Statement of the Public Policy Objective

1. The key policy objective of this paper is to provide options for effective partnership arrangements between Maori and the Crown in the health and disability sector (CAB (00) M 2/4 refers). Effective partnership arrangements with Maori (above and beyond partnerships with any other ethnic group in New Zealand) are inevitably grounded in the Treaty of Waitangi. They would contribute to achieving three goals:
   • Maori capacity building and participation throughout the sector
   • building forward on current gains made in Maori service delivery and policy development
   • Maori health gain and reductions in the health disparity gap between Maori and other New Zealanders.

2. The Government has signalled that key goals are to endeavour to uphold the principles of the Treaty of Waitangi and to close gaps between Maori other New Zealanders. To date there has been no clear direction from Government on the Treaty of Waitangi in relation to the health and disability sector. As a result there have been different interpretations of Treaty policies and Treaty partnerships. Despite gains made by Maori and some mainstream providers in the health and disability sector, the health disparity gap continues to widen.

Statement of Options for Achieving the Desired Objectives

Non-Regulatory Measures

3. A number of strategies are employed in the health and disability sector to achieve Maori health gain and more effective relationships with Maori, including involvement of Maori in service prioritisation and funding for Maori provider development. This paper proposes to strengthen and build on these through regulatory measures as well.

Regulatory Measures

4. Aspects of this policy will be picked up in the Public Health Services Bill, operating rules for DHBs, and accountability frameworks.

Statement of the Net Benefit of this Proposal

5. Benefits to Maori and the Government include:
   • progress towards meeting the Government's goal of upholding the principles of the Treaty of Waitangi
   • enhanced accountability to the Minister of Health on Maori health gain
   • Increased Maori participation throughout the sector at all levels of decision-making
   • further gains in Maori service delivery and policy development
   • progress towards meeting the Government's objective to support and strengthen the capacity of Maori and Pacific Island communities and better co-ordination of strategies across sectors, so that health disparities are reduced
   • reducing the health disparity gap will lead to long term social and financial benefits including lower hospital admission rates for preventable disease.

Costs

6. These include:

• compliance costs such as the establishment of partnership arrangements including election of Maori District Health Board members
• consultation is already a requirement in the sector so there will be no additional costs
• the HFA has a number of Treaty partnerships - the proposal extends these
• there will be increased transaction costs for DHBs and Maori providers through the development and implementation of strategic plans.

Consultation

7. In preparing this paper the Ministry of Health consulted with Te Puni Kökiri, the HFA, Treasury, the Ministry of Justice, the State Services Commission, CCMAU, DPMC, and a focus group of Maori health and disability sector representatives.