Partnership, not centralisation in Pae Ora health reforms
MEDIA STATEMENT
FOR IMMEDIATE RELEASE
Tuesday 24 June 2025, 10:00 AM
2 minutes to Read
Te Tiratū Iwi Māori Partnership Board is concerned over proposed legislative reforms to the Pae Ora (Healthy Futures) Act 2022 that removes the current direct role of Iwi Māori Partnership Boards (IMPBs) in shaping the local health service design and delivery.
Stripping IMPBs of their decision-making authority and reducing our role to that of a ‘consultative’ body risks undermining the spirit and intent of Pae Ora, weakening community-led health leadership, and falls well short of the Crown’s obligations under Te Tiriti o Waitangi,” said Hagen Tautari, co-chair of Te Tiratū Iwi Māori Partnership Board.
“Te Tiriti is a constitutional foundation. Reforms must reflect the Crown’s enduring duty to uphold Te Tiriti obligations in both law and practice, not through policy alone.”
The sentiment is also shared by the larger Te Manawa Taki IMPB collective that comprises of Te Tiratū, Tairāwhiti Toitū Te Ora, Te Moana a Toi, Te Taura Ora o Waiariki, Tūwharetoa, and Te Pūnanga Ora.
The rōpū has called for the legislative changes to enter a formal co-design phase with Iwi Māori Partnership Boards and asked the Minister for urgent clarification on:
- How IMPBs’ Community Health Plans will influence service outcomes under the new framework
- What mechanisms will ensure IMPBs retain their role in local service design
- How the Crown will ensure accountability and transparency without undermining Tiriti-led governance
While Te Tiratū supports the Minister’s back-to-basics approach putting patients first and stated goal of timely, quality healthcare for all New Zealanders, Tautari says the proposals risk centralising decision-making in Wellington which would erode decades of hard-won progress trying to improve health outcomes for highest-need group in New Zealand’s health system.[1]
A letter to the Minister has been penned and endorsed by the Te Manawa Taki IMPB collective providing constructive feedback and solutions. It supports reforms that strengthen national oversight and equity outcomes – including the proposed expansion of the Hauora Māori Advisory Committee (HMAC) – but only if they are adequately resourced and do not displace the unique, community-based role of IMPBs.
“Partnership is not a principle to be referenced in policy—it is a constitutional obligation that must be upheld in law and practice,” said Tautari. “The voices of our whānau are strongest at the local level, where services are delivered, where the gaps are being identified by Whānau Voice and where IMPBs are making a real difference.”
The Board points to recent success in Te Moana a Toi, a member of te Manawa Taki IMPB collective where the regional IMPB worked alongside Whakatāne Hospital to address critical maternity service issues, delivering faster solutions than waiting on national intervention.
“Equity comes from working alongside whānau, listening to communities, and enabling local solutions. The reforms must protect that,” Tautari said. Reiterating the Board’s commitment to working constructively with the Government to ensure the health system delivers better, more equitable outcomes for Māori and all New Zealanders.
[1] Pg23-24 https://forms.justice.govt.nz/search/Documents/WT/wt_DOC_195476216/Hauora%202023%20W.pdf
Uncompromising call to govt on Budget 2025
MEDIA STATEMENT
FOR IMMEDIATE RELEASE
22 May 2025, 12:00 PM
2 minutes to Read
[Photo: Tipa Mahuta and Hagen Tautari, co-chairs of Te Tiratū Iwi Māori Partnership Board]
The Te Tiratū Iwi Māori Partnership Board, the statutory voice for 114,000 whānau Māori across the central North Island, is issuing an uncompromising call to the Government: make Budget 2025 a decisive turning point so the health system is timely and accessible for whānau.
The Board is calling for urgent action and bold direct investment in Māori-led, community-based health services — warning that failure to do so will mean continued whānau premature death from preventative disease, entrenched hardship and inequity across the rohe.
Board co-chair Hagen Tautari said, “We hear it from our people every day — the system is not meeting the needs of our whānau who top the table in terms of mortality and morbidity statistics.”
He acknowledged steady progress in key service areas — particularly newborn enrolment, early intervention, and screening coverage across the Tainui Waka rohe. However, he stressed that falling immunisation rates and long specialist wait times now demand urgent attention.
“Whānau are waiting months — even years — for essential care. Many needing to access services beyond a GP clinic are forced to travel vast distances, bear unaffordable costs, or give up altogether because the system isn’t designed for them — culturally, practically, or equitably. It’s not just unjust — it’s deadly. This failure is costing lives.”
