Part 5: Public organisations' support for Whānau Ora

5.1
In this Part, we discuss:

• how well public organisations are supporting Whānau Ora; and
• the need to clarify expectations for public organisations about their support of Whānau ora.

5.2
We wanted to understand what progress Te Puni Kōkiri had made on its strategic focus area for increasing investment in Whānau Ora.

5.3
We also wanted to understand what public organisations have done to provide "complementary effort" for Whānau Ora, which is what the 2013 Cabinet paper setting up the commissioning approach envisioned.

5.4
To achieve the aims of Te Puni Kōkiri, we expected that public organisations would:

• work with Whānau Ora commissioning agencies and providers to address the needs and aspirations of whānau;
• adapt their systems, processes, and practices to better support Whānau Ora; and
• understand and take action to address systemic barriers to supporting Whānau Ora.

Summary of findings

5.5
The compounding effect of the lack of clear expectations for public organisations and the barriers posed by public sector processes and practices means that limited progress has been made in increasing investment in Whānau Ora, the Government's flagship whānau-centred approach.

5.6
There has not been much change since the Whānau Ora ministerial review in 2018. Providers still struggle to access services and support for the whānau they work with. This has been detrimental to providers' ability to support whānau and the effectiveness of the Government's overall investment in Whānau Ora.

5.7
The Cabinet paper setting up the Whānau Ora commissioning approach said that public organisations should carry out a "complementary effort" to support Whānau Ora. However, what is meant by complementary effort has never been clearly defined.

Public organisations' support for Whānau Ora has been limited

5.8
Although public organisations are investing in Whānau Ora commissioning agencies, this funding typically does not directly support the design and delivery of whānau-centred approaches.

5.9
As discussed in Part 4, we consider that there are several reasons for this. They include:

• a lack of clear expectations for public organisations;
• real and perceived barriers posed by public sector processes, practices, and system-level settings; and
• the still-developing capability and willingness of staff at public organisations to engage with Māori and with whānau-centred ways of working.

Te Puni Kōkiri remains the main funder of the Whānau Ora commissioning approach

5.10
Aside from the contracts Te Puni Kōkiri had with commissioning agencies, we identified few examples of public organisations funding commissioning agencies and providers to design and implement whānau-centred services. This affects the ability of providers to support whānau to meet their needs and aspirations, and the effectiveness of the Government's overall investment in Whānau Ora.

5.11
For example, the Ministry of Education has a school attendance contract with one commissioning agency that is intended as a whānau-centred approach. The Ministry of Education told us this contract allows providers to decide what actions should be taken to address attendance. However, we were also told that the contract does not adequately cover work to address wider student experiences or challenges, nor the experiences or challenges of their whānau.

5.12
The main examples we saw of public organisations funding whānau-centred initiatives by Whānau Ora commissioning agencies and providers are Paiheretia te Muka Tāngata (see Part 4) and Ngā Tini Whetū.

5.13
Some of the iwi providers involved in piloting Paiheretia te Muka Tāngata in Northland and Hawke's Bay are Whānau Ora providers.

5.14
Ngā Tini Whetū is the first and only use of a commissioning agency contract to jointly fund a whānau-centred initiative that we are aware of.

Few public organisations and providers partner to plan and design services

5.15
Providers emphasised the importance of setting up and sustaining partnerships to design and plan services in a way that holistically addresses the aspirations and needs of whānau. This is also important for providers that are not part of Whānau Ora.

5.16
However, as with the commissioning agencies, most examples of public organisations working with Whānau Ora providers involve them funding and contracting specific services (such as the Police's implementation of Te Pae Oranga).

5.17
As discussed in Part 4, the barriers created by some public sector processes, practices, and system-level settings can significantly limit providers' relationships with public organisations and their ability to design and deliver whānau-centred services.

5.18
Providers value and rely on the connections they have with individual staff at public organisations who understand the work that they do. However, providers do not have these relationships with every public organisation, and staff turnover in public organisations makes these relationships vulnerable.

5.19
One provider told us about a significant improvement in its relationship with a public organisation after it appointed a new regional manager who was experienced in working with iwi. Another provider described being "scared" about its future relationship with a public organisation after a key contact moved to another role.

Providers struggle to access some service support for whānau

5.20
There appears to have been little change in the accessibility of services since the Whānau Ora ministerial review. Providers continue to face high demand for support from whānau, who are referred to them by their own networks in communities and by public organisations.

5.21
Some of these whānau need crisis responses or specialist services that are either the responsibility of public organisations or not adequately covered by any existing services. In particular, we heard that some whānau have serious mental health needs that are not met.

5.22
We were told that this is because existing mental health services are inadequate and because there are service gaps. As the Whānau Ora ministerial review noted, many Whānau Ora providers are not funded or fully qualified to provide crisis response services.

5.23
We saw indications that the work providers are doing to respond to crises or provide specialist support can take up much of their time. This can mean they are not able to do their work on longer-term Whānau Ora outcomes and supporting whānau to achieve their aspirations.

