There’s no doubt the major health shake-up announced on Wednesday will transform the sector for those working within it. But with so little detail on what the Māori Health Authority will look like, it’s difficult to know whether those most in need of medical care will be the ones feeling the change, writes political editor Jo Moir.

It was a powerful delivery from Associate Minister for Māori health, Peeni Henare, who announced the new Māori Health Authority to hundreds gathered at Parliament on Wednesday.

“We talk a lot about being a transformational Government. Some imagine this statement means big infrastructure builds, massive policy commitments all leading up to a single grand reveal.

“But this is what I see as transformation….Māori feeling comfortable and able to go to the doctor when they get sick…our nannies would stop refusing to get their sore foot checked even though it’s been bothering them for a month.

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“Mum wouldn’t have to ration out her boy’s antibiotics cause her GP is an expensive hour drive away, thousands of whanau would no longer get their diagnosis too late – too late to make a difference, too late to save a life.

“We would no longer hang in there, wait it out, or tell ourselves ‘I’ll see how I feel in the morning’ only to see the morning never come,’’ Henare said.

It paints a picture of a health system never before seen in New Zealand despite decades of statistics showing it is Māori who are most in need of better healthcare delivery.

The Māori Health Authority is this Government’s answer to what has been a weeping sore in a long list of negative statistics in which Māori are overwhelmingly represented.

Yet, when pressed on what the authority would deliver and how, what it might cost, or whether there will be targets attached, the response was obfuscation and bureaucratic speak.

Henare answered multiple media questions about whether there should be Māori health targets with, “we want to see a Māori Health Authority that has the right function, form and design’’.

He eventually got there, saying there would “most definitely’’ be specific Māori targets, but when later asked to expand on that he refused to confirm targets would be set, referring back to it being about the “function and form’’ the authority takes.

On how much money would be allocated to the authority and whether it would receive a slice of the health pie equal to the Māori population, both Little and Henare refused to be drawn.

Little said: “The funding itself is yet to be worked out’’, while Henare dismissed the question saying, “I’m not going to get caught up on a quantum’’.

It gives no sense of whether the new authority will actually have the cash and resource to make the considerable difference the Government is insisting will take place.

And with no commitment to specific targets yet, it raises questions about whether ministers are avoiding measuring the authority’s success for fear of it being too transparent.

Just how much the Government wants to improve Māori health inequities would have been a target better worked out before the new authority was announced.

Instead the cart has been put before the horse.

Henare says the next eight to 12 weeks will be spent engaging with Māori leaders and whānau about what shape the authority should take.

Convincing Māori the health system that has failed their whānau for generations has turned a corner, when there is so little detail to support that claim, is an unfortunate starting point for the people tasked with selling it.

A new health agency

District Health Boards will be scrapped under the new reforms and replaced with one single national entity, Health NZ.

Little is right when he says the country simply doesn’t need 20 different sets of decision-makers.

“DHBs cherish their independence and that has made coordination and cohesion difficult’’.

The current system will continue until June next year when all of those roles will come to an end, Little said.

What’s known is that a restructure of this size will mean a number of jobs will be gone, while some staff will apply for new positions created under the reforms.

Roles for DHB chief executives and board members will cease to exist, but what the changes will mean for some of the country’s most vulnerable still remains unclear.

Little said the “proof of the pudding will be in the eating – we’ve still got to get there’’.

Having met with kaupapa service providers to brief them on the reforms, Little said “there’s a sense they see an opportunity, and it’s incumbent on all of us to turn that into something meaningful’’.

For Little and Henare, there’s still a lot of work ahead.

Jo Moir is Newsroom's political editor.

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