Te Tiratū questions removal of ethnicity criteria for funded type 2 diabetes medicines
Te Tiratū Board member, Dr Mataroria Lyndon speaks to Whakaata Māori about the impact of changes to diabetes medicine access.
Pharmac’s decision to remove Māori and Pasifika-specific eligibility criteria for four type 2 diabetes medicines has raised concerns about whether widening access will translate into equitable access for the people experiencing the greatest burden of diabetes.
Te Tiratū Iwi Māori Partnership Board member Dr Mataroria Lyndon spoke to Whakaata Māori about the decision and the implications for Māori.
From 1 September, access to empagliflozin, empagliflozin with metformin, liraglutide and dulaglutide will be widened to people with type 2 diabetes whose blood sugar remains high despite other treatment. Pharmac says the change will give an additional 31,000 people access to the medicines over five years.
Dr Lyndon says while wider access is positive, a universal approach does not automatically mean Māori and Pasifika will have equal access in practice.
Māori are twice as likely as non-Māori to have diabetes and are also more likely to experience serious complications, including cardiovascular disease, kidney disease and lower-limb amputations.
“Māori are three times more likely than non-Māori to lose their leg or foot,” he said.
Diabetes can contribute to serious complications including cardiovascular disease, kidney disease, vision loss, and amputations.
Te Tiratū believes these concerns cannot be separated from the wider inequities Māori experience across the health system.
“Pharmac needs to demonstrate that removing the ethnicity criteria will not worsen outcomes for Māori. The issue was that even proposing to remove an ethnicity criterion is a breach of Te Tiriti, but it also undermines the need,” said Dr Lyndon.
The concern is that removing targeted eligibility criteria assumes everyone is starting from the same position, despite longstanding inequities in diagnosis, monitoring, treatment, and access to healthcare.
“That’s why we need a targeted response to address it, not a one-size-fits-all approach.”
According to Te Tiratū, the impact of the changes must be closely monitored to ensure Māori are not disadvantaged and that increased eligibility translates into improved access and health outcomes.
Unhealthy food marketing targets Māori youth: How advertising drives type 2 diabetes rates
Te Tiratū Iwi Māori Partnership Board member Dr Mataroria Lyndon has spoken to Whakaata Māori about the growing impact of unhealthy food marketing on Māori communities and the links to rising rates of type 2 diabetes.
The interview follows research highlighting how rangatahi are increasingly exposed to fast-food advertising, larger portion sizes and food environments where unhealthy options can be cheaper and easier to access.
Dr Lyndon says the issue cannot simply be reduced to individual choice.
“We know that especially our lower income communities are more targeted with fast food, with that type of marketing.”
He also points to the growing size of meals and the impact this has on what people perceive as a normal portion.
“The portion of our kai is a lot more than we need, and also a lot more calories, a lot more sugars and fat in that kai, so we are eating a lot more than what’s good for us.”
Researchers say Māori continue to experience disproportionately high rates of type 2 diabetes, with many developing the condition at younger ages.
The discussion also highlights the importance of Māori-led approaches to prevention and wellbeing, including reconnecting with traditional kai, mātauranga Māori and the practices of tūpuna that supported healthy communities.
For Te Tiratū the issue reinforces the need to address the wider conditions shaping whānau health and not simply place the responsibility on individuals.
Healthy choices are much harder when the environment around whānau is designed to promote unhealthy ones.
Supporting smokefree and vapefree communities across our rohe
Creating healthier futures for our tamariki, rangatahi and whānau is a shared responsibility. One way we can all contribute is by helping ensure tobacco and vaping laws are followed in our communities.
Health New Zealand has developed a range of resources to help people recognise and report illegal smoking and vaping activity under the Smokefree Environments and Regulated Products Act 1990. By raising concerns when the law is not being followed, communities can help reduce harm and protect future generations from nicotine addiction.
Why this matters for our Tainui waka rohe
Te Tiratū represents more than 121,000 Māori across the Waikato. Despite significant progress in reducing smoking over recent decades, tobacco use continues to have a disproportionate impact on Māori health and contributes to preventable illness, chronic disease and premature mortality.
Nationally, Māori adults are more than twice as likely to smoke daily as the overall population (15.0% compared with 6.8%). Daily vaping is also significantly higher among Māori adults (27.5%), highlighting the importance of supporting evidence-based prevention and cessation initiatives while protecting young people from developing lifelong nicotine dependence.
The picture is particularly important for rangatahi. While youth smoking has declined to historically low levels, vaping remains common among secondary school students, with Māori rangatahi continuing to experience the highest rates. Preventing access to tobacco and vaping products by those under 18 is an important step towards improving long-term health outcomes and reducing inequities experienced by Māori.
Healthy communities are built when tamariki can grow up in environments that support wellbeing, reduce exposure to harmful substances and make healthy choices easier.
