Part 2: Origin of Whānau Ora and the Initiatives

Whānau Ora: The first four years.

2.1
Whānau ora became part of government policy in November 2002, when the Ministry of Health published a strategy for Māori health.3 In the strategy, whānau ora meant, briefly, "healthy families". In their foreword to the strategy, the responsible Minister and Associate Minister said that achieving whānau ora would need an approach that recognises and builds on the strengths and assets of whānau to encourage whānau development.

2.2
In 2009, the then Minister for the Community and Voluntary Sector4 got Cabinet's agreement to set up a taskforce to address her concerns. These were that health and social services often intervene after matters went wrong for an individual,5 rather than restoring full whānau functioning or extending whānau capabilities. The Minister was also concerned that government contracting practices had led to many Māori providers competing for contracts, which fostered a piecemeal approach and inhibited collaboration and co-ordination.

2.3
In June 2009, the Government set up a taskforce to provide advice on a new way of interacting with Māori providers of community-based services to meet the social needs of Māori whānau. The taskforce of community representatives was led by Professor Sir Mason Durie. The Ministry of Social Development gave the taskforce administrative and other support.

2.4
The Government asked the taskforce to come up with an evidence-based framework to help government agencies and community-based providers work together better to improve the well-being of Māori whānau and to help whānau help themselves. The Government wanted the framework to result in improved cost-effectiveness and value for money.

2.5
The taskforce gave its report to the Government in January 2010. It was called Whānau Ora: Report of the Taskforce on Whānau-Centred Initiatives.6 In its report, the taskforce produced a framework that focuses on whānau well-being. This framework set the scene for the Government's decisions, and we refer to it throughout this report. Figure 1 summarises the taskforce's whānau ora framework.

Figure 1
Summary of the taskforce's whānau ora framework

Overarching aim The framework's overarching aim is "best outcomes for Māori".

The whānau-centred framework should achieve a balance between social, economic, cultural, and collective gains to whānau consistent with the whānau ora philosophy.

The whānau ora philosophy is distinctive because it:
  • recognises a collective entity (the whānau);
  • endorses a group capacity for self-determination;
  • has an intergenerational dynamic;
  • is built on a Māori cultural foundation;
  • asserts a positive role for whānau within society; and
  • can be applied to a wide range of social and economic sectors.
 Outcomes should be measured at the level of whānau, service providers, and the population.

In choosing measures, there should be a balance between service provider accountability, and flexibility and responsiveness.

Outcome-focused information should be collected.

Data should be timely and continuous, value should be given to quantitative and qualitative information, and there should be a research component.
Principles The principles serve as essential foundations for the framework and help guide the selection of indicators and outcome measures, and allocation of funding, for whānau-centred initiatives.

They are:
  • nga kaupapa tuku iho (which means the ways in which Māori values, beliefs, obligations, and responsibilities are available to guide whānau in their day-to-day lives);
  • best whānau outcomes;
  • whānau integrity;
  • coherent service delivery;
  • effective resourcing; and
  • competent and innovative provision.
Whānau outcome goals The results expected of whānau-centred initiatives are that whānau will be:
  1. self-managing;
  2. living healthy lifestyles;
  3. participating fully in society;
  4. confidently participating in te ao Māori;
  5. economically secure and successfully involved in wealth creation; and
  6. cohesive, resilient, and nurturing.
Whānau-centred services goals These are services that focus on whānau as a whole, build on whānau strengths, and increase their capacity.

They should be characterised by:
  • whānau-centred methodologies;
  • commitment throughout government;
  • the establishment of an independent trust with a dedicated government appropriation;
  • a primary focus on best outcomes for whānau through integrated and comprehensive delivery;
  • strong regional direction; and
  • building on existing service provider capabilities.
A whānau ora trust Establish a trust to govern whānau-centred initiatives to:
  • provide a point of contact with government and administer the whānau ora fund;
  • provide national leadership and co-ordination;
  • establish regional panels to ensure that local needs are understood and regional networks are established; and
  • use a relational model of governance and management for all activities, including contracting with service providers.

2.6
The taskforce defined whānau as a multigenerational group that is made up of many households, supported and strengthened by a wider network of relatives. This definition was not adopted for the Initiatives. Whānau and provider collectives (groups of service providers) that applied for funding through the Initiatives had their own definitions of whānau.

2.7
The taskforce defined whānau ora as a holistic approach to well-being aimed at achieving best outcomes for Māori. Because it is holistic, whānau ora includes whānau health, education, housing, income, employment, relationships, and wealth.

2.8
In the taskforce's framework, providers should work with whānau instead of focusing solely or mainly on the specific needs of one or two people within a whānau.

2.9
The taskforce considered that everyone involved – funders, government and non-government providers, and whānau – would need to change from a "deficit approach" to a "strengths-based approach" to achieve best outcomes for Māori.

2.10
Funders, providers, and whānau would also need to change the way that they work together. For a start, they should work together. The taskforce considered that providers working within a whānau ora framework should have more flexibility in how they meet whānau needs. The taskforce also considered that contracts should focus on results (that is, the improvements achieved by whānau) rather than units of activity completed by the provider, such as the number of visits made or tests completed.

2.11
Most providers deliver services to individuals. The taskforce considered that providers that change their focus to whānau might not be able to meet the full range of whānau needs from their existing mix of services. The taskforce considered that, rather than doubling up on or fragmenting services, providers should have networks or alliances to ensure smooth referrals and co-ordinated services for whānau. This applied equally to government agencies and community-based providers.

2.12
The taskforce recommended that:

  • an independent trust be formed to govern, co-ordinate, and implement whānau ora, and report to a Minister for Whānau Ora;
  • a specific whānau ora appropriation be established for the trust to manage;
  • whānau ora services be integrated and comprehensive, and focused on measureable outcomes that will help to empower whānau;
  • whānau ora services be shaped by te ao Māori (that is, by the Māori cultural context, including norms, traditions, and heritage);
  • all government agencies with responsibilities for any aspect of whānau well-being commit to the whānau ora principles and support the Whānau Ora initiatives; and
  • the trust establish regional groups to ensure that whānau ora contributes in positive and realistic ways in local communities.

3: Ministry of Health (2002), He Korowai Oranga: Maori Health Strategy. See www.health.govt.nz.

4: At the time, Honourable Dame Tariana Turia was also Associate Minister of Health and Associate Minster for Social Development and Employment.

5: This could include a health incident, child abuse, school truancy, homelessness, or criminal offending.

6: The report is available from www.msd.govt.nz. It was published in April 2010 and includes the taskforce's full terms of reference and membership.

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