Evidence from Whānau Voice surveys, the Board’s monitoring mechanism on Te Whatu Ora Health New Zealand reveals that Māori communities across the Te Tiratū region — spanning from Waikato to Hauraki, from Te Kuiti to Kawhia and especially the surrounding rural settlements — continue to face persistent, systemic failures in accessing even basic health care.
“Since June 2023, I’ve been on a waitlist for gallbladder surgery. This one condition is stopping me from getting back to work,” said one Tokoroa-based whānau. “My partner needed someone to talk to. There was no mental health support for him. Nothing,” shared another. “As a teacher here in Tokoroa, I don’t think there’s enough on offer for our tamariki in terms of mental health.”
Tautari believes these stories are not isolated — they are representative of widespread experiences shared by whānau across the rohe that are leaving them frustrated, overlooked and unsure on where to get help.
Even the government’s recent pre-announcement of a funding boosts for 24-hour urgent care in selected locations, Ōpōtiki—part of the Te Manawa Taki region where Te Tiratū operates—was overlooked despite having a clear need and geographic isolation. As a result, the lack of accessible services continues to place whānau lives at risk.
The resounding call from the flaxroots is clear: more GPs, more specialists, shorter wait times, and longer appointments. “We need to be able to see a doctor the same day — not in two weeks. You could be dead by then,” said whānau from rural Waikato.
Te Manawa Taki Central North Island Region: Delays, Disconnection, Causing Disadvantage
Whānau in the Te Tiratū catchment compared to the general population continue to face higher rates of cancer, diabetes, mental health conditions, and preventable illnesses — with poorer outcomes and shorter life expectancies.
These outcomes are worsened by the current service delivery experience:
- Surgery and specialist waitlists stretching months to multiple years
- Lack of local mental health support especially for tāne and rangatahi
- Shortages of GPs and specialists in rural and coastal communities
- Disjointed services that are not designed to reflect Māori cultural values, realities, or aspirations
From rural towns like Putāruru and Mangakino to coastal Ōpōtiki, many whānau struggle to access timely, affordable, and culturally safe health care. Services are stretched, under-resourced, and often located far from where whānau live.
- Teachers in Tokoroa are concerned about the lack of mental health services for students even though suicide rates for rangatahi are among the highest globally, and tamariki are more likely to experience barriers to accessing mental health services.
- Te Whatu Ora data for the Te Tiratū region indicates more whānau are now waiting over 4 months for their first specialist appointment. Delays in accessing timely care especially for rural and remote areas is worsening the health conditions for whānau and eroding their trust in the system. As a result, many are disengaging entirely — avoiding the very services meant to support them.
- In the western Bay of Plenty, whānau report long waits for referrals and specialist treatment in Hamilton, often delayed by transport, time off work, or simply unaffordable travel.
“Referrals wait times are really long!” said whānau. “We need doctors full-time — the same doctor, not locums that come and go,” said another.
Many reported being bounced between services, without follow-up, clarity, or support. “We’re constantly referred elsewhere. No one checks in. The system is disconnected, and people as a result fall through the cracks.”
Decades of Underinvestment: Now a Measurable Impact
This crisis is not new. Back in 2019 the Waitangi Tribunal released its Hauora Report on WAI 2575 matters that was further supported by the historic Sapere Report that calculated a $531 million longstanding underfunding experienced by Māori providers which still has not been addressed and compounding – six years later.
While Te Tiratū waits for the official details of the Budget 2025 commitments— such as a proportion of the allocated $6.8 billion capital spend on health and what the $190 million Social Investment Fund entails— there is no assurance that these will reach Māori communities unless targeted, ringfenced, and co-designed.
Te Tiratū urges the Government to:
- Deliver dedicated investment into kaupapa Māori and whānau-centred health models
- Address workforce shortages in GPs, mental health specialists, and kaiārahi/navigators across the rohe
- Guarantee equitable access to timely mental health care care for tamariki, rangatahi and tāne
- Uphold Te Tiriti o Waitangi in health system governance and decision-making
“What works for our whānau already exists. We just need the government to invest in it — as Māori-led care can deliver,” said Tipa Mahuta, co-chair of Te Tiratū Iwi Māori Partnership Board.
A local initiative already making a measurable difference is a community outreach pilot launched by BreastScreen Aotearoa, in partnership with Hauraki PHO, to connect under-screened wāhine through hospital and community pathways.
Equity Is Not a Luxury — It’s a Legal and Moral Obligation
Te Tiratū Iwi Māori Partnership Board believe whānau Māori across the Tainui waka rohe cannot afford more delays, trade-offs, or one-size-fits-all approaches.