What can be reported?
Anyone can report concerns about businesses or individuals who may be breaching New Zealand’s smokefree and vaping legislation, including:
- Selling tobacco or vape products to people under 18 years of age.
- Selling illegally imported or illicit tobacco products.
- Selling prohibited disposable vaping products.
- Displaying or advertising tobacco or vaping products unlawfully.
- Smoking or vaping in smokefree workplaces, restaurants, bars or other regulated public spaces.
- Retailers not complying with the requirements of the Smokefree Environments and Regulated Products Act 1990.
- Community reporting helps Health New Zealand investigate potential breaches, improve compliance and strengthen protections for everyone.
How to make a complaint
If you are concerned about illegal smoking or vaping activity in your community, you can make a report directly here: https://healthnz.govt.nz/TellUs
We need to curb the rising uptake of vaping products across the Waikato rohe.
Te Aka Whai Ora may be shut down but Māori health leaders are continuing its work
Te Aka Whai Ora may be gone, but the lessons remain. (Design: Tina Tiller).
Te Tiratū Iwi Māori Partnership Board member Dr Mataroria Lyndon reflects on the enduring importance of Māori leadership in hauora Māori following the disestablishment of Te Aka Whai Ora Māori Health Authority.
In his opinion piece for The Spinoff, Mataroria shares his reflections as a founding board member of Te Aka Whai Ora and considers the lessons from its short but significant journey.
He writes that while the organisation may have ended, the kaupapa of Māori decision-making, equity and whānau-centred health transformation continues through iwi Māori partnership boards, Whānau Ora commissioning agencies, Māori health providers and communities.
Mataroria says the future of hauora Māori must be built on enduring Māori leadership, strong partnerships and decisions made closer to whānau and communities.
Te Kūiti rural healthcare hub strained by rising demand
The Waikato Herald has featured the Te Kūiti Hauora Report by Te Tiratū Iwi Māori Partnership Board, highlighting the growing pressure on Te Kūiti’s health services as they support both the local community and surrounding rural areas. The article outlines the report’s findings on barriers to healthcare, including GP shortages, transport, affordability and workforce challenges, along with recommendations to strengthen primary care, maternity, dental and kaupapa Māori services. Health New Zealand said the report provides valuable insight that will help inform future planning for rural health services.
New Te Kūiti Hauora Report reveals mounting pressure on rural ‘health hub’ serving the wider district
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FOR IMMEDIATE RELEASE
Monday 13 July 2026, 10:00AM
2 minutes to Read
Te Tiratū Iwi Māori Partnership Board has today released its 48-page Te Kūiti Hauora Report, revealing the growing strain on one of the Waikato region’s key rural health hubs, where local services are supporting not only Te Kūiti residents but whānau from surrounding communities who rely on the town for everyday healthcare.
The report is the latest in the Hauora Report Series by the Iwi Māori Partnership Board examining health across ten localities in the Tainui waka rohe – Taumarunui, Putāruru, Tokoroa, Paeroa, Thames, Te Kūiti, Ōtorohanga, Te Awamutu, Raahui Pookeka and Ngaaruawaahia, and Kirikiriroa.
While every community has its own story, the Te Kūiti report identifies a unique challenge – a comparatively young Māori population combined with the responsibility of delivering healthcare across a much wider rural catchment.
Te Tiratū Board member and Chief Executive of Te Nehenehenui, Sam Mikaere said the report demonstrates why rural communities require different solutions than larger urban centres.
“Te Kūiti isn’t simply providing healthcare for one town. It is a rural service hub carrying the health needs of communities across the wider district. That means pressure on local services is constant, and when capacity is stretched, the effects are felt far beyond Te Kūiti itself.”
Almost 47 percent of Te Kūiti’s population is Māori, with nearly half of residents under the age of 30. At the same time, local providers are managing increasing demand from surrounding communities for GP services, maternity care, dental care and chronic disease management.
Unlike reports that focus solely on health statistics, the Te Kūiti Hauora Report combines the lived experiences of whānau with local health data revealing how transport, cost, workforce shortages, childcare and the availability of appointments influence whether people can access care early or delay treatment until conditions worsen.
The findings Mikaere said point to a straightforward conclusion.
“Te Kūiti doesn’t need the health system redesigned. It needs sustained investment in the local services already carrying the load. When whānau can access care close to home, they stay healthier, avoid unnecessary hospital admissions and the whole system performs better.”
The report found that many whānau experience difficulty enrolling with a GP or securing appointments when they need them. Travel to Hamilton often becomes the alternative, adding cost, time and disruption for families already balancing household expenses.
Providers are also managing sustained demand from long-term conditions including diabetes, asthma, cardiovascular disease and mental health concerns, while high levels of deprivation continue to shape everyday health outcomes.
