Māori Health Purchasing - Some Current Issues

Mark Barrett

This paper discusses Māori health development, including some of the impacts of New Zealand’s health reforms and Treaty of Waitangi issues. The Government has recognised the applicability of Article 3 of the Treaty to health policy (which guarantees the same rights of citizenship to Māori and British subjects), but not the applicability of Article 2 (which guarantees Māori rights of ownership and chiefly authority over taonga). Which is to say, the Government has resisted changing the discourse from one about needs to one about rights to health, and, by extension, control over their own social services.

The paper also takes a wider look at health purchasing models, especially in light of the split between purchaser and provider under the New Zealand health reforms, and asks what purchasing policy is likely to lead to the best outcomes for Māori.

I argue that devolution of health purchasing to Māori offers the opportunity to meet Māori demands for greater control over their social services, while shifting purchasing decisions closer to the consumer, thereby providing the potential to develop services that are more responsive to Māori needs.