Terms of reference of Te Apārangi: Māori Partnership Alliance.
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Kaupapa
Te Apārangi: Māori Partnership Alliance (Te Apārangi) will use Te Tiriti o Waitangi as the framework for providing recommendations on work and future areas of work.
To provide recommendations to the Ministry of Health (the Ministry) on the HealthCERT implementation of the updated Ngā Paerewa Health and disability services standard 2021 and the implementation of The End of Life Choice Act programme.
Whakapapa
Health and Disability Services Standard
In 2019 Te Apārangi: Māori Partnership Alliance was established to provide expert advice across the review of the 2008 Health and Disability Services Standard (the 2008 Standard) to the HealthCERT within the Quality Assurance and Safety (QAS) Group, HSII. An aim was to elevate the voice of Māori and Māori providers in the review. Te Apārangi worked in tandem with the working groups and provided the content relevant for Māori health equity. Te Apārangi’s chair held a seat on the Standards New Zealand committee.
Te Apārangi: Māori Partnership Alliance ensures the standard review and implementation follows a Te Tiriti approach The Wai 2575 Health Services and Outcomes Kaupapa Inquiry (the inquiry) commenced in 2016 to investigate issues of national significance relating to health services and outcomes for Māori. The Hauora Report (Wai 2575) principles and He Korowai Oranga will be used to underpin the Standards review process.
Te Apārangi recognises that previous reviews have been industry dominated and in setting up Te Apārangi the Ministry is seeking to ensure broader representation of viewpoints and consistent practice around review.
Te Apārangi’s terms of reference has been extended to March 2023 to support the implementation of the updated Ngā Paerewa Health and disability services standard 2021 (the 2021 standard) and the implementation of The End of Life Choice Act.
Implementation of The End of Life Choice Act
In June 2021, the EOLC Governance Group Chair and co-Chair (Clare Perry and John Whaanga) requested that Te Apārangi take an oversight role on the implementation of The End of Life Choice Act. The End of Life Choice Act Implementation Team is located within Regulatory Assurance within the QAS Group. The Assisted Dying Service will be available from 7 November 2021.
At the 2020 General Election, New Zealanders had the opportunity to vote in a referendum on whether the End of Life Choice Act 2019 (the Act) should come into force. A majority of voters supported the Act. All the Māori electorates supported the Act (ranging from 57.6% in the Waiariki electorate to 67.6% in Te Tai Tonga).
The Act gives people who experience unbearable suffering from a terminal illness the option of legally asking for medical assistance to end their lives. The Act outlines the legal framework for assisted dying and includes controls to ensure anyone who seeks assistance to end their life is making an informed decision of their own accord.
The Ministry of Health will be responsible for the Act and has developed a work programme to implement it. This will include developing policy and preparing guidance for health providers. Riana Manual, the Chair of Te Apārangi, is the Māori representative on the EOLC Governance Group.
Te Apārangi recognises that the implementation team is engaging currently with national Māori health workforce organisations, Māori and iwi led PHOs, Māori and iwi health providers and other Māori stakeholders on the assisted dying service. Ongoing engagement with a range of Māori and iwi stakeholders will occur after implementation to ensure the Ministry has adequate Māori participation in all parts of the assisted dying service including monitoring and review.
Māhi
Te Apārangi will undertake the following functions:
HealthCERT
- To work in partnership with HealthCERT to provide guidance, direction and recommendations on the implementation of the 2021 Standard
Implementation of The End of Life Choice Act programme
- Ensure Te Tiriti o Waitangi framework is used across the design/development, implementation, and monitoring of the work programmes and this should be consistent with Whakamaua:Māori action plan
- Provide representation and make guidance, direction and recommendations to work programmes governance
- Make sure work programmes are responsive to the Māori population
- Ensure the work programmes meet the needs of the Māori.
- Ensure the work programmes reflect the principals and values of a Kaupapa Māori model of care.
