Speech: Turia - Manaia Health PHO Forum North Whangarei
te-pati-maori
Sat Feb 05 2011 13:00:00 GMT+1300 (New Zealand Daylight Time)
Speech: Turia - Manaia Health PHO Forum North Whangarei
Saturday, 5 February 2011, 11:33 am
Speech: The Maori Party
Hon Tariana Turia
Associate Minister of Health
Friday 4 February 2011; 6.30pmSpeech
Manaia Health PHO Forum North Whangarei - Primary Health Education session
Thank you for the opportunity to be with you at this special event in honour of Waitangi Day 2011.
In politics, we are often told that it’s all about the timing.
And I can’t help but be impressed by your decision to hold this launch tonight; on the brink of such a significant event in our national calendar, as we honour the signing of Te Tiriti o Waitangi; the foundations of our land, Aotearoa.
The timing is even more interesting if we think about 24 hours in the life of the North.
This morning at 9am, at the political forum tent at Tau Rangatira in Waitangi, ‘The State of Maori Rights’ was officially launched. It is a book crafted by Professor Margaret Mutu; documenting the events of the last fifteen years in the journey towards self-determination.
And what a fascinating history that is – the fiscal envelope of 1994, the hikoi of 2005, Maori success, enterprise and ingenuity; and all the challenges along the way.
Then tomorrow, at Paihia Library, the great-great-grand-daughter of Henry Williams, Caroline Fitzgerald, will return home to launch ‘Te Wiremu: Henry Williams – Early Years in the North’. Her book tells the story of a man much maligned; but none-the-less a man central to our national story.
She writes about the 4th February 1840, when Henry and his son, Edward, worked through the night; translating a drafted copy of the Treaty of Waitangi into te reo Maori, with nothing but the light of a candle to guide them.
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Caroline described it as an excruciating task; her ancestor being fully aware of what the tidal wave of Europeans heading to New Zealand could mean for the future of Maori life. He later wrote about his determination to
“preserve entire the spirit and tenor of the treaty – which though severly tested has never yet been disturbed, notwithstanding that many in power have endeavoured to do so”.
So here we are, 171 years later, on the 4th February 2011, considering the state of Maori rights, while at the same time thinking critically about how the spirit and tenor of the treaty has fared.
The timing could never be more relevant.
Into this discourse then, this event – and indeed Manaia Health PHO as an entity – is perfectly placed to help us all examine our histories and evaluate our present.
It is an honour to acknowledge the leadership of people such as Chris Farrelly; Rob Cooper; Whaea Ani Fox and all those who have shaped your vision in establishing yourself as a treaty-based organisation.
I want to particularly commend both shareholders – Terenga Paraoa – bringing with you the Maori health providers and hapu of the Whangarei District; and Whangarei Healthcare – comprising the general practitioners and practice nurses of the Whangarei District.
In all that I have read about your organisation I can’t help but marvel at the scope of your coverage across the rohe.
Over 92,000 people on your books; 21 general practices, 68 GPs including locums, and 72 practice nurses.
And of course, the PHO draws from the distinctive strengths of Ngati Hine Health Trust – one of the largest Maori health providers in Te Tai Tokerau; and Ki a Ora Ngatiwai – an iwi health provider delivering mobile services to the people within the rohe of Ngati Wai.
It all sounds enormously complex – and when we consider the vast range of services from home support, to oral health, to mental health and addiction – it can become somewhat daunting.
How then, can and does Manaia Health PHO hold it all together?
I found that answer in a letter written to me by your CEO last year, and I quote:
“It is our intention that Te Tiriti o Waitangi will underpin all relationships and permeate all activities and behaviours within Manaia Health PHO”.
That is one hefty sentence.
I am reminded of the vital benchmark set in Section 4 of the New Zealand Public Health and Disability Act 2000 – the infamous Treaty clause. That section set in legislation, instructs us that:
“in order to recognise and respect the principles of the Treaty of Waitangi and with a view to improving health outcomes for Maori, Part 3 provides for mechanisms to enable Maori to contribute to decision-making on, and to participate in the delivery of, health and disability services”.
All of us in this room will know just how important words and meanings are, and particularly when associated with the Treaty.
I want to perhaps state the obvious, that while contributing to decision-making and participating in health service delivery is a laudable goal, what you are doing here at Manaia really excites me in your efforts to respect and uphold the spirit and the tenor of the treaty in all your activities and behaviours. In effect, you are extending the legislation; making it live in your context.
It’s all in that word – permeate.
So returning to the Treaty – and your aim to ensure it permeates all activities and behaviours within Manaia Health PHO.
How does it enter our every move, our every thought? How does the Treaty become woven into the fabric of our lives?
And this is where we come to Whanau Ora.
When we think of the principles that underline the Treaty relationship, we think of partnership, participation and protection.
