#MediaRelease

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.

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.”

Te Tiratū Iwi Māori Partnership Board is calling on health regulators to immediately reject any proposal to remove cultural requirements from the regulation of healthcare professionals, saying such a move would be “irresponsible, inequitable, and dangerous.”

It is responding to the current Ministry of Health online survey Putting Patients First: Modernising health workforce regulation that closes just before midnight. One of the survey questions tests whether regulators should focus on factors beyond clinical safety — such as mandating cultural requirements.

Te Tiratū, which represents 114,000 whānau Māori of the Tainui waka rohe, has submitted a formal response opposing the proposal to remove cultural requirements from regulation.

The submission, Response to Proposal to Remove Cultural Requirements from Regulation was prepared by Board member Dr Mataroria Lyndon (MBChB, MPH, PhD), a Senior Lecturer in Medical Education at the University of Auckland, where he trains health professionals in cultural safety.

Dr Lyndon emphasises that cultural safety is not an optional extra — “You cannot have clinically safe care without culturally safe care. Cultural safety is not a parallel concern to clinical standards; it is foundational to them,” he said.

“Removing cultural requirements from regulation can compromise quality of care, deepen inequities, and breach our rights as tangata whenua under Te Tiriti o Waitangi.

“When patients don’t feel culturally safe, they may not share pertinent health information, and as a result diagnosis, treatment, and trust can all suffer. Cultural safety isn’t just about respecting cultural values — it’s about improving health outcomes, clinical quality, and patient wellbeing.”

Te Tiratū fully backs this position. Without cultural safety, patients may not feel comfortable disclosing vital information or engaging with treatment plans — all of which undermines clinical outcomes.

Cultural safety empowers patients — not providers — to define what ‘safety’ means in their care. Without it, patients, especially Māori and other marginalised communities such as takatāpui (LGBTQI+) and tāngata whaikaha (disabled) whānau, face disengagement, reduced access to services, and poorer health outcomes.

The Council for Medical Colleges’ Cultural Safety Training Plan, developed in partnership with Te ORA (Te Ohu Rata o Aotearoa Māori Medical Practitioners), outlines how cultural safety must be embedded across training, clinical practice, governance, and at a systems level.

Its principles are widely recognised by national health bodies, including the Australian Medical Council and Royal Australasian College of Physicians, which link cultural safety directly to clinical and patient safety.

“Culturally unsafe care is unsafe clinical care,” said Dr Lyndon. “To remove these requirements would not only wind back decades of progress toward health equity — it would expose our communities to poorer quality care.”

Research shows that cultural safety is an important pathway to health equity, supporting respectful and accountable engagement between practitioners and communities.

It enables clinicians to work more effectively with Māori whānau by recognising and countering bias, racism, and harmful stereotypes — all of which contribute to more positive patient experiences in the health system.

In September 2024, as part of its legislated functions under the Pae Ora (Healthy Futures) Act 2022, Te Tiratū delivered its Priorities Report to the government, which emphasised the importance of culturally responsive care.[1]

In a separate Community Health Plan also handed to the Deputy Chief Executive of Te Manawa Taki region and senior officials, Te Tiratū reinforced the need for high-quality, community-led, culturally safe healthcare across the Te Tiratū rohe. [2]

Even the government’s own Te Pae Tata Interim New Zealand Health Plan reaffirms the importance of cultural safety training for the Te Whatu Ora workforce.[3]

“These are not new ideas — they are community-driven imperatives and government-endorsed priorities,” said Dr Lyndon. “Contemplating removing cultural requirements from professional regulation flies in the face of both.”

“It’s about ensuring our patients, whānau, and communities are seen, heard, and treated with dignity. Cultural safety is a critical lever to transform the system and structures that continue to disadvantage Māori who on average die between seven and nine years earlier than the general population.”

He points to the recommendations in the groundbreaking 2019 Hauora Report from the WAI 2575 Health Services and Outcomes Kaupapa Inquiry, which affirms the Crown’s binding obligation to ensure Māori have access to culturally appropriate healthcare.

“We are urging all regulators to uphold their obligations to Māori under Te Tiriti o Waitangi and to Aotearoa’s wider commitment to equitable, patient-centred care.”