Rather than proposing new structures, the Te Kūiti Hauora Report calls for practical investment in the services already supporting whānau, including:
• Greater access to primary care and GP services.
• Stable local maternity services.
• Expanded dental care.
• More specialist outreach clinics.
• Better transport connections for rural communities.
• Stronger kaupapa Māori services and whānau navigation.
The report also calls for Ngāti Maniapoto to be genuine partners in designing and leading health services, recognising that locally informed solutions produce better outcomes for whānau.
“Decisions about rural healthcare must reflect how rural communities actually live. The evidence shows that when services are local, accessible and designed with communities, people receive care earlier and health outcomes improve,” he said.
All the Hauora Reports combine population health data with insights from the Whānau Voice engagement programme run by Te Tiratū Iwi Māori Partnership Board out in the community to inform future health planning and investment.
Each edition in the series reflects the unique health challenges, strengths and aspirations of its community, recognising that no two localities experience healthcare in the same way.
Waikato Hospital ED death prompts iwi call for urgent action
In an interview with the NZ Herald, Te Tiratū Iwi Māori Partnership Board has called for urgent, system-wide action following the death of a patient at Waikato Hospital’s emergency department after a reported nine-hour wait.
The patient was found unresponsive in a waiting room toilet and could not be revived.
Te Tiratū says the incident reflects escalating, hospital-wide pressures rather than an isolated failure, including “access block,” staff shortages, and lack of inpatient beds causing flow breakdown across the system.
Board member Dr Mataroria Lyndon said the tragedy has deeply affected whānau, witnesses, and staff, and highlighted moral injury among clinicians working under sustained pressure.
Co-chair Glen Tupuhi said the review must go beyond the single incident to address wider system failures, including ED congestion, ambulance delays, and hospital capacity issues.
Health New Zealand has launched both an immediate clinical review and a full Serious Adverse Event Review.
Partnership reset under Pae Ora reforms between IMPBs & Ministerial Committee
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FOR IMMEDIATE RELEASE
Friday 3 July 2026, 10:00AM
2 minutes to Read
Photo, left to right: Hauora Māori Advisory Committee Chair Tā Mark Solomon, Amohaere Houkamau and Te Ururoa Flavell.
Iwi Māori Partnership Boards (IMPBs) and the Hauora Māori Advisory Committee (HMAC) have agreed to reset their working relationship following changes to the Pae Ora legislation, with IMPBs pushing for system responsiveness to whānau voice to become a formal, monitored measure.
The move follows a shared frustration. IMPBs say they are generating strong evidence and community health plans, but that this isn’t consistently translating into system decisions.
“Whānau Voice is our core asset. We are capturing it, codifying it and presenting it clearly through our community health plans and engagement systems, but too often it is not reflected back in system decisions,” IMPB representatives said.
One account by a kaumātua from Te Wai Pounamu on long-term travel for dialysis captured the human cost of the gap between evidence and action. “The treatment won’t kill me, but the travel will,” he said pointing to the cumulative burden of distance and cost on whānau in remote communities.
IMPBs said in some areas whānau cannot be confident they will be born or die on their own whenua, due to service access gaps. Boards across all regions raised consistent barriers: access to services, rurality, workforce shortages, and travel costs.
They also flagged contracting uncertainty as urgent, delays in signed agreements, no assurance for the new financial year, and repeated cancellations of engagement processes and called for longer, more stable multi-year contracts for Hauora Māori providers.
Data sovereignty was another flashpoint, with boards investing in their own data systems and demanding clearer governance and ownership of Māori data. IMPBs also warned that the system’s shift toward deprivation-based measures risks making Māori health inequities less visible.
HMAC, whose influence runs through direct engagement with the Health Minister and the Health New Zealand Board, acknowledged the gap and conceded it needs to sharpen how it packages advice for decision-makers and close the loop back to IMPBs.
Photo: Elijah Pue, Tumu Whakarae of Te Mātuku Iwi-Māori Partnership Board, a Whanganui rohe iwi-Māori Partnership Board.
“We have heard clearly that there is strong alignment across IMPBs, but we also recognise we need to be sharper in how we translate that into advice that lands, and how we report back on what happens as a result,” HMAC members said.
Both parties agreed to make system responsiveness to whānau voice a formal monitoring focus. Four models for structuring the relationship were discussed, a kawenata (formal covenant), a board-to-board mechanism, a regional reflection-based approach, and regionally tailored arrangements, with HMAC to engage regionally on which model boards prefer rather than imposing one.
A practical first step was agreed. That HMAC will spend a dedicated day in each region, combining collective and one-on-one sessions with individual boards, backed by a planned engagement calendar.
Three enablers were identified as necessary: a national secretariat and policy function (funding and governance still to be settled), strategic national hui timed to influence decisions particularly budget cycles, rather than serve as updates, and a predictable reporting cadence with advance notice to IMPBs ahead of HMAC’s engagements with the Minister.
