded or visible in the current system?

The decision making opportunities, structures and processes within Te Whatu Ora districts, hospitals, and services are currently void of those requirements to effect the necessary changes as is desired.

The brief to this dialogue is not explicit for ensuring equitable health care for Māori and other population groups.  - "Pae ora means healthy futures. We are working to make sure our health system helps all New Zealanders to live longer in good health and have the best possible quality of life."

Māori do not live longer nor do they have the best possible quality of life than ther majority of all New Zealanders, yet the focus continues to desiring to get it right for everyone.

Shift the focus and priority to "getting it right for Māori - first and foremost, and only then will this enable getting it right for everyone" rather than getting it right for everyone and hoping for the best, which hasn't worked in decades.

What is my idea? 

Simple, do a stocktake of all the decision making positions, opportunities, and processes in the current system to measure if there is equal representation for Māori, those who have matauranga Māori, those who know about kaupapa Māori and those who have lived experience.

If the positions, opportunities and processes reflect a genuine Te Tiriti partnership of co-design, co-decision making and co-governance, then carry on.

But it doesn't, so reform and change the system as was intended and this includes changing who and how decisions are made for hauora Māori within Te Whatu Ora, not alongside or added on to.

Why is there an obvious wait or resistance to do so?  The legislation and policy documents have already been mandated to enact these changes.

Keeping the current status quo of who and how decisions are made within districts, hospitals and services for Māori health has not and will not effect healthy futures for Māori and/or the Government's vision for Māori health.

Health legislation honouring te Tiriti o Waitangi;

• The health system should engage with Māori to develop and deliver services that reflect their needs and aspirations.
• The health system should provide opportunities for Māori to exercise decision-making authority.
• The future will be characterised by Māori in leadership positions making decisions in their own right and in partnership with other key stakeholders.

Māori health gain enabling actions;

• More Māori are in leadership and decision-making roles in Te Whatu Ora and Te Aka Whai Ora.
• Establish a Te Ao Māori intelligence and insights function, that includes use of mātauranga Māori.
• Ensure accountability for results for Māori.

Align and embed mana motuhake, rangatiratanga, matauranga Māori and kaupapa Māori within the bulk of health service delivery (Te Whatu Ora) in order to achieve hauora Māori aspirations and success, not incompatible alternatives.