Iwi Governance

Partnerships between iwi and Lakes.

Why we have Iwi Governance

Lakes DHB has had formal relationships with Te Arawa and Ngāti Tūwharetoa since 2002.

The basis for the relationships is:

• Provide leadership, direction, and advice to the Lakes DHB, Board committees, chief executive and management on all strategic matters affecting the health of Māori.
• To participate at a governance level (Board and Board committees) in agreeing the principles that underpin decision making processes that impact on the health and disability services for Māori within the Lakes DHB district.
• To be the vehicle for ensuring effective consultation, and participation of whānau, hapū and Iwi (Te Arawa and Ngāti Tūwharetoa).
• To participate in strategic development and planning to support the wellbeing of Te Arawa and Tūwharetoa and providing information and advice with the ability to influence and direct health service delivery.

Iwi governance representatives now participate in the Board and the Finance and Audit Committee (FAC) and continue to participate in the Hospital Advisory Committee (HAC), Community and Public Health Advisory Committee (CPHAC) and Disability Support Advisory Committee (DSAC).

Executive Governance – Te Kāhui Oranga

Te Kāhui Oranga is a combined leadership/executive group of Lakes DHB Board and Iwi governance representatives from Te Arawa and Ngāti Tūwharetoa.

Te Kāhui Oranga aims to provide leadership, direction and advice to Lakes DHB, Board committees, the chief executive and management on all strategic matters
affecting the health of Māori.

Te Kāhui Oranga ensures participation at a governance level by agreeing the
principles that underpin the decision making processes that impact on the health and disability services for Māori within the Lakes DHB district.

Te Tiriti o Waitangi

Tihei Mauri Ora – The Breath of Life signifies the direction for Māori health, Lakes DHB.

Lakes DHB is committed to Te Tiriti o Waitangi (The Treaty of Waitangi) and the principles and articles of partnership, participation and protection.

Lakes DHB’s implementation of the Treaty principles and articles is through a shared understanding that health is a taonga (treasure).

Giving proper and full effect to the Treaty goes beyond the traditional ‘three Ps’ principles of Protection, Partnership and Participation.

The Waitangi Tribunal recommends adoption of the following principles:

• The guarantee of tino rangatiratanga, which provides for Māori self-determination and mana motuhake in the design, delivery, and monitoring of primary health care.
• The principle of equity, which requires the Crown to commit to achieving equitable health outcomes for Māori.
• The principle of active protection, which requires the Crown to act, to the fullest extent practicable, to achieve equitable health outcomes for Māori. This includes ensuring that it, its agents, and its Treaty partner are well informed on the extent, and nature, of both Māori health outcomes and efforts to achieve Māori health equity.
• The principle of options, which requires the Crown to provide for and properly resource kaupapa Māori primary health services. Furthermore, the Crown is obliged to ensure that all primary health care services are provided in a culturally appropriate way that recognise and support the expression of hauora Māori
models of care.
• The principle of partnership, which requires the Crown and Māori to work in partnership in the governance, design, delivery, and monitoring of primary health services. Māori must be co-designers, with the Crown, of the primary health system for Māori.

Te Arawa and Ngāti Tūwharetoa are currently developing their Iwi Strategy – TRHOTA, and Action Plan Te Kapua Whakapipi, Ngāti Tūwharetoa.

These key lead documents will provide the platform and direction for Lakes DHB
ensuring that we work together to achieve the aspirations and visions of the Iwi.

Improving equity for Māori

The World Health Organization defines equity as “The absence of avoidable, unfair, or remediable differences among groups of people, whether those groups are defined socially, economically, demographically or geographically or by other means of stratification.

“Health equity” or “equity in health” implies that ideally everyone should have a fair opportunity to attain their full health potential and that no one should be disadvantaged from achieving this potential.”

“In Aotearoa New Zealand, people have differences in health that are not only avoidable but unfair and unjust. Equity recognises different people with different levels of advantage require different approaches and resources to get equitable health outcomes.”

Lakes DHB is continuing the process of redesigning the Māori health service model in partnership with Ngāti Tūwharetoa and Te Arawa Iwi.

Part of this redesign centres on the acknowledgement that tikanga, kawa and
Māori values are the key to improved Māori health outcomes. The model is a  partnership model based on shared values that will see us working closely with Te Arawa Whānau Ora and Tūwharetoa Health Whanau Ora.

There is a strong focus in Te Manawa Taki, working with joint Iwi and chairs to increase impact and decrease inequity for Māori.

Each DHB has a senior executive member in the equity leadership team with a focus on delivering the following aims:

• Prioritise a Te Ao Māori world view and whānau voice.
• Measure achievement (or not) of Māori Health equity using clear and evident data.
• Develop and apply a Hauora Commissioning Framework to commission health services using the optimal
mix of cultural and clinical specificity.
• Agree, implement and monitor equitable funding strategies.
• Collaborate on the development and implementation of wellbeing plans for priority Māori health equity
areas of mental health, child health, cancer and cardiology.
• Ensure the workforce reflects the needs and aspirations of Māori communities.
• Build Māori capacity to meet whānau Māori health needs and the regional Māori population.
• Build Māori provider capacity and capability to meet whānau Māori health needs.