5.24
For example, referrals from public organisations can mean that Whānau Ora navigators spend a lot of their time doing crisis-response work rather than planning the preventative or aspiration-focused programmes and services that whānau want them to work on.

5.25
The Covid-19 pandemic has put pressure on all public organisations and community providers that remained operating during the pandemic. We heard that the Covid-19 pandemic highlighted the tension between the intended role of Whānau Ora as a strengths-based approach and public organisations' over-reliance on Whānau Ora providers to deliver acute, emergency support for whānau.

5.26
We did not sense that providers or Whānau Ora commissioning agencies were reluctant to help those whānau needing significant short-term support during the pandemic. This kind of work is consistent with the Whānau Ora Outcomes Framework, and the response to the pandemic has increased the profile of Whānau Ora. However, some are concerned that this could create a perception that the purpose of Whānau Ora is to respond to crisis instead of supporting the strengths-based, aspiration-focused work it was primarily set up to do. We share this concern.

Adverse perceptions risk undermining relationships

5.27
We heard mixed views from public organisations, providers, and Whānau Ora commissioning agencies about the extent and strength of their relationships. We also heard perceptions about the behaviours and motivations of parties that risk undermining these relationships.

5.28
We heard that public organisations' approach to developing new services sometimes fails to acknowledge the expertise and work of Whānau Ora commissioning agencies and providers.

5.29
For example, we were told that one public organisation spent considerable time drawing on a commissioning agency's knowledge and experience of supporting whānau without telling the agency that it intended to set up a similar service. We also heard about a public organisation engaging providers in a lengthy co-design process and then contracting others to deliver the service.

5.30
In both instances, the commissioning agencies perceived the public organisations' actions as competitive behaviour that undermined their relationships.

5.31
We also heard concerns about the development and implementation of the Ministry of Social Development's (the Ministry) Community Connection Service, which was established in June 2020 to support people impacted by the Covid-19 pandemic. The service established navigator-type roles called Community Connectors.

5.32
The service was developed and implemented at pace during the Covid-19 pandemic. Currently, 500 Community Connectors are based in providers throughout the country. The Ministry told us that its contracts are outcomes-based, which gives providers the flexibility to tailor their services to the needs of communities.

5.33
The Ministry told us it engaged with iwi and community partners throughout the country on its design and how it might best work in practice. However, in our interviews, we heard concerns from providers, Whānau Ora commissioning agencies, and an iwi representative that the early development phase of the Community Connector service did not involve them enough.

5.34
These differing views on the quality of the Ministry's engagement could explain why we heard mixed views in our interviews about the service itself. For example, we were told by some that the roles are an unnecessary duplication of Whānau Ora navigators, especially when they are deployed in the same areas. On the other hand, we were also told that, although there was duplication at first, the service now better complements existing Whānau Ora services.

5.35
The Ministry told us that, since mid-2022, it has been working closely with Te Puni Kōkiri to develop options to make it easier for community providers to facilitate collaboration between Community Connectors and Whānau Ora navigators. The Ministry said this includes considering how the new relational commissioning principles might apply to its contracting guidelines, standards and safety, regional engagement, monitoring, and reporting.

5.36
Further, the Ministry told us it has been working closely with Te Puni Kōkiri and other social sector public organisations to ensure that any new services or functions are complementary and do not duplicate existing initiatives. The Ministry said that this work includes a stocktake of publicly funded navigator-type roles.

5.37
Strong relationships are essential for developing high-quality, integrated, and co-ordinated services for whānau. In our view, regardless of whether public organisations partner with providers and community organisations or whether they develop a new whānau-centred service on their own, services need to complement one another.

5.38
In some instances, designing a new whānau-centred service will be the right approach. In other instances, public organisations could make greater use of the Whānau Ora commissioning infrastructure before developing alternatives.

A clearer definition of "complementary effort" is needed

5.39
Te Puni Kōkiri has a strategic focus area to increase investment in the Whānau Ora commissioning approach. The Cabinet paper that set up the commissioning approach expected public organisations to provide "complementary effort" to Whānau Ora. However, there are no corresponding expectations for other public organisations to support Te Puni Kōkiri to achieve its aim, and what the "complementary effort" entails has not been defined in detail.

5.40
The Whānau Ora Partnership Group was set up in 2014 to provide oversight of Whānau Ora. One of its tasks was to co-ordinate public organisations' "complementary effort". However, the Partnership Group stopped operating in 2017 and has not yet been permanently replaced.

5.41
As discussed in Parts 3 and 4, Te Puni Kōkiri told us that its work with Te Kawa Mataaho on advice to the Minister for Whānau Ora includes considering how to secure cross-government investment opportunities for Whānau Ora.

5.42
We consider that Te Puni Kōkiri should also seek to clarify what is meant by the "complementary effort" that public organisations are expected to provide for Whānau Ora. This will assist with clarifying how public organisations should support the aim of Te Puni Kōkiri to increase public sector investment in Whānau Ora.

5.43
It will be important for Te Puni Kōkiri to seek the views of other public organisations in developing its advice.