A game of slides and ladders: Māori health providers and funders

Abstract

Devolution of government responsibility after the neo-liberal reforms of the 1980s, and the re-orientation of health services towards public health in the 1990s, created an opportunity for Māori to take control of their own health outcomes through the delivery of culturally relevant and appropriate services. By 2000 “By Maori, For Maori” service provision had burst forth as the preferred approach with Māori. While grappling with the tendency of government agencies to fund services based on pre-existing health output criteria, Māori service providers were “walking on egg shells” under the constant threat of losing their funding. Currentcontracting does not capture the extent of the work done by Māori providers to serve precariat families. Nor does it adequately acknowledge, validate or value indigenous approaches to health and wellbeing. Instead, narrow, administratively demanding and difficult to interpret contracts threaten the provision of culturally relevant services. This chapter talks about some of the creative and insightful ways Māori service providers manage contrasting cultural and contractual expectations.