Decade Long ACC Systemic Barriers Impacting Access Revealed In Homecare Waitangi Tribunal Hearing

Multiple systemic barriers within Whaikaha and the Accident Compensation System that impact whānau access to homecare from Māori providers have been revealed before the Waitangi Tribunal in the last 48 hours.

Lawyers representing Lead Claimant Lady Tureiti Moxon, Managing Director of Te Kōhao Health and Chairperson of the National Urban Māori Authority drilled down to policy detail finding numerous areas of concern.

Responses under cross-examination by senior government official witnesses in WAI 2910, the homecare claim exposed where, how and why Māori clients are prejudiced due to barriers that require urgent reform. 

“We’ve been listening to the witnesses talk about a Treaty relationship yet when you delve deeper it confirmed yet again that the Crown is not meeting its obligations arising out of the Treaty relationship,” says Lady Tureiti Moxon.

 “The set-up of the State-run system continues to perpetuate a lack of choice and control for injured or disabled Māori people and their families contradicting the Crowns public claims.” 

“Even from our experience at Te Kōhao Health we have only been sub-contracted by ACC for the last decade and never as Leader Provider, yet we serve thousands of whānau Māori in Hauraki-Waikato.”

“Despite what Crown websites say about ‘system transformation and enabling good lives’ in reality, Māori needing homecare from Māori providers they elect through their own volition cannot due to the system.”

The hearing revealed more questions than answers about data integrity after Ms Amanda Bleckmann, Deputy Chief Executive of Whakaha for Commission, Design and Delivery could not confirm the numbers.

Legal counsel, Ms Roimata Smail said, "I've gone through the list of 54 providers, 17 were Māori but I have no idea how many Māori clients they have."

It led to Judge Stone asking Whaikaha to provide current figures on how many Māori receive ACC homecare because the figure of 12% supplied in evidence could not be verified.

Out of 3,114 Māori Whaikaha says receive individual funding (IF) support - to give them more choice in how they are supported to live their lives – it could not say if any are receiving IF from a Māori provider.

Ms Bleckmann also admitted, "we do not have a consistent way to identify kaupapa Māori providers.”

The Accident Compensation Act 2001 in its current form is another barrier because rongoā is not considered a recognised treatment of providers so ACC holds the power to fund it at its discretion.

The Tribunal heard another “glaring issue” that Māori organisations are generally sub-contracted by large Pākehā service providers as this has been the only way they have been able to participate in the provision of care to Māori under ACC. 

It means they are not equal contractually or financially by comparison. 

Megan Main, Chief Executive of ACC when challenged, “the buck stops with you” about the outcome responded, “it's not an unusual model in a national tendering approach”.

When asked to comment about the calibre of Māori providers being the gold standard, Ms Main said, “I wouldn't want to make a blanket statement". 

She was reminded by legal counsel about the record in the Hauora Inquiry that included submissions by the former Director General of Health Sir Ashley Bloomfield that "recognised Māori providers as the benchmark".

While Ms Main confirmed that the ACC created the first Māori Tier Two role in 50 years. It also changed the centralised structure of a core equity team at ACC of 30 Māori roles.

The rōpū was restructured and dispersed across the organisation in late 2023 further weakening the Māori voice, not strengthening it.

Now the dedicated ‘equity role’ covers all minorities and is held by a Tier Three Manager that is expected to influence her Tier Two superiors. There is no specific role responsible for addressing inequity suffered by Māori. 

Ms Val Ripley Head of 156 home support kaimahi at Te Kōhao Health attended the hearing with Lady Tureiti Moxon. She provided lived experience evidence in the briefs filed by the Māori health and services provider.

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