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HCA's Beginnings

Health Care Aotearoa was born out of the union health centre movement. In 1993 eight centres and a small number of Maori health providers formed a national office to provide strategic management and co-ordination of their services. They appointed two part-time advisors, Wellington GP Don Matheson and financial advisor Pat Snedden.

The organisation had three aims:

  • to share experience and knowledge in primary healthcare services and contracting;
  • to provide support and back-up for services experiencing difficulties with management contracting;
  • to canvas support for the development of a national network of community controlled primary healthcare services.

A year later, with a number of health services now supporting the network’s kaupapa, HCA held its first hui. The theme was ‘Unity and Diversity’. The hui, hosted by the Turia whanau at Whangaehu Marae, planted the seed that was to grow into a thriving organisation committed to providing quality healthcare for those hardest to reach.

Te Tiriti o Waitangi and HCA

The inaugural HCA hui recognised that providing health care for Maori required a genuine commitment to biculturalism and rangatiratanga (the ability of Maori to exercise their chiefly authority as trustees over their own taonga).

The network’s leaders – both Maori and Pakeha – developed a strong partnership between tangata whenua and tauiwi. This became a leading model in holistic, community-driven healthcare, and an inspiration for other organisations about living treaty partnerships.

HCA’s constitution has a formal commitment to Te Tiriti o Waitangi that is reflected in our decision-making processes:

  • At each AGM, members elect an executive committee, at least half of whom must be Maori, as the governing body.
  • A kaumatua kaunihera (group of elders) guides HCA in its tikanga (processes and protocol).
  • A te kaihautu co-directs HCA with a national coordinator.

Alongside its commitment to Te Tiriti o Waitangi, HCA has adopted the 1978 Alma Ata Declaration of the World Health Organisation relating to people’s rights to health care.

Te Wana Quality Programme

A focus on quality led to the launch of HCA’s quality assessment programme, Te Wana in 2000. The programme is based on sets of quality standards with a process to measure organisations against those standards. It is a systematic way for an organisation to look at what it does and how it can improve.

The values that underpin Te Wana are:

  • Te Tiriti o Waitangi
  • community governance and participation
  • collaborative teamwork
  • continuous quality improvement
  • health promotion
  • social justice

Developing the initial standards involved extensive consultation over 18 months, including a trial in six pilot sites and the training of reviewers.

The Quality Improvement Council (QIC), based at La Trobe University in Melbourne, Australia, is the accrediting body. This gives the programme international standing and credibility.

Te Wana has rapidly become widely accepted and recognised. Participating organisations vary from marae and iwi services to national lobbying groups, local health centres and community groups. Most are primary health providers, though the programme is expanding to include other types of community organisations.

I would like to know more about Te Wana.

From there to here

HCA is now a large network of community-driven and governed primary health providers. We lead the way in the primary health care sector not only among our peers but also within the wider health and governmental environments. Our members continue to inspire others with their innovative and creative programmes, concentrating on reducing inequalities in healthcare and improving the health of those hardest to reach.

In his book, ‘Pakeha and the Treaty’, published in 2006 and winner of the 2006 Montana New Zealand Book Awards’ best first work of non-fiction, our financial advisor Pat Snedden devoted a chapter to HCA’s establishment and relationship with Te Tiriti o Waitangi. You can read this chapter, ‘How a Treaty based approach can work for us all’ ( link to pdf of chapter) by kind permission of Pat and Random House.

‘Pakeha and the Treaty’ is available from all good bookstores or online at www.paperplusbooks.co.nz

Rowena Gotty, HCA’s te kaihautu has also written a history of HCA, ‘10 years of Healthcare Aotearoa 1993-2003’.