TREATY OF WAITANGI ISSUES

1. noted that:
   1. at its meeting on 9 March 2000 the Ad Hoc Ministerial Committee supported inclusion of the Treaty of Waitangi in the Public Health Services Bill (which may be entitled the Public Health and Disability Services Bill);
   2. the Health Sector Development Officials Group, in consultation with the Ministry of Justice, will provide advice to the Ad Hoc Ministerial Committee by 13 April 2000 on issues around including the Treaty of Waitangi in the Public Health Services Bill (which may be entitled the Public Health and Disability Services Bill);

ASSESSING PARTNERSHIP OPTIONS

2. agreed that partnership options be assessed against the extent to which they:
   1. continue to build Maori capacity for participating in the health and disability sector, and allow Maori communities to provide for their own health needs;
   2. encourage effective relationships between District Health Boards (DHBs) and Maori (including good information and good communication);
   3. create incentives to improve Maori health outcomes and reduce health disparities between Maori and other New Zealanders (including mainstream responsiveness to Maori);
   4. build forward from the base already established;
   5. recognise diverse Maori realities, and allow both different organisational forms in different areas according to the wishes of mana whenua and their circumstances, and change over time;
   6. encourage integration with other social and economic services. Maori health gain requires collaboration with other sectors to address wider determinants of health. Maori consumers and whanau benefit from services provided more holistically;
   7. provide significant input and support to the ongoing development of a Maori health workforce within Maori health organisations;
   8. establish clear accountabilities for achieving Maori health objectives;
   9. are cost effective;

MITIGATING RISKS TO BUILDING MAORI CAPACITY

3. noted that the proposed DHB structure entails considerable possibilities for Maori capacity building, and will ensure a strong Maori voice in the health and disability sector, by the use of regulatory tools (the DHBs' operating rules and accountability framework) and the Government and Ministry of Health's leadership role in the sector;

MAORI REPRESENTATION

4. noted that DHBs will be required to consult with their Maori communities just as they will with other populations for whom they are responsible;

5. agreed that DHBs should be able to set up Maori advisory committees or similar arrangements where needed, and be monitored around the level of consultation they undertake;

6. noted that the Health Sector Development Officials Group will report to the Ad Hoc Ministerial Committee by 13 April 2000 on options for ensuring equitable representation on DHB Boards and effective representation on DHB primary care and hospital committees;

6. directed the Health Sector Development Officials Group to include in the report on the DHB accountability regime (due with the Ad Hoc Ministerial Committee by 13 April 2000) advice on how it will:
   1. minimise incentives for DHBs to favour their own services over Maori providers where Maori provision would be more effective;
   2. strengthen incentives on DHBs to encourage Maori service development where appropriate, including:

      1. giving DHBs explicit objectives relating to Maori health gain, meeting Maori preferences, and Maori capacity building;

      2. requiring DHBs to report on their spending on Maori health, progress towards Maori health goals and targets and other agreed performance measures;

      3. maximising the transparency of DHB decisions;

   3. address risk management issues for small rural boards with high Maori populations;

FUNDING

8. directed the Health Sector Development Officials Group to advise on whether there should be a Maori health funding "ring-fence", in its report on DHB funding that is due to the Ad Hoc Ministerial Committee by 30 June 2000;

REGIONAL / NATIONAL SERVICE MANAGEMENT

9. directed the Health Sector Development Officials Group to provide further advice to the Ad Hoc Ministerial Committee as part of its report on regional and national services, on whether some Maori health and disability services or development functions should be managed at a regional or national level, by 30 April 2000;

THE PROPOSED PARTNERSHIP MODEL

10. agreed that:
    1. the starting point for an effective partnership between Maori and the Crown will be the generic partnership model described in the attached annex, which would see Maori participation throughout the sector;

    2. the Health Sector Development Officials Group undertake further work on this option and report to the Ad Hoc Ministerial Committee by 13 April 2000;

    3. the Health Sector Development Officials Group provide further advice by 13 April 2000 on the possible costs and benefits of transferring some DHB functions to Maori as proposed under the mandated or delegated options described in the paper under SPH (00) 34;

TREATY RELATIONSHIP AGREEMENTS

11. agreed that the Health Funding Authority's existing Treaty relationship agreements be continued in the new environment until replaced with more appropriate ones at the DHB level, and that where such agreements do not exist at present, DHBs develop a Treaty relationship agreement with mana whenua;

COMMUNICATIONS

12. agreed that the Government's ongoing commitment to Maori provider and workforce development is a key message to be conveyed in the communications strategy [SPH (00) M 6/6 refers].