Rangatiratanga captures people’s right to participate in making decisions about their health and to have meaningful ways to decide how health services might be provided for their benefit.
Enabling whānau, hapū, iwi and Māori to exercise control over their own health and wellbeing, as well as the direction and shape of their own institutions, communities and development as a people, is a key thread of He Korowai Oranga.
As a key thread, rangatiratanga recognises that Māori are both a legitimate and an essential part of decision-making in the health and disability sector. There are formal ways for DHBs to incorporate this – as set out in the New Zealand Public Health and Disability Act 2000, which requires them to improve health outcomes for Māori. The Act requires DHBs to enable Māori to particpate in DHB health governance. However, other methods of participation are also important, such as influencing the way services are designed or delivered.
Māori institutions, including Māori health providers, are a key part of what makes the New Zealand health system effective. Māori health providers are generally described as Māori owned and Māori governed. While the government and DHBs put in place service and contract requirements for these providers, Māori owners and governors set the overall direction and shape of these organisations.
This next decade will see more iwi enter the post-treaty settlement phase. This provides an exciting opportunity for whānau, hapū and iwi to exercise their rangatiratanga, as well as to set the foundation for, and ultimately achieve, healthy futures for current and future generations.