Lyndon Hūhana; Pugh MaureenHŪHANA LYNDON (Green): Tēnā koe Mr Speaker. I'd like to take the opportunity as an uri of Te Tai Tokerau to invite the Minister of Health and his colleagues to stand on Mōkau Marae in Whangaruru and address the people of Ngāti Wai to come to Ōtīria Marae in Moerewa and address the people of Ngāti Hine and talk to us about this reform—talk to us around why Te Aka Whai Ora isn't good for our people. As we mobilised hundreds of people to attend locality meetings hundreds came to Moerewa to talk about their local health priorities; whether it's Matawaia Waikare te Rāwhiti vanloads of whānau arrived to talk about their health goals and aspirations because that's what localities provided. It's an opportunity for our local voice whānau hapū marae community local government and the sector to come together and about what is best for their communities.Let's be clear that successive Governments have breached Te Tiriti obligations through the generations by failing to protect the health and wellbeing of te Iwi Māori. In 2019 the Waitangi Tribunal report for Wai 2575 confirmed the view and states that our primary healthcare legislation and policy breaches Te Tiriti and fails to care for Māori health and wellbeing. The system has failed to look after Māori and we know this because Māori die at twice the rate of non-Māori from cardiovascular disease. Māori tamariki have a mortality rate of 1.5 times more than non-Māori children. Māori are more likely to be diagnosed and die from cancer. Nau mai ki Te Tai Tokerau. [Welcome to Northland.] Māori die on average seven years earlier than non-Māori in this country.The Waitangi Tribunal report into hauora found that the legislative framework of the New Zealand primary healthcare system should recognise and provide for the Treaty of Waitangi and its principles. The report recommended the following principles for primary healthcare: te tino rangatiratanga the guarantee of tino rangatiratanga which provides for Māori self-determination and mana motuhake in the design and delivery and monitoring of the health and disability services; equity the principle of equity which requires the Crown to commit to achieving equitable health outcomes for Māori; active protection the principle of active protection which requires the Crown to act to the fullest extent practical to achieve equitable health outcomes for Māori; options—I'm big on options; I love a bit of options. And there's a principle of options from the Waitangi Tribunal which requires the Crown to provide for and properly resource Māori health and disability services.But furthermore the Crown is obliged to ensure that health and disability services are provided in a culturally appropriate way that recognises and supports the expression of hauora Māori models of care aka mātauranga. Partnership: the principle of partnership which requires the Crown and Māori to work in partnership in governance design delivery and monitoring of health and disability services. Māori must be the co-designers with the Crown in the delivery of primary health systems for Māori. That's what Te Aka Whai Ora was doing; it was designing the health system alongside Te Whatu Ora as partners.Now let's look at Te Aka Whai Ora. They were there to ensure that the planning and delivery of services responded to the aspirations of whānau hapū iwi and Māori in general. They were there to design and deliver and arrange for services that were in accordance with the Act Te Pae Ora our pathway our road map and to achieve the best practical outcomes for whānau hapū and iwi in general. And then to promote Māori health and prevent and reduce and delay the onset of ill health for Māori including collaborative approaches with other agencies organisations individuals to address the determinants of Māori health. I hark back to localities. Bringing local government into the conversation. Hauora is everyone. We're all in this together—localities provided for that.So I question: where is the good faith of this Government in working with us as te Iwi Māori to address the well-documented evidence of Māori health inequalities? Now in the urgent hearing which is before the Waitangi Tribunal the Crown opening submissions shared on 23 February 2024: For completeness the Crown does not intend to raise the issue of whether engagement with Māori carried out by the current Minister of Health while in Opposition met a standard of consultation required under Te Tiriti and its principles. Accordingly it does not intend to adduce evidence from the Ministry of Health." So I guess the question is: did the Minister engage with te Iwi Māori while on the campaign trail in 2023 on the proposed scrapping of Te Aka Whai Ora? Because we've heard it's been promoted for quite some time. Did he engage with te Iwi Māori on his proposal? Now as the Minister of Health did he carry out any engagement with te Iwi Māori on the proposal since becoming the Minister and if he has who's it been with and when was it and what response has he received?It's been reported that Te Aka Whai Ora will lift and shift into Te Whatu Ora; so indicating that somehow it's just simply pick up the team—nearly 300 kaimahi—and put them into the mothership of Te Whatu Ora. Now I have to query the transition plan for our Te Aka Whai Ora team because you're moving an ao Māori perspective into the mainstream ecosystem of Te Whatu Ora and they may not have the capacity and competency to understand the Ao Māori world view that our team has. I question what work within Te Whatu Ora has been undertaken to uphold Te Tiriti o Waitangi and address the recommendations of the Waitangi Tribunal report 2575.In Te Whatu Ora Health Status Report 2023 Te Whatu Ora will meet the requirements and expectations of the Pae Ora Act by enabling Māori to exercise authority over health in accordance with Māori philosophies values and practices. Can the Minister confirm how Te Whatu Ora is going to enable Māori to exercise our authority over Māori health in accordance with our Māori philosophies and values and practices? He pātai miriona tāra tērā. [That's a million-dollar question.]I ask this because it's a fundamental question as to how this Government believes it knows best in terms of how to deliver health services for Māori. Te Whatu Ora is required to have capacity and capability to understand kaupapa Māori services cultural safety and responsiveness of services. Now I query the board of Te Whatu Ora. There are currently two Māori members of Te Whatu Ora. And with the ending of Te Aka Whai Ora the chair comes off that board meaning that there's only one Māori board member. So with only one Māori board member does the Minister believe that the governance of Te Whatu Ora have enough Māori capacity and capability? What is the plan to increase the clear capacity and capability gaps on the board of Te Whatu Ora?Now if we look at the scrapping of Te Aka Whai Ora and shushing out community voice and te Iwi Māori voice I reflect back on the submissions received on the Pae Ora legislation from November 2021 to August 2023—some 4685 submissions. It's an amazing thing to see the voice of our community come through the process. Now we're sitting in urgency we've blocked out community voice our people have no say on what's happening right now. The creation of the 15 iwi-Māori partnership boards is a step in the right direction and we know this—providing perspectives for whānau hapū and iwi in the design and delivery of healthcare. Now that's the mechanism for mana whenua to have a say. E te Minita I ask and seek that we power up the iwi-Māori partnership boards that we enable commissioning of services. Let's go—let's go.But I do worry about the Hauora Māori Advisory Committee because in the new legislation it's not clear what their purpose is. Are they just an advisory board for the Minister of Health on hauora Māori as requested? How are the members to be appointed to this committee? Do iwi-Māori partnership boards have a role in nominating and appointments or is it just purely a ministerial appointment process? The Hauora Māori Advisory Committee is a strong group. They're health leaders. They're professionals. Surely they could input and support the whole system: Te Whatu Ora Ministry of Health and the wider health ecosystem. Can we not power them up also?I wish to note my observations around the Director-General of Health because it appears that powers have been delegated back to that role in the new legislation to confirm iwi-Māori partnership boards. That's interesting because in my mind surely the iwi-Māori partnership boards should be approved—ASSISTANT SPEAKER (Maureen Pugh): The member's time has expired."