The health and disability system is committed to fulfilling the special relationship between Māori and the Crown under Te Tiriti o Waitangi.
The Ministry of Health’s Te Tiriti o Waitangi (Te Tiriti) Framework provides an updated expression of the Crown’s Te Tiriti obligations in the context of the health and disability system.
As a department of the public service, the Ministry of Health has a responsibility to contribute to the Crown meeting its obligations under Te Tiriti. This statement confirms our commitment and provides high-level direction for how we will go about delivering on it.[1]
Meeting our obligations under Te Tiriti is necessary if we are to realise the overall aims of He Korowai Oranga: Māori Health Strategy and achieve outcomes for the health and disability system as a whole. This includes a desire to see all New Zealanders living longer, healthier and more independent lives. These Tiriti obligations underpin Whakamaua: Māori Health Action Plan 2020–2025 which sets the government’s direction for Māori health advancement over the next five years.
Our expression of Te Tiriti
The text of Te Tiriti, including the preamble and the three articles, along with the Ritenga Māori declaration,[2] are the enduring foundation of our approach. Based on these foundations, we will strive to achieve the following four goals, each expressed in terms of mana.[3]
- Mana whakahaere: effective and appropriate stewardship or kaitiakitanga over the health and disability system. This goes beyond the management of assets or resources.
- Mana motuhake: Enabling the right for Māori to be Māori (Māori self-determination); to exercise their authority over their lives, and to live on Māori terms and according to Māori philosophies, values and practices including tikanga Māori.
- Mana tangata: Achieving equity in health and disability outcomes for Māori across the life course and contributing to Māori wellness.
- Mana Māori: Enabling Ritenga Māori (Māori customary rituals) which are framed by te ao Māori (the Māori world), enacted through tikanga Māori (Māori philosophy & customary practices) and encapsulated within mātauranga Māori (Māori knowledge).
Our approach to achieving these goals
The principles of Te Tiriti o Waitangi, as articulated by the Courts and the Waitangi Tribunal, provide the framework for how we will meet our obligations under Te Tiriti in our day-to-day work. The 2019 Hauora report recommends the following principles for the primary health care system.[4] These principles are applicable to wider health and disability system. The principles that apply to our work are as follows.
- Tino rangatiratanga: The guarantee of tino rangatiratanga, which provides for Māori self-determination and mana motuhake in the design, delivery, and monitoring of health and disability services.
- Equity: The principle of equity, which requires the Crown to commit to achieving equitable health outcomes for Māori.
- Active protection: 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.
- Options: The principle of options, which requires the Crown to provide for and properly resource kaupapa Māori health and disability services. Furthermore, the Crown is obliged to ensure that all health and disability services are provided in a culturally appropriate way that recognises and supports the expression of hauora Māori models of care.
- Partnership: The principle of partnership, which requires the Crown and Māori to work in partnership in the governance, design, delivery, and monitoring of health and disability services. Māori must be co-designers, with the Crown, of the primary health system for Māori.
[1] Further detail can be found in the Cabinet Office circular CO (19) 5 Te Tiriti o Waitangi/Treaty of Waitangi Guidance 22 October 2019.
[2] Often referred to as the ‘fourth article’ or the ‘verbal article’.
[3] Mana is a uniquely Māori concept that is complex and covers multiple dimensions.
[4] Waitangi Tribunal. 2019. Hauora: Report on Stage One of the Health Services and Outcomes Kaupapa Inquiry. Wellington. Waitangi Tribunal. pp. 163–164