Envisioning a Tiriti-responsive New Zealand Health Plan: lessons from district health boards' annual plans.

AIMS

Over recent decades, a body of research has established the presence of pervasive health inequities experienced by Māori. Work to identify the root causes of inequities has focused on the unequal distribution of the determinants of good health, access to healthcare, and racism. This study contributes to a small but growing field of work which engages with Te Tiriti o Waitangi to critique key health documents, focusing on district health boards' (DHBs) annual plans.

METHODS

A qualitative, directed content analytical approach was used to investigate whether DHBs' 2019/2020 annual plans were consistent with the principles of Te Tiriti o Waitangi, as identified by the Wai 2575 Waitangi Tribunal inquiry.

RESULTS

While annual plans contained actions that aligned with the principles of active protection and equity, comparatively few related to the principles of options, partnership, and tino rangatiratanga. Overall, DHB actions operated to constrain options available to Māori and efforts to exercise the Tiriti-guaranteed right of tino rangatiratanga in the provision of health services.

CONCLUSION

While DHBs' annual plans expressed commitment to Te Tiriti o Waitangi, their content did not give effect to these commitments. Significant shifts are necessary if future New Zealand Health Plans are Tiriti-responsive documents that deliver Tiriti-responsive health services.