“We are on the same side of this mahi,” IMPB representatives said. “The measure of success over the next 12 months will be whether Whānau Voice is clearly reflected in decisions and whether the system responds in ways that can be seen and felt in communities.”
Photo, left to right: Te Tiratū Iwi Māori Partnership Board member Dr Mataroria Lyndon, Hauora Māori Advisory Committee Chair Tā Mark Solomon, Te Tiratū Iwi Māori Partnership Board Tumu Whakarae Brandi Hudson, and Te Tiratū Iwi Māori Partnership Board Co-chair Glen Tupuhi.
A death in the ED waiting room is a system failure, not one bad day
A person died in a toilet in the waiting room of Waikato Hospital’s emergency department this week, after reportedly waiting nine hours to be seen. Staff performed CPR in front of a packed waiting room, full of whānau and tamariki. The patient could not be revived.
Three factors typically drive it. Patients wait too long for assessment and a definitive management decision by a senior clinician. Those who require admission remain in the emergency department because no inpatient beds are available. Delays in diagnostics, such as CT scans, slow diagnosis and treatment, create further bottlenecks throughout the hospital.
The consequences ripple well beyond the waiting room. Ambulances queue outside because they cannot hand patients over. Emergency clinicians cannot move patients into treatment spaces. Hospital wards remain full because people who are medically ready cannot be discharged while community and aged-care services are stretched. Pressure builds across every part of the system, from primary care through to hospital discharge. Simply adding more emergency department staff cannot solve a problem when there is nowhere for patients to go.
For whānau Māori, these system pressures compound barriers that already exist. Waikato Hospital serves a vast region extending far beyond Hamilton, where rural communities often face longer travel times, fewer primary care services and more limited access to urgent healthcare. Combined with the wider determinants of health, including poor housing and socioeconomic disadvantage, many whānau become seriously unwell before they even reach the hospital.
Understanding these realities does not excuse what happened this week. It helps explain why the burden of an overstretched system falls disproportionately on those who already experience the greatest inequities.
Two reviews are now under way: a rapid review and a serious adverse event review. Those processes must establish exactly what happened clinically, and that work should proceed without prejudice.
But our responsibility cannot end when those reports are released.
Te Tiratū will continue to scrutinise emergency department performance and the wider health system that sits behind it. We will continue advocating for meaningful implementation of the recommendations that emerge, for Waikato Hospital and for a health system under strain across the country.
The evidence for the solutions already exists, even if implementing them requires sustained investment and political commitment.
We need stronger primary and community healthcare, including Māori health providers delivering care closer to where whānau live. We need workforce planning that ensures graduates from the new Waikato medical school progress into specialist training and remain in our region. We need hospital infrastructure that provides safe clinical spaces rather than relying on corridors and waiting rooms. We also need better information sharing across primary care, community providers and hospitals so patients are not forced to repeat their story every time they encounter another part of the system.
To whānau who may now feel anxious about seeking care, please do not let this tragedy stop you from accessing health services when you need them. Delaying care carries risks of its own. If your condition is not an emergency, your GP, community pharmacy, telehealth services and Māori health providers remain important options. If it is an emergency, please still come to hospital.
As winter deepens, we can all help reduce pressure on the health system by getting influenza and Covid-19 vaccinations, keeping childhood immunisations up to date to protect against serious vaccine-preventable illnesses such as whooping cough and pneumococcal disease, staying home when unwell, and checking in on kaumātua and those living with chronic health conditions.
A whānau has lost someone they loved. We owe them, and the staff who tried to save them, more than sympathy. We owe them a health system that learns from this tragedy and is better because of it.
Dr Mataroria Lyndon (Ngāti Hine, Ngāti Wai, Ngāti Whātua, Waikato) is a member of the Te Tiratū Iwi Māori Partnership Board, director of population health and equity at Tend Health, and senior lecturer at the University of Auckland’s Centre for Medical and Health Sciences Education.
Māori health leaders respond after person dies waiting in Waikato Hospital
A Whakaata Māori News report has highlighted renewed concern about pressure on Waikato Hospital’s emergency department following the death of a patient after a reported nine-hour wait for care.
Lady Tūreiti Moxon, managing director of Te Kohao Health, said the impact of the tragedy would extend well beyond the hospital, affecting the patient’s whānau, hospital staff, and others who were present. She said long emergency department delays have become distressingly common.
Te Tiratū Iwi Māori Partnership Board, also expressed condolences and emphasised that no whānau should endure the trauma of losing a loved one while waiting for emergency care.
Board member and Hauraki PHO chair Glen Tupuhi said the focus must be on understanding systemic failure and preventing recurrence, noting that Māori experience disproportionate harm within the health system, including for rurally based whānau who face added barriers such as travel and long wait times.