- Ensure the work programmes require health and disability service providers to deliver consistent outcomes for Māori across all services.
- Review and strengthen monitoring mechanisms and processes in the work programmes which impact on Māori.
Composition of the Te Apārangi
Current membership of 7-10 people to include a wide range of skills and expertise to deliver the terms of reference of this Te Apārangi:
- Riana Manuel, Te Korowai Hauora o Hauraki, Māori Home & Community Services Provider CHAIR
- Tristram Ingham, Te Ao Mārama, Ministry of Health Māori Disability Advisory Committee DEPUTY CHAIR
- Natalia Kaihau, Te Kotuku Ki Te Rangi Charitable Trust, Māori Mental Health Provider representative
- Maria Clarke, Te Puna Ora O Mataatua, Māori Home & community Services Provider representative
- Bernadette Jones, Māori health and disability researcher, University of Otago
- Leilani Maraku, Lived Experience Advisor, Mental Health and Addiction
- Dr Jason Tuhoe, General Practitioner, Papakura Marae
- Kaumātua to be appointed by Te Apārangi
Members are considered to be knowledge holders within their respective areas of work and as such will help strengthen stakeholder trust and confidence in the implementation of the updated Ngā Paerewa Health and disability services standard 2021 and the implementation of The End of Life Choice Act programme.
If the membership needs to change then Te Apārangi and will work in partnership with the Quality Assurance and Safety Group to select the new member using a nominations process.
Technical Advisors
Te Apārangi may choose to invite other individuals with special knowledge and expertise related to the priority issue to attend meetings to provide information and/or advice.
Advisors will be encouraged to participate in discussions but shall not participate in the decision-making of Te Apārangi.
Technical Advisors are considered to be knowledge holders within their respective areas of work and as such will help strengthen stakeholder trust and confidence in the review.
Te Apārangi, in partnership with Ministry representatives, will determine the technical advisors.
Quorum
Decisions will only be made by consensus where a quorum of members is present. There must be at least five members present to make a quorum. The Chair will decide if the group is split in a decision.
Meetings
Meetings will be held at least one annually. Exceptional meetings may be called as required and/or if emergent issues present.
Supporting papers will be provided by the Ministry representatives including:
- Agenda
- Previous meeting minutes
- Supporting papers.
Meeting packs will be made available to Te Apārangi not less than three days prior to scheduled meetings. Te Apārangi in partnership with the Ministry representatives will determine the membership.
The Ministry will maintain a Te Apārangi recommendations register and will report back on how Te Apārangi's advice was acted upon, with rationale as required.
Linkages and Relationships
Establishing and/or maintaining the following linkages to the Ministry, the Standards Review project team, the EOLC implementation team and governance and external relationships will help Te Apārangi members achieve the functions of this terms of reference.
- Standards Review Project Team
- Group Manager, Quality Assurance and Safety
- Manager, HealthCERT
- Principal Advisor, HealthCERT
- Principal Advisor, Quality Assurance and Safety
- Senior Advisor, HealthCERT
- EOLC Governance Group (end date is November 2021)
- Deputy Director-General, Health System Improvement and Innovation (Chair)
- Deputy Director-General, Māori Health (Co-Chair)
- Chair of Te Apārangi
- Team EOLC implementation team
- Group Manager, Quality Assurance and Safety
- Manager, Regulatory Assurance Unit
- Programme Leads
- Māori Health Equity Advisor
- Principal Advisor, Quality Assurance and Safety
- Coordinator, Regulatory Assurance
- Māori and iwi providers, Māori working in general providers (DHBs and NGOs), Māori consumers including tāngata whaikaha, tāngata whaiora, and Māori auditors (for Standards review) will be represented in all decision-making groups.
Review Process and End Date
Te Apārangi in partnership with the Ministry will review its role in March 2023. The review may lead to changes in these Terms of Reference and Group membership.