Te Tiriti excellence

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What we are aiming for

Ko tō mātou wawata kia tūhono katoatia nga hunga o Aotearoa i raro iho te mana o te Tiriti o Waitangi.

We want to be seen by Māori, as tangata whenua, to act in partnership – premised on the principle that all groups of people in New Zealand will honour and uphold te Tiriti together. This includes ensuring we have Māori in key roles across our work, including at Board, leadership, staff and in our advisory network. As we give effect to te Tiriti we will see diverse benefits for Māori within and from Pharmac’s work. Built on a strong whānau-centred and kaupapa Māori approach, and pursuit of mana motuhake, we are resolute as kaitiaki to maximise our contribution to Māori health outcomes across all our work. 

Where we’re currently at

Along with the wider health system, Te Pātaka Whaioranga Pharmac needs to meet obligations and responsibilities within the new Pae Ora legislative framework. We have already made a strong commitment to give effect to Te Tiriti across our work. Several improvements have been made, with significant improvement still required.

The review underscored – and we agree – that we need stronger Māori voice in our work, including better ways to incorporate mātauranga Māori. We also need stronger partnerships with Māori, including to be clearer on the partnerships that Māori want us to form and we feel we need. Our analysis, assessment and prioritisation also need to evolve to more strongly embody considerations from te ao Māori.

Our key pathway for giving effect to te Tiriti is Te Rautaki o te Whaioranga, our Māori Responsiveness Strategy. The review expressed that the strategy lacked detail, and that aspirations were not matched by action. We acknowledge this feedback and will ensure it is reflected in an updated strategy, co-developed with Māori in 2023.

Key initiatives over the last 12 months to make improvements have included:

  • Adoption of te Tiriti accountabilities for Board members
  • Appointment of the first Māori chair of PTAC, Dr Jane Thomas (Ngāti Porou, Ngāti Kahungunu)
  • Reappointment of a Māori chair of CAC, Lisa Lawrence (Ngāti Kahungunu, Ngāti Ruapani)
  • Appointment of two new Māori Board members, Dr Anthony Jordan (Ngāti Wai) and Talia Tioro Anderson-Town (Ngāti Maru (Hauraki), Ngā Wairiki, Ngāti Apa, Ngā Rauru, Ngāti Tuwharetoa, Te Atihaunui-a-Pāpārangi me Ngāti Kahungungu.), building on the important roles played by previous Māori Board members
  • Establishment and early engagement with Te Rōpū Māori, comprised of members nominated by Māori stakeholder groups
  • Completion of an initial independent te Tiriti review
  • Development of a monitoring framework for medicines access in areas of high importance to Māori
  • Adoption of new organisation values based on concepts from te ao Māori
  • Adoption of ethnicity criteria in the Special Authority for some medicines (with likely greater use of this mechanism to support access and uptake ahead)
  • Adoption of a lower age threshold for Māori and Pacific for access to influenza vaccine for 2022
  • Delivery of a campaign, devolved to and designed by a Māori organisation, to raise awareness of diabetes medicines amongst Māori and Pacific communities
  • Commencement of staff training in Critical Tiriti Analysis, along with other development initiatives to build capability to operate in te ao Māori
  • Commencement of a partnership with Tupu Toa for an annual intake of Māori internships. 

Actions and initiatives underway or commencing in 2022/23

To continue our progress, during 2022/23 we will:

  • Prioritise giving effect to the health sector principles of Pae Ora, noting their significance for giving effect to te Tiriti, ensuring involvement of and engagement with Māori, and achieving Māori health equity.
  • Prioritise an effective partnership with Te Aka Whai Ora
  • Work with Te Rōpū Māori to co-develop a partnership framework
  • Adopt our te Tiriti policy
  • Commence a review, with Māori, of Te Whaioranga, noting the desirability of bringing this forward to ensure a strategy fit for purpose under Pae Ora
  • Adopt specific Te Tiriti accountabilities for the Senior Leadership Team
  • Commence a full review of systemic bias and racism as they relate to Māori across our work (noting also the potential benefits of this work for other population groups)
  • Increase the number of Māori employed by Pharmac and appointed across our expert advice network

As noted in the priority area of enhanced assessment and decision making, we are also working to further improve how Māori health considerations are embedded into funding assessment work and the decisions we make. 

Further work and considerations for our full response in October 2022

Increasing Māori involvement in our workforce

We are giving consideration to what initiatives may best assist us to grow the number of Māori staff, including (beyond recruitment) what workforce development activities could assist longer term, such as better leveraging our existing scholarships and internship programme. 

Deepen the application of the Te Arawhiti Māori Crown Engagement Framework

Current system changes elevate the importance of integration, partnership and engagement. This is also a critical aspect in building and maintaining relationships with Māori health professionals. This will need a specific focus to ensure we are effectively meeting the expectations of Te Arawhiti’s framework. 

Integrate our work with the wider health system in exploring partnership

As in other parts of government, we are giving consideration to different forms of partnership and look forward to continuing this work. 

Identify opportunities to work with and for Māori with Disabilities and Rare Disorders 

Initial discussions with individuals and external groups about disability and rare disorders have indicated severe inequities for Māori within and across these groups. Further engagement and discussion will be needed to discern how we might best work in collaboration and partnership. 

Further extend our strategic alliance with Whānau Ora

Whānau Ora organisations, both commissioning agencies and collectives, have for some time indicated a desire to work more strategically with our organisation rather than in a transactional way. We are keen to explore this shift.