Kaupapa

Our Vision Statement:

Our vision is to make New Zealand a better place. For our children and our children's children. To strive for equality and fairness, working in partnership with friends and allies who share our values. Creating our own success, with skill and passion. Celebrating difference, nourishing opportunities for action, And being leaders in everything we do.

kaupapa

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The Dynamics of Whanaungatanga

Te Puna Hauora kaupapa, tikanga and kawa are embodied in the traditional concept of whanaungatanga.

We pay tribute to Pa Henare Tate, who is the author and teacher of this inspirational concept.

Whanaungatanga encapsulates the tikanga of tapu, mana, and their expression through the principles of tika, pono and aroha.

The following explanations for tapu, mana, tika, pono and aroha, are scribed from a 1999 hui conducted by Pa Henare Tate in whanaungatanga:

Tapu can be broken down into three perspectives.

Firstly there is the intrinsic tapu or sacredness of being, for instance:

  • tetapuiteatua’ (the tapu/ sacredness of god/s),
  • tetapuitetangata’ (the tapu/sacredness of people),
  • tetapuitewhenua’ (the tapu/sacredness of earth).

The underlying principle here is that all living things (birds, rocks, tress etc) have an intrinsic sacredness.

Secondly, there is the tapu/sacredness of relationships between atua, tangata and whenua. Therefore the intrinsic sacredness of both a person and the earth must be acknowledged and respected in any relationship between them.

Many believe that the relationship between people and earth is validated through the relationship between people and god/s. A person breaching the relationship with the earth via abuse i.e. burying toxic waste, is in effect also breaching their relationship with atua as well as whenua.

Thirdly there are tapu or sacredness as relating to tapu/restrictions. These restrictions support and enforce the intrinsic tapu and relationship tapu. An example of this kind of tapu would be ‘rahui’.

  • Rahui is a limit or ban on use of a particular resource which is put in place either to protect the resource or people.

Mana is the spiritual power that creates, produces and restores tapu. It can be expressed in a number of ways including:

  • Mana-whakahaere is the spiritual power and authority of people to order and determine their own lives according to tika, pono and aroha.
  • Mana-tuku is the spiritual power and authority of those with tapu and mana to share of themselves and their resources with others. Aroha is the principle under-pinning mana-tuku.
  • Manaaki is the act of sharing.
  • Mana is also authority, prestige, honour bestowed by atua of people upon individuals or representatives.

Tika can be defined as the principle concerned with the right ordering of relationships, among atua, tangata and whenua, the right response to those relationships and the right exercise of mana.

In other words the right way to do things.

Pono is the principle that seeks to reveal reality and to achieve integrity of relationships. In other words it calls for honesty and integrity in all that we do.

Aroha is the principle of expressing empathy, compassion and joy for others in all that we do.

Tika, Pono and Aroha are the principles of action by which we exercise tapuand mana. If one wants to have mana, one must first seek after tapu. To possess tapu one must exercise tika, pono, aroha.

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Our Whakatauki

He aha te mea nui?
he tangata, he tangata, he tangata
What is important
it is people, it is people, it is people

He aha te huarahi?
I runga, I te TIKA, te PONO, me te AROHA
What is the pathway?
it is Doing what is RIGHT with INTEGRITY and COMPASSION

TIKA – the agreed pathway is a shared understanding and vision, to support clients, internal/allied colleagues and our organisations to achieve maximum potential with equity

PONO – our decisions are underpinned by, and made with, integrity

AROHA – compassion to care enough for those affected by inequalities and to challenge comfort zones in an effort to make a healthy difference for the population we are funded to serve

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These whakatauki underpin the kaupapa Maori component of our model. The attitude of practice must reflect the spirit contained in this whakatauki, entwined throughout delivery at every level.

The restoration of Mana of people cannot take place unless the other three parts of the corner stone of Maori health are underpinned by the fourth, which is Taha Wairua (spiritual component) drawn from the Whare Tapa Wha model as articulated by Professor Mason Durie.