“Equity is not optional — it is a Treaty commitment, and the path forward to sustainable wellbeing. Now is the time for genuine partnership — one that shares power, resources, and responsibility with Māori to achieve oranga for all.”
Data showing alarmingly low Immunisation rates, delays, costs still undermining Māori health
Photo: Co-chair of Te Tiratū Iwi Māori Partnership Board Hagen Tautari
Te Tiratū Iwi Māori Partnership Board April Whānau Voice Report mirrored by Te Whatu Ora data has evidenced immunisation rates 33% lower than the national average, widespread inequities, long wait times, and unaffordable care still plaguing whānau Māori in its Tainui waka rohe.
The Board, which holds legislative responsibilities under the Pae Ora (Healthy Futures) Act 2022 to represent Māori voices in health and monitor health system delivery of Te Whatu Ora, gathered lived experiences from 53 whānau across its rohe.
Behind every statistic is a whānau member struggling in silence.
The April Whānau Voice report revealed:
- 23% of whānau identified access to care—like GP appointments or surgeries—as their biggest barrier.
- 27% said cost was the major obstacle, forcing choices between essentials like kai and medication.
- 14% highlighted the need for more culturally safe, Māori-led care.
“Whānau are still waiting—too long—for care that should be timely and accessible,” said Hagen Tautari, co-chair of Te Tiratū Iwi Māori Partnership Board.
“One kuia told us her husband had life-saving heart surgery, but no specialist follow-up for almost a year. Another Māmā has waited two years for her child’s ear operation. These are not exceptions—they are systemic failures.”
Whānau are being left to manage complex conditions like diabetes, cancer, and heart disease with minimal support. Many avoid primary care due to cost and instead turn to overburdened emergency departments—even for non-urgent issues.
“We go to hospital because there’s nowhere else,” said another whānau.
In rural areas, lack of transport compounds the problem. Some whānau reported sitting in shuttle vans for hours to access basic services. Others gave up entirely.
Cultural safety also emerged as a major issue for whānau, ironically at a time when the government is looking to proactively remove cultural requirements from workforce regulation.
While Māori health workers were praised for their manaakitanga, whānau shared painful stories of clinical encounters with the non-indigenous workforce that lacked empathy, understanding, or cultural connection.
“We need more Māori nurses and doctors,” said one whānau. “They didn’t just treat us—they respected us.” But the report goes beyond what’s broken. Whānau were clear about what needs to change.
Photo: Raven Torea Whānau Voice kaimahi, of Te Tiratū Iwi Māori Partnership Board receiving whānau whakaaro
Priorities included:
- More doctors, more appointments, and reduced wait times (24%)
- Lower costs for basic care (27%)
- Improved transport and localised services (14%)
- More culturally grounded, Māori-led health care (14%)
- Better coordination between health services (13%)
- Holistic, whānau-centred support for housing, income, and wellbeing (10%)
Data from Te Whatu Ora for Waikato as at 31 December 2024 reinforces these concerns:
- HPV Vaccination rates for Māori aged 14 are only 46%, far from where they need to be to prevent sexually transmitted diseases and cervical cancer.
- Tamariki immunisation rates under 24 months are alarmingly low at 62%, well below the 95% national target, increasing the risk of preventable disease outbreaks.
- Emergency Department wait times are unacceptable: 27% of Māori wait over 6 hours before being admitted, transferred, or discharged—placing undue stress on kaumatua, māmā, and tamariki.
- For elective surgery, only 65% of Māori receive timely treatment, compared to 71% of Non-Māori—leaving 35% waiting over four months.
- Cancer screening rates are critically low:
- Bowel screening: only 46% for Māori aged 60–74
- Breast screening: 55% for wāhine aged 45–69
- Cervical screening: 58% for wāhine aged 25–69
- Cancer treatment within the 31-day target is met for only 62% of Māori, far below the 90% national goal.
“These numbers are not just data points—they’re warnings,” said Tautari. “They tell us that inequity is embedded and urgent.”
“Our care needs to reflect our world. Te ao Māori matters in healing,” one whānau member said in the Whānau Voice report.
Te Tiratū says the April report and supporting health data are a wake-up call to decision-makers across the motu. The stories and statistics are not just feedback—they are a call to action.
“We carry both a legal and moral obligation to ensure whānau voices are not only heard, but acted upon,” Tautari said.
“System change begins when we honour the truths our whānau are brave enough to share and cultivate service delivery grounded in manaakitanga, equity, and tino rangatiratanga.”
