Pae Ora – What’s Changing and Why It Matters

It came about after years of pressure from Māori health leaders, whānau, and public health advocates who were tired of seeing Māori die younger, get sicker, and face more barriers to care. The WAI 2575 Waitangi Tribunal report had made it clear – the Crown wasn’t meeting its Te Tiriti obligations in health, and the system needed big changes.

Under the Act, some important new structures were set up:

• Te Aka Whai Ora – the Māori Health Authority, to lead kaupapa Māori solutions and hold the health system accountable for Māori outcomes
• Iwi-Māori Partnership Boards (IMPBs) – local voices feeding into health decisions
• Hauora Māori Advisory Committee (HMAC) – to advise the Minister of Health
• Health system principles that made equity and Te Tiriti obligations part of how health planning and services were delivered

For many, Pae Ora was a huge step forward – giving Māori real influence over decisions and building a system that could work better for everyone.

Side note: what’s an amendment?

An amendment is basically a change to an existing law. It could add something new, tweak what’s already there, or take things out altogether. Sometimes amendments strengthen a law – other times, they can weaken it.

The Pae Ora Amendment Bill is a set of proposed changes to the original Pae Ora Act. It’s currently at the Select Committee stage, which means the public can make submissions and MPs are reviewing it in detail.

What’s happening now?

In 2023, a new Government came in – National, ACT, and NZ First. They campaigned on removing what they call “co-governance” from public services and making the health system more centralised.

In 2025, they introduced the Pae Ora Amendment Bill. If passed, it would:

• Remove the Māori Health Authority (already shut down in 2024)
• Reduce the role of IMPBs and remove Health NZ’s requirement to work directly with them
• Shift Māori decision-making from local to mostly national advisory roles
• Remove the legal requirement for a dedicated Hauora Māori Strategy
• Drop the rule that health boards must have expertise in Te Tiriti, equity, or kaupapa Māori
• Put more focus on national hospital targets (like wait times) rather than prevention and broader wellbeing

Why this matters

The original Pae Ora Act ensured that the health system was accountable to Māori outcomes. These changes would:

• Undermines Māori leadership – takes away decision-making power in health
• Waters down equity commitments – makes them harder to measure or enforce
• Pushes kaupapa Māori services to the side – treats them as optional instead of essential
• Shifts focus away from prevention – back to short-term hospital targets instead of long-term wellbeing

What’s good for Māori is good for everyone – because when the system is designed to meet the needs of those most impacted, it becomes stronger, fairer, and more effective for all. Equity for Māori isn’t a side issue – it’s the blueprint for a health system that actually works.

Have your say

Right now, the Pae Ora Amendment Bill is at the stage where the public can have the biggest impact – the Select Committee stage.

If you care about protecting Māori leadership in health, keeping equity at the heart of our system, and making sure community voices aren’t lost, make a submission. It doesn’t have to be long – even a few sentences about why this matters to you can make a difference.

Submissions close 1pm, 18 August 2025.