  • TAHA TINANA – Physical
  • TAHA HINENGARO – Mental
  • TAHA WHANAU - Whanau
  • TAHA WAIRUA – Spiritual

Our Kaupapa Maori model of delivery is encapsulated in our Harakeke-IMAP model. This model when practiced within it’s true spirit, both generic and kaupapa Maori, is the korowai which encompasses the individual, whanau, hapu and iwi.

It focuses and brings alive the whakatauki which we have heard mai rano. It is the heartbeat of Maori development when practiced in partnership with different groups biculturally, multiculturally, intersectorally, intra-sectorally, intra-physically.

TWONA's Alliances

Tech Management Group
(Maori Company)

Values based relationship (MOU) with shared opportunities with Maori owned and managed IT company to host TWONA website and data collection from alliance providers

Te Oranganui Iwi Health Authority

A leading Health Care provider delivering a quality service contributing to the mana motuhake of whanau, hapu, iwi and other peoples.

Whakatū Marae

Situated in the leeward breezes of Taitapu Bay on the northern entrance into Whakatū, Nelson.

Whakatū Marae development in the 1960’s from an disused land to a beautiful site that houses the Whare Tupuna-Kaakati, a Wharekai-Mauriora, 6 Whare Kaumatua, Kopuawai Te Kohanga Reo, a Kokiri Centre that services Health and Social Services, an equipment shed and ablution block.

In March 2013 Whakatū Marae signed a Memorandum of Understanding with TWONA. Whakatū Marae is currently using TWONA IMAP Online for their community support services, and is one of the most active provider.

North Shore Community and Social Service Inc. (NSCSS)
(Community Development)

Values based relationship (MOU) with shared opportunities attempting to integrate local NGO providers delivering services to greater community

ProCare Regional Networks Ltd
(Mainstream Medical)

Values based relationship (MOU) with shared opportunities, medical and Values Based Best Practice across Primary Care Sector. ProCare leading medical, Te Puna Whanau Ora Network Alliance leading Whanau Ora

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The Journey

The first Maori Health Provider service on the North Shore was established in 1995 at Awataha Marae under the management of the Marae committee. The practice was focussed on primary healthcare and consisted of a GP, a nurse, a community services worker and receptionist.

By 1997 the community had become very involved in the development of the health provider, so an Incorporated Charitable Society was set up which gave the community control of the provider.

Te Puna Hauora o te Raki Paewhenua

te puna hauora The organisation was renamed Te Puna Hauora o te Raki Paewhenua and a board of 10 consisting of 5 staff and 5 community members was appointed, with the Chairperson always chosen from the community and having a casting vote.

Most importantly, from a Kaupapa Maori perspective, a Kaumatua and Kuia advisory group was established to support the board and organisation. This has now evolved into kaumatua and kuia being both part of the board and part of the organisation.

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In 2000 the government enacted the New Zealand Public Health & Disability Act, changing the health funding and contracting environment from one Health Funding Authority to twenty one District Health Boards.

In 2001 the Ministry of Health released the Primary Health Care Strategy (February 2001) and He Korowai Oranga: Maori Health Strategy Discussion Document (April 2001).

These documents formed the basis for Te Puna Hauora, in conjunction with Comprehensive Healthcare Services, an Independent Practitioners Association on the North Shore creating a Primary Health Organisation.

This is named the North Harbour PHO Trust and was created on the 25th of June 2002.

In May 2001 the organisation moved into new premises which consists of a large building donated by the Lady Allum Home on the North Shore. This was placed on land leased from the Awataha Marae, on the marae grounds.

Funding was secured from both the Lotteries Commission and the ASB Trust to build a conference room, kitchen and carparks. Further funding was obtained from the Ministry of Education, ASB Trust, and Lotteries Commission to build an early childhood centre for 50 children on site.

In December 2003, Te Puna Hauora achieved ISO 9001 accreditation.

In October 2004 Te Puna Hauroa won the Ministry of Health Whanau Supreme Innovation Award for the Harakeke I-MAP model and was joint Supreme winner with Ngati Porou Hauora of Te Matarau Maori Health Provider Award.

