“It is about enabling Tino Rangatiratanga and Mana Motuhake”: An analysis of submissions on the Pae Ora (Healthy Futures) Bill 2021 endorsing a Māori health authority

Abstract

Indigenous leadership in healthcare is one way for Indigenous peoples to exercise sovereignty over their health. In Aotearoa New Zealand, the establishment of the Māori Health Authority (MHA) was grounded in a decades-long imperative to address Māori health inequities and operationalise te Tiriti o Waitangi within the health system. However, the populist National-led coalition government formed in November 2023 included the abolishment of the MHA in their first 100-day plan and eventually disestablished it in February 2024. This study analysed 155 public group submissions on the Pae Ora (Healthy Futures) Bill made in 2021 and representing health professionals, iwi, hapū, and community groups. Core themes endorsing the MHA as a statutory entity included honouring te Tiriti, advocating for Māori-led solutions to health inequities, decolonising health systems, and affirming Indigenous rights. The political decision to remove the MHA is antithetical to the explicit endorsement statements made by an overwhelming majority of group submitters with expertise in health organisational structures and healthcare provision. Our study has implications for future local and international research in documenting counter-narratives for Indigenous struggles in health systems.