Partnership will be seen in working together with iwi, hapu and whanau to develop best thinking for Maori health gain.
Participation is evident in involving Maori at all levels of the sector – making decisions, planning, development, delivery.
And Protection is achieved when the sector ensures Maori have at least the same level of health as non-Maori; and that Maori cultural concepts, values and practices are safeguarded.
The challenge is – how does your organisation – a Treaty based organisation – achieve this?
I want to acknowledge the efforts you have gone to in using the quality accreditation framework to facilitate cultural competence, and to confront and address issues around equity as a pretty good place to start.
I know that there are some important discussions that are taking place around the Very Low Cost Access scheme – and in particular the criteria that only practices with 50% or more enrolees classed as high need can opt in.
It is a conversation that needs to happen between this PHO and the Northland DHB, and I am certainly interested in learning about the solutions that may come through.
And I do believe that it is vital that in any of the conversations between providers and DHBs, that all players right across the health and disability sector remember they have a duty to adhere to the Treaty principles of protection, participation and partnership – as indeed, is articulated in He Korowai Oranga.
But if I could place my focus anywhere, at this time, and on this day, it would be to emphasize the strategic importance of Whanau Ora; in bringing the treaty principles through to fruition.
As you will be aware, three of the 25 collectives selected around the motu to develop and deliver Whanau Ora are here in the North:
Te Pu o Te Wheke;
Te Hau Awhiowhio o Otangarei, and
Te Tai Tokerau Whanau Ora Collective – which includes both Ngati Hine Health Trust and Ki a Ora Ngatiwai.
So if you have wondered what the buzz in the air is, it is the sound of these collectives putting the Treaty into action. They are charged with working with whanau to identify their aspirations and to work towards them.
They are driven by the momentum that comes with self-determination and leadership.
And their strength is consolidated through connections made through whanau and whakapapa; linkages embraced across sectors and services.
It is so exciting to see uniquely Maori-led models and solutions creating the way for leadership in the development of our health services.
We have, of course, seen such innovation in many of the cases brought to the Waitangi Tribunal over the years, which have called for relationships across many different realms – environmental, educational, socio-economic, cultural.
And our long-established history of Maori health services has pioneered practice which is centred on the needs of the whole whanau; which has shown the way about achieving better integration of primary health care.
In Whanau Ora; quite simply; whanau are placed at the centre, because they are the best people to make decisions for themselves; to take ownership of their solutions. It is determined by the whanau itself and what the whanau judges to be best for them.
It’s about tapping into the vast potential of whanau to understand the issues that confront them, to share their stories, and to spread the word.
I want to share a recent example of how this works.
Northland DHB has been leading the way in terms of the responses that the health sector has responded to the appallingly high rates of rheumatic fever we currently face. They have been running a sore throat clinic in Kaeo for ten years and have successfully managed to prevent any further cases.
All the papers tell that rheumatic heart disease is rampant amongst Maori and Pasifika children – and it’s getting worse. A simple streptoccus throat infection, which is easily treatable, can lead to permanent heart defects and a shorter lifespan.
So up here, in Kaeo, they came up with their own solution – they let everyone know that Sore Throats Matter – they linked together schools with GPs with health promotion - and they have been remarkably successful.
Whanau Ora is about placing that same emphasis on connections; integrating services, and reorientating our focus to centring on the whanau.
It is about telling ourselves, Whanau Matter.
Finally, I want to return to the history of Henry Williams – and how these stories enable the spirit and the intent of the Treaty, to permeate our lives.
It is humbling to be in the presence of Dame Anne Salmond – someone who has showed us all how we can learn from the legacy of those before us. Tena koe Anne.
The book being launched tomorrow came about when his mokopuna, at the grand age of 21, proudly made her ancestral connections known in her very first visit to a marae.
As she sat down, the reaction she experienced made her regret any association she had to the missionary man, Henry Williams; and I share her words with us now,
That morning had a large impact on my life….I had no idea my great-great-grandfather was a contentious public figure and open to attack; I personally felt the insults on his reputation.
Worst of all, I couldn’t protect him. I didn’t know his story, so I couldn’t give him a voice from the grave. However I left the marae that day with a thousand questions.
That to me is the key – the hunger to ask the questions.
Whether it be Whanau Ora - or honouring and living the spirit of the Treaty – our challenge is to stimulate and encourage a thousand questions in our journey to nationhood.
Our whanau need to have a voice; to know their stories; to protect their heritage; their whakapapa; their future.
I hope that what you are striving to achieve in Manaia PHO – and indeed particularly with the Te Tai Tokerau Whanau Ora Collective – is to put into place the ideals and aspirations that all of our ancestors anticipated would come with the Treaty as our guiding document.
It is, collectively, our greatest challenge and our most important opportunity to get it right for all our mokopuna, to lay the foundations of a great future for all of them and for all of us.
Tena tatou katoa
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