“This is not the time to retreat — it’s time to double down on cultural safety, for the benefit of all.”

Sources:

[1] Pg23 https://tetiratu.co.nz/wp-content/uploads/2024/10/Te-Tiratu_Hauora-Maori-Priorities-Summary-Report_FINAL.pdf

[2] Pg 6,8,11 https://tetiratu.co.nz/wp-content/uploads/2025/02/Te-Tiratu-IMPB_Community-Health-Plan_FINAL-updated.pdf

[3] Pg15 https://www.tewhatuora.govt.nz/publications/te-pae-tata-interim-new-zealand-health-plan-2022

Today marks a pivotal milestone for Māori health in the Waikato as the Te Tiratū Iwi Māori Partnership Board (IMPB) holds its first-ever forum with specific regional health providers both mainstream and Māori.

It has brought together those specifically focussed in the area of primary care and cancer to align with current reporting topics that Te Tiratū is canvassing in the community.

The hui is a vital step in realising the aspirations of the Pae Ora (Healthy Futures) Act, which mandates IMPBs to bring the voices of whānau directly into the heart of Te Whatu Ora Health New Zealand planning and decision-making.

At the heart of the discussions are insights gathered through the Whānau Voice initiative — a culturally grounded approach led by Te Tiratū kaimahi using surveys, hui, kanohi ki te kanohi kōrero, and existing research and data.

This powerful community feedback tool paints a sobering picture of the current health landscape for Māori in Waikato.

Key Challenges Raised by Whānau Voice:

 Access & Availability

• • Long wait times for appointments.
  • Shortage of Māori-led, tamariki-focused, and mental health services.
  • Disrupted continuity in GP care and low trust in the system.
• Health Navigation
  • Strong call for more health and whānau navigators.
  • Confusion around available services and support pathways.
  • Lack of follow-up and poor communication post-diagnosis.
• Cancer Journeys
  • Late diagnoses, particularly lung and prostate cancers.
  • Emotional and financial strain on kaumātua caregivers.
  • Gaps in transport, spiritual care, and access to rongoā Māori.
• System Gaps
  • Fragmented care and poor integration between hospitals, PHOs, and services.
  • Limited awareness of entitlements like travel support and Cancer Society aid.

“These stories are a clear call to action,” says Brandi Hudson, Te Tumu Whakarae of Te Tiratū.

“Whānau are asking for a system that listens, responds, and restores trust. Today’s forum is a first step in reshaping that system together with these providers who understand the lived realities of our people.”

“It’s only the start as we intend to proactively meet with many diverse stakeholders in the system operating in our regional area – Māori providers, mainstream providers, NGOs – to zero in on specific areas of interest we’re monitoring.”

Demographic Realities Driving the Urgency:

The Te Tiratū region has a youthful and growing Māori population, projected to rise from 25% in 2023 to 29% by 2043. Nearly half (48%) of Māori are under 25, demanding proactive and youth-focused planning.

At the same time, the Māori population aged 65+ is set to grow by 40% by 2043, increasing the need for age-friendly, culturally safe services for kaumātua and kuia — who already face greater financial barriers to care than their non-Māori counterparts.

Health Priorities Set by Te Tiratū IMPB:

As part of its Community Health Plan, Te Tiratū has tabled three immediate priorities with Te Whatu Ora:

1. Pepe and Māmā – First 100 Days
   • Māori infants face 1.5x higher rates of avoidable hospital admissions and are almost twice as likely to die as non-Māori infants.
2. Hauora Hinengaro – Mental Wellbeing
   • Psychological distress among Māori adults is climbing (from 11% to 18%), with 18% of the region’s 47,000 mental health-related GP visits involving Māori.
3. Ngā Kaumātua me Ngā Kuia – Elders’ Health Equity
   • While older Māori may delay care less frequently, they report more hardship accessing services than non-Māori peers.

Today’s forum is the first of many to come facilitated by Te Tiratū IMPB uniting health system stakeholders to explore and respond to the latest Whānau Voice insights.

“Whānau Voice is not just a report — it’s a relationship,” says Hudson.

“The insights shared come from trust built kanohi ki te kanohi. That’s what our health system needs more of: trust, connection, and commitment to Māori solutions.”