In 2004 approximately $2.3m of funding was received from the Ministry of Health, Waitemata District Health Board, Ministry of Education and Child, Youth and Family Services.

In 2005 services were offered from 166 Birkdale Road, a building which was purchased by Te Puna Hauora to service the Birkdale and Beach haven whanau/client who prefer to access services closer to home.

The contracted services grew in the period to 2004 to include:

  • General practitioners & Nursing service
  • Mobile nursing service
  • Mobile mental health service
  • Mobile community worker service
  • Mobile homecare support services
  • Tamariki ora (well child) services
  • Health and social services networking and training
  • Student placements for health, social work and childcare education
  • Work placements for GP trainee interns, house surgeons and registrars
  • A Certificate in Community Work joint venture with AUT
  • A community conference room for community hui
  • An early childhood centre for 50 children.

In line with this development phase, a number of relationships with external agencies, service providers and individuals were developed to deliver services that were requested by the local community.

Te Puna Hauora 2005

Services delivered on Te Puna Hauora premises by external agencies, providers and individuals include:

  • Paediatrician
  • Midwifery Service
  • Nutritionist
  • Three Psychotherapists
  • A Physiotherapist
  • Nurse Ear Specialist
  • Diabetes Clinics
  • Legal Services
  • Alcohol and Drug Counselling
  • Retinal Screening
  • Podiatry for Diabetes
  • Meningococcal trials and a broad range of other services and specialists.

Te Puna Hauora 2012

  • Clinical Services
  • Doctors Clinic
  • Nurses Clinic
  • Cardiovascular Risk Assessment
  • Diabetes Get Checked
  • Care Plus
  • Free Cervical Smears
  • Immunisations
  • Immigration Medicals
  •  Tamariki Ora/Well Child service
  • Family/Whanau Support
  • Mobile nursing service
  • Healthy Lifestyles Service
  • Podiatry Service
  • Transport (Criteria applies)
  • Allied Services
  • Pharmacy Service
  • Dental Service
  • Midwifery Service
  • Physiotherapy
  • Retinal Screening – Provided by WDHB
  • Community Services
  • Social Worker
  • Community Support Workers
  • Adult Mental Health Support Services
  • Budgeting Service
  • Youth Worker

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As of 1 November 2013, Te Puna Hauora has:
10,500 Funded Population
9,977 Casual Population
769 Visitor Population
785 Community Support Population
52 Employees across health and social services
ISO 9001:2008 Accreditation
Cornerstone General Practitioner Accreditation

Te Puna PHO Ltd

te puna pho

In April 2005, NHPHO was dissolved

In July of the same year, Te Puna PHO established as a charitable company with Te Puna Hauora as its sole beneficiary

October 2005, Windsor Medical Centre joined Te Puna PHO

At establishment there were no funds. The financial set up of the PHO was funded solely by Te Puna Hauora

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The Waka

te puna pho

The concept is based on the Whanaungatanga Principles of sharing opportunities and resources. GM PHO is Clinical Director in designing and managing new concepts in the Primary Care Team in exchange for sharing the Human resources in the business arm including contracting, financial control, HR and Quality Assurance.

All staff in the clinical arm are interviewed and chosen by GM PHO and employment pathway managed by GM Te Puna Hauora.

All health mainstream contracting arrangements and funding streams are responsibilities of the GM PHO. The continued management including financial is the responsibility of the GM Te Puna Hauora.

The PHO is the post-box for unfettered money to flow through to Te Puna Hauora

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Te Puna Whanau Ora Network Alliance Ltd (TWONA)

te puna whanau oraJune 2008 – November 2010
Te Puna PHO became a member of the National Maori PHO Coalition.

