National level
At the national level, there would be regular opportunities for the Ministers of Health and the Ministry to meet with national and regional Maori representatives to discuss national strategies, priorities and sector performance issues for Maori health. The Maori partners could be drawn from the regional and local Treaty partners as well as national organisations such as Te Ohu Rata (the Maori Medical Practitioners Association). It could be formalised into a forum, perhaps with the ability to report to and provide advice to Ministers or the Ministry. A formal organisation would give it status but would be expensive and run the risk of becoming irrelevant over time. The Ministry's informal Maori Provider Reference Group which meets two to three times a year on a structured but relatively informal basis for information sharing and discussion of policy issues is a current example of this type of forum.

Local governance level
Local Treaty partnerships would have the role of developing with DHBs' strategic priorities for improving Maori health in the DHB area, informing the DHB of local Maori expectations, aspirations and priorities, and other issues at the governance level. They would also have a role in disseminating information to the Maori community and monitoring DHBs on their performance on Maori health.

Local Treaty partnerships would normally be mana whenua (iwi) based (including organisations mandated by the local iwi). Partnering arrangements could be developed with significant non-iwi social service providers, but these could be most appropriately through the DHB advisory or technical committees or at the provider level. This approach may, however, be problematic and Ministers need further discussion on these issues.

A number of Maori Treaty partners would operate across DHB boundaries, so would be in a strong position to co-ordinate services across regions. Members of the Maori partner could be co-opted onto the Board's technical and advisory committees where appropriate.

The MAPO co-purchasing model currently operating in the northern region shares responsibility with the funder for strategic planning and purchasing services.

Another option is the regional model that Ngai Tahu Development Corporation is developing, which will span its 6 DHB areas. The Corporation envisages having a pool of board members on more than one board, so sharing around expertise (some HHS boards currently have this arrangement). The Corporation is also extending its relationships to other sectors such as employment and education, so creating opportunities for an integrated approach to Maori development.

The HFA has already established Treaty relationships with around 10 iwi organisations (see Annex 1). To maintain momentum, these should be rolled over and built on in the new environment. The existing Treaty partners are eager to take on these responsibilities.

Local operational level
The DHBs would operate memoranda of understanding with Maori capacity building organisations who would work with the DHB operational arms (including its committees) to operationalise the DHBs strategies for Maori health gain and development. They would have an explicit role in fostering the development of high quality Maori providers and encouraging collaboration and co-ordination across services both within the health and disability sector, and with other sectors. This would facilitate more holistic service delivery to whanau, hapü, iwi and Maori.

As with Treaty relationships there are currently fewer Maori Development Organisations or similar with Maori capacity building functions than there will be DHBs, so it is likely many would have agreements with more than one DHB. While this will increase transaction costs for the Maori capacity building organisations, again it would have the advantages of giving access to a range of skills that would not otherwise be available to small emerging Maori provider organisations, increasing co-ordination of Maori services across DHB boundaries and social service boundaries, creating economies of scale, and leveraging the number of skilled Maori in the sector.

At present, although some Maori Development Organisations are beginning to enrol Maori populations, they manage little service funding. Over time, the Maori capacity building organisations would be expected to assume a greater level of responsibility for a population of Maori.