Largest iwi Māori partnership board calls for Māori-focused equity in access
Te Tiratū Iwi Māori Partnership Board that serves 114,000 Māori in the Waikato rohe welcomes the Government’s decision to lower the eligibility age for free bowel cancer screening from 60 to 58 announced today.
“Screening is an essential tool for prevention and early detection, and expanding access will definitely save lives,” said Hagen Tautari, co-chair Te Tiratū Iwi Māori Partnership Board.
“However, what we don’t want is to leave our people who are high-risk behind as they face substantially poorer health outcomes. What we need is an easier diagnostic process that removes systemic barriers.”
Published tested evidence shows that Māori are twice as likely to die from all types of cancer compared to non-Māori.
Research shows the rate of colorectal cancer diagnoses among young Māori under 50 years has increased by an average of 36 percent per decade.
In the rohe Te Tiratū operates Māori cancer numbers are some of the highest in the country.
Photo: Co-chairs of Te Tiratū Iwi Māori Partnership Board Kataraina Hodge and Hagen Tautari
While Māori continue to face grave Māori health inequities and significantly lower cancer screening rates, Te Tiratū prioritises prevention as a fundamental step toward improving outcomes.
This adjustment in funding, which moves away from a previously targeted approach for Māori and Pacific communities discontinued in December, raises concerns about whether the expansion will effectively reach and benefit those most at risk.
Pae Tū, the Hauora Māori Strategy is currently being redesigned, following extensive public consultation. Te Tiratū expects it will reflect the needs and expectations of the region to better address the specific needs of Māori and ensure more effective, equitable health outcomes – access to screening being one of them.
Te Tiratū advocates strongly that cancer screening must be culturally appropriate and properly resourced to ensure Māori participation over a lifetime.
It acknowledges that the solutions lie in true partnership between the community and Te Whatu Ora. A prime example is the Taakiri Tuu Wellness and Diagnostic Centre, established in 2024 by Māori health provider Te Kōhao Health in a high-deprivation area, specifically designed to serve whānau Māori.
Kataraina Hodge, co-chair of Te Tiratū Iwi Māori Partnership Board, believes that without targeted strategies, partnerships in community and resourcing for high need populations existing disparities could be reinforced rather than reduced.
Te Tiratū Iwi Māori Partnership Board invites clear commitments by Te Whatu Ora to support:
• Resourcing Māori-led, community-driven promotion of screening.
• Accessible screening locations, particularly in rural areas where services are often out of reach for our whānau.
• Investment in workforce and resources to support increased demand without creating further barriers to timely diagnosis and treatment.
“Te Tiratū remains committed to advocating for hauora solutions that reflect the needs of our people. We urge the Government to engage with Hauora Māori providers and leaders to ensure that screening programmes deliver equitable outcomes—not just increased numbers,” Tautari said.
The Te Tiratū Iwi Māori Partnership Board given their legislative responsibility under the Act monitor and represent local Māori perspectives on the design and delivery of services and public health interventions.
The Board represents the whānau of Pare Hauraki, Waikato, Raukawa, Te Nehenehenui, Ngāti Hāua (Taumarunui) and Te Rūnanga o Kirikiriroa from the localities of Waikato, Hauraki, Maniapoto, Raukawa, Ngāti Hāua.
Sources of Statistics:
Pg 49 Waitangi Tribunal Hauora Report
University of Otago 2024 Early onset cancer on the rise
Pg 17 Te Tiratū Iwi Māori Partnership Board Hauora Priorities Summary Report
Pg 14 Waitangi Tribunal Hautupua Report
Iwi Māori partnership boards unite in Whakatāne to lead regional health planning: unveiling community health plans & hauora Māori priorities
A third of the Iwi Māori Partnership Boards including five from the Te Manawa Taki region have united in Whakatāne to present their Community Health Plans to government officials, fulfilling their legislated function on behalf of Iwi, hapū, and whānau.
As part of the reset of Te Whatu Ora Health New Zealand, Newly appointed Deputy CE and Regional Director, Catherine Cronin received the Community Health Plans and Hauora Māori Priority Reports highlighting Whānau Voices.
This information was gathered from whānau, hapū and hapori to shape individual IMPB priorities and consolidated into regional priorities to tackle the ‘grim picture’1 of the state of Māori-health.
“The purpose of our collective is to mahi tahi – to work together- to achieve the health and wellness aspirations of our whānau,” said Kataraina Hodge, Co-Chair of Te Tiratū IMPB.
Collectively, the 6 boards serve a combined Māori population of 285,560.
