Health Minister Dr Shane Reti has come under fire for abolishing the Māori Health Authority Te Aka Whai Ora.
But Māori health remains top of mind for Reti, who is also a GP and Whangārei’s MP, with Māori health providers set to tackle key concerns like measles and rheumatic fever.
But Northland Māori health providers say they are already addressing these issues and the change undermines what they are doing. Northern Advocate reporter Denise Piper reports.
A measles outbreak in the face of low childhood vaccinations is a key concern for Health Minister Dr Shane Reti.
“The Prime Minister and I are very concerned about a measles outbreak,” said Reti, saying he was particularly concerned how a measles outbreak could impact Māori.
The concern is not unfounded. A measles outbreak in 2019, centred in Auckland and Northland, infected 2200 people, hospitalising 770, with Māori and Pasifika most impacted.
In October 2023, there was a high alert again for measles when a Northlander attending a week-long Shakespeare festival in Wellington contracted the disease.
Reti said the threat of a measles outbreak is one of the reasons why childhood immunisation is so important, with the government introducing a health target of 95 per cent of children to be fully immunised at 24 months.
Northland’s childhood vaccination rates are far lower than the national average of 81 per cent. Just 67 per cent of Northland two-year-olds were fully vaccinated in 2023 and only 59 per cent of Northland Māori.
Reti said immunisation of Māori was a particular focus, with a $50 million package announced in December 2023 to help lift vaccination of Māori and those most at-risk, including $30m going to Whānau Ora providers and $20m to Māori health providers.
Reti said he had been working directly with iwi-Māori partnership boards, including Northland’s Te Taumata Hauora o Te Kahu a Taonui - the health arm of the Te Tai Tokerau iwi chairs collective.
Quashing the Māori Health Authority is about empowering Māori health providers to focus on issues relevant to their area, as well as meeting key targets like immunisation, he said.
“Everyone’s got to do immunisation - there’s some big things like that - but actually, they might decide that rheumatic fever is what they need to focus on in Northland and we’ll collaborate with them on what those targets look like.”
Rheumatic fever, caused by an autoimmune response to untreated strep throat, is another issue of concern in Northland as it is closely linked with overcrowding.
ESR, which monitors notifiable diseases, reported there were 22 cases of rheumatic fever notified in January 2024, twice as many as the same month in 2023, and 64 per cent of these came from Northland and Auckland. The majority, 86 per cent, were of Māori or Pacific ethnicity.
Hone Sadler, chair of Te Hau Ora o Ngāpuhi (THOON), said both rheumatic fever and measles are already key points of focus for the Kaikohe-based Māori health provider.
To help address high rates of rheumatic fever, THOON is now providing warm and dry housing for its people, with 10 units opening in October 2023 and another 20 by June this year.
When complete, the site on Kaikohe’s former RSA will provide 60 social housing units and a service hub, catering for healthcare and centres for Hato Hone St John, Ministry of Social Development and IRD, Sadler said.
In the long-term, THOON is also developing a 12ha site on Bisset Rd, providing a mix of housing which will be rentals, rent-to-buy and privately owned homes.
“This is our focus; we looked at what is the most need for our people to keep them healthy and housing is the problem,” Sadler said.
Immunisation has also been a key focus for THOON since Covid-19, with health navigators being used to talk with people and help counter misinformation about vaccines.
But Sadler is concerned all this good work could be undone with the abolition of Te Aka Whai Ora and no guarantee of funding for Māori health providers.
“I would like to see a continuation of Te Aka Whai Ora - they have a formula on the plus side in terms of Māori health,” he said.
“I would like to be given assurance that our funding is not going to be cut.”
While Reti may have been talking with Te Taumata Hauora o Te Kahu a Taonui, he has not been talking with providers at a grassroots level, Sadler said.
One size does not fit all when it come to Māori health, he said.