Hon Tariana Turia

Minister for Whanau Ora

Friday 8 March 2013; 12.00pm

Whānau Ora : Patient and Whānau Story

Ko Awatea Room 107; Middlemore Hospital; Auckland

Kōrero from Hon Tariana Turia

Delivered by Tania Kingi on behalf of the Minister (who was speaking at an International Women’s Day event in Palmerston North)

I want to firstly congratulate Ian Kaihe-Wetting; Te Kaahui Ora and Middlemore Hospital for their great initiative to establish a Patient and Whānau Centred Care programme.

I think the theme for the Grand Round Panel on Thursday best expressed your intentions in holding this awareness week – “from caring for someone to caring about someone: how patient experiences share our practice”.

It signals an important change from doing “to and for”; acting on behalf of another – to a comprehensive approach which is driven and determined by the people themselves.

In this way our whānau are perceived not as consumers but as creators – taking an active role in determining their destiny; demonstrating their belief that their whānau are their future.

I like the priorities that you have set yourselves in your mission to improve the experience of patients – recognising whanau as care partners; improving opportunities for patient and whanau feedback; providing greater face-to-face engagement and keeping patient and whanau informed.

These are all practical, tangible steps towards opening your doors and welcoming whānau in.

But of course it takes more than just unlocking the door and turning the handle.   It takes mental readiness – being alert to the possibilities that the unpredictable may occur; understanding that the journey our whānau take may deviate than the path we may think best for them.

It is a journey of most significance to the whānau themselves, and we must never forget that.

This is about whānau achieving the outcomes they most seek for themselves.   It is about recognising that whānau are the absolute foundation for social, economic, educational and cultural success.   Whānau by whānau, they are moving forward, driven by their own leadership.

And so we must recognise that whānau capability is the baseline for whānau wellbeing.  I sometimes think that for too long we have looked to others for our own salvation – whether it be the arms of the state, a Māori provider, a health service, a community group.

Whānau Ora views whānau as the untapped resource that we must support to build collective strength.   This is about laying the groundwork for future prosperity.   It is about fostering resilience and long-term leadership.     Essentially it works best when whānau determine their own outcomes and measure the difference made.

In a national workshop held last November over 350 Māori and Pasifika stakeholders gathered to tell us what Whānau Ora meant to them.   Consistently we heard stories around four central indicators of success: connectedness and cultural identity; self-sustainability and inter-dependence; healthy lifestyles and happy whanau; and participation.

And I want to clear up a common mis-understanding that Mr Peters and some of the press gallery like to promote – and that is that Whānau Ora should operate the way in which conventional policy programmes function – and that is by establishing a rudimentary ‘count by numbers’ approach to outcomes.

The state machinery has spent decades perfecting the art of the ‘count by numbers’ methodology.   This is the mistaken belief that simply by being able to count the number of visits taken; posters displayed; pamphlets distributed; phone-calls completed that somehow we will know a difference has been made.   Whānau Ora turns this on its head – recognising that for whanau, success is not about how many service providers walk up the garden path – but instead it’s about whānau determining their own solutions and requiring less and less of state intervention to turn their lives around.

It is about rebuilding and revitalising our sense of self – restoring our rights to ourselves, to believe that we can do this.

I don’t want to pretend that any of this is easy.   But the task we have ahead of us in Whānau Ora is also a task that we have faced before – it is a challenge that people of all cultures face; even if we express it in different ways. 

It is about the ultimate calling for our families to be inspired and enabled; to be in control of their own lives; to believe in their own potential.

Some of you may be familiar with the words of a poem written over a century ago, Letter to a Young Poet – by Rainer Maria Rilke.

'It is also good to love: because love is difficult.  For one human being to love another human being: that is perhaps the most difficult task that has been entrusted to us, the ultimate task, the final test and proof, the work for which all other work is merely preparation.'

I really like the meaning behind those words – that it does take effort and devotion to make relationships work – but the rewards are all enduring.

And I’m not the only one that thinks that way!

Since 2010, when Whānau Ora was announced, we now have a total of 34 Whānau Ora collectives representing 180 health and social services providers.   More than 3000 whanau have set plans in place to consolidate their own direction.    More than 33,000 New Zealanders have directly benefitted from a focus which is driven by outcomes.

Early results show positive signs of change for whānau are occurring through Whānau Ora. Although the lives of whānau are complex and multi-dimensional, we see ample evidence that the approach supports whānau to progress towards aspirations holistically.

In a Whānau Satisfaction Survey of 51 whānau representing some 235 individuals, the results were promising: 84% agreed/strongly agreed that they have more confidence in parenting/care-giving; 77% agreed/strongly agreed that their whanau has an improved housing situation; and 71% agreed/strongly agreed that their whanau has improved income.

I want to return to the theme of this week – patient and whānau centred care.

And I cannot help but reflect on the significance of the name of the room in which we are gathered today – room 107 – Ko Awatea.

While the number tells us where we are – it is the name that symbolises what we are hoping to achieve – the dawning of a new day. 

In so many ways the same could be said of Whānau Ora – while I could tabulate the quantitative results and speak of success related to when and where are making the difference; the real results are based in the what and the how.  It is all about whānau.

What I really like about your emphasis on patient and whānau centred care is your understanding that whānau support can directly improve patient experiences; bringing with it clear benefits to their health and wellbeing outcomes.

It is in recognising the comprehensive, holistic nature of health and wellbeing.   We have long gone past the view that good health is merely the absence of disease.   We appreciate that in many circumstances laughter is indeed the best medicine; that the spiritual, emotional, social support of whānau is intimately associated to enhancing wellbeing as inpatients or at home.

It would be remiss of me to conclude these comments without recognising today is International Women’s Day – and to acknowledge the significance of the 2013 theme, “A promise is a promise : Time for action to end violence against women”.

Whānau Ora operates on the premise that any attack on an individual is an attack on the whānau; is an attack on their whakapapa; their history; their name.

In much the same way, racism – whether personal, cultural or institutional – is about ignoring or freezing out the cultures of those who do not belong to the majority.   It is manifest in negative attitudes or actions towards another culture’s values or lifestyle.

Whānau Ora must be just as meaningful in the ability to confront sexual violence; abuse and neglect; or racist discrimination as it is in improving health outcomes or addressing homelessness or the circumstances of any family in crisis.

Healing and recovery occurs from a relationship of trust – trust in one another; trust that navigators can help provide guidance and support for whānau to establish their true direction; trust that providers and agencies are prepared to truly be whānau centred.

And it is also about the state trusting in the people – refusing to be spooked by those who seek instant results  - realising that the injustices and inequalities that have emerged over a century and more will not be suddenly or easily forgotten.

It will take time for us all  - but the important point to remember is that we are embarking on a new dawn – ko awatea – and although the transformation is neither easy nor immediate, success will be self-evident when we see for ourselves the changes we have made translating into improved outcomes.

Thank you for letting me share some thoughts with you about the value of the refocus exercise you are pursuing.    I truly believe that all your whānau will thank you for the bold sense of purpose you are pursuing.

ENDS

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