“Our role is not only integral, but fundamental to the success of Te Whatu Ora Health New Zealand and the system’s responsiveness to Māori health needs,” said Louisa Wall, Chair of Tūwharetoa IMPB.
The IMPB are responsible for assessing, monitoring, planning and represent local Māori perspectives on the design and delivery of services and public health interventions within localities.
Their shared priorities focus on public and population health, primary and community care, hospital and specialist services and priorities, workforce, data and funding appropriation for a redesigned delivery model.
“We are all experiencing the same levels of high health need for our whānau so the strategic emphasis into the prevention and health promotion space is essential to make meaningful progress,” Hodge said.
Each IMPB collected the voices of whānau through workshops and surveys, blending these insights with data from Te Whatu Ora and Primary Health Organisations to develop comprehensive, evidenced-based reports for each rohe.
This effort upholds the IMPB’s statutory responsibility in their relevant localities.
The Boards have aligned around regional strategies and delivered all key documents within Minister Reti’s expected timelines—most significantly, meeting the 30 September deadline to be ready for co-commissioning opportunities from 1 January 2025.
Today is another important milestone in achieving our moemoeā (vision) for our whānau. We are actively participating in shaping regional health priorities that we expect will influence funding based on need ahead of the 2025 Budget,” said Aroha Morgan, Co-Chair of Te Taura Ora o Waiariki IMPB.
One critical task ahead is addressing the status of legacy contracts for Māori Providers – to maintain continuity and capacity in the system – which have been extended until 30 June next year.
“We strongly advocate for evergreen contracts for our providers, given the urgent state of our health needs. At every opportunity, we’ve made it clear to politicians and officials: contracts for Māori health providers must be extended and prioritised,” said Rutu Maxwell-Swinton, Co-Chair of Te Moana a Toi IMPB.
The hui was hosted at Te Whare Wānanga o Awanuiārangi, a Ngāti Awa-founded tertiary provider known for its essential role in training and developing the Hauora Māori workforce. The Boards expressed deep appreciation to the Wānanga for providing the venue for this important briefing.
“Since our establishment, we’ve been following our statutory responsibilities to ensure that we have robust governance structures and operational capability,” one Board member explained.
“We’ve had to set up charitable trusts and ensure that trustees represent iwi and mātāwaka organisations from each rohe, which is no small task.”
The IMPBs have collaborated with Te Whatu Ora and Manatū Hauora navigating changes in legislation, leadership, and planning approaches during the transition to a new coalition government.
“We’ve seen a shift from Locality Plans to Community Health Plans. It wasn’t until July this year that we had clarity on the new Minister’s expectations—before that, we were operating under Labour’s directives,” said Hone Te Rire, incoming Co-Chair of Te Moana a Toi IMPB.
The independent analysis aligns with key government priorities, reflecting a shared commitment to achieving mutual goals.
“It’s a great day for us but it’s got to be taken seriously, I was here 35 years ago and not a lot has changed in Māori health,” said Te Pahunga Davis Chair of Te Punangaora IMPB.
“I live in hope that we can make a difference that we can measure. With that I support our pukapuka being placed into the kete but we’ll be watching you, or we aren’t doing our job.”
The rōpū has heard “loud and clear” the consistent message from whānau about Hauora Māori that mirrors what’s been happening over the last 40 years societally that has led to more highly, complex comorbidities.
“Nothing’s really changed. Now we’re living in a climate of household stress, whether that be income, unhealthy homes, violence, lack of job security – all those determinants of health have doubled down on our people over this last decade especially,” said Davis.
Beyond forming the Iwi Māori Partnership Boards and underpinning flax-roots efforts, there is a shared belief that true solutions lie in our vibrant young Māori demographic, now 978,246 strong according to the 2023 Census.
Our emerging next generation bring an inspiring energy and a sense of hopefulness for the future. For us ultimately that’s going to play a pivotal part in the shift for addressing health inequities.”
ENDS
Media Liaison: Sarah Sparks Email: Sarah.sparks@sparksconsulting.co.nz Mobile: 021318813
Background:
The collective of Iwi Māori Partnership Boards that in the Te Manawa Taki region are:
1. Te Taura Ora o Waiariki IMPB (Te Arawa)
2. Te Tiratū IMPB (Tainui Waka, Ngāti Hāua Iwi ki Taumarunui & Mātāwaka)
3. Te Moana a Toi IMPB (Bay of Plenty)
5. Te Pūnanga Ora IMPB (Taranaki)
6. Toitu Tairawhiti IMPB (Tairawhiti)