29 March 2011
Commenced official MOU relationship with ProCare Ltd

May 2011
Te Puna Whānau Ora Network Alliance Ltd was established. It is a subsidiary company of Te Puna Hauora o Te Raki Paewhenua set up to replace the dis-established Te Puna PHO

The TWONA focus has been expanded
A) Maintenance of PHO functions in partnership with ProCare Network Ltd
B) Whanau Ora Values Based Best Practice implementation

July 2011
Auahatanga contract under MoH directorate innovation funding commenced. Facilitation and training of selected Whanau Ora providers in preparation for implementation

September 2011
TWONA joined with two other organisations (Hauora.Com and Te Oranganui Iwi Health Authority) in presenting their Briefing Paper to Associate Minister of Health TarianaTuria that proposed a strategic pathway for Whānau Ora Workforce Development. The paper was titled: ‘National Leadership Centre for Whānau Ora Workforce Development’.

The proposal highlighted the transformative changes needed across the sectors that had to be intergenerational in their impact. New skill sets, new models of care, and new alliances and relationships needed to be forged to provide the strong and cohesive networks pivotal for success in delivering whānau ora services via a well-developed indigenous/and whānau workforce.

The proposal aimed to provide Government with a viable and sustainable indigenous model of workforce development and deployment. Its scope was national; it had credibility and bridged both the regulated and non-regulated components of the workforce.

The three organisations were participants in a national wānanga held early in 2012, which addressed many of the directions the briefing paper promoted.

August 2012-March 2013

TWONA conveyed in an open letter to the Minister for Whānau Ora a vision regarding a structure and pathway for whānau ora nationally. The TWONA vision was to have Whānau Ora NA&WC’s that would be broadened to include comprehensive assessments across votes: health, social development, justice, and education sectors, etc.

Subsequent concept development hui have been held with the MOH [specifically, the Sector Capabilities and Innovations Directorate]. These have helped shape the development of this business case and the future direction and role for TWONA.

Included in this series of hui has been a combined one involving WDHB Senior Management in which it was agreed that WDHB would work with TWONA on setting up a pilot for Whanau Ora development along the lines proposed to the Minister.

TWONA has also been working with the GM Maori in the Nelson and Marlborough DHB re their possible involvement in a second pilot in their Rohe. This is very timely given the new direction NMDHB and its seven Maori Provider organisations are developing for Whanau Ora delivery

In parallel TWONA management attended a workforce partnership Summit in Wellington with Te Rau Matatini, J Tamehana from Whanganui, and contributions from each entity were identified: ;TWONA – offers provider, enabling and enhancement tools and Change Management; Te Rau Matatini – offers policy, research, training, and National Conference and Hui Facilitation; J Tamehana, Whanganui – offers indigenous curriculum, training and education at NZQA Level 6 equivalent.

To further strengthen its multi sector reach TWONA has also been working with NZ Corrections to pilot the use of The Harakeke IMAP® for pre release prisoners.

All this activity has positioned TWONA well to be an active and enabling partner in the further development of the full Whanau Ora proposal. TWONA sees a continuation of this alliance and partnership building as a strategic priority.

In April 2012 journey of development of IMAP® Values Based best practice model from paper-based to website completed Concentration on Values Based Alliance models with shared opportunities developed.

November 2012 – Ki a Ora Ngatiwai signed MOU and SLA with the TWONA.

March 2013 – Whakatū Marae signed a Memorandum of Understanding and a Contract for Software and Support Services with TWONA.

April 2013 – Te Oranganui Iwi Health Authority signed a Memorandum of Understanding and a Contract for Software and Support Services with TWONA.

3 June 2013 – TWONA IMAP Online version 2 launched.

July 2013 – Te Rūnanga o Te Rarawa signed a Contract for Software and Support Services with TWONA.

4 Oct 2013 – TWONA IMAP Online User Manual launched.

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MOU – Procare Health Ltd – Mainstream Relationship

An important component of the alliance will be the retention of the sovereignty of each organisation.

The Parties share the key values of; Tika [shared vision and pathway]; Pono [integrity]; and Aroha [compassion] and these will be the foundations supporting the relationship.

The parties see this as an enduring relationship that will grow and mature without ever losing sight of its founding Kaupapa

Te Puna is seeking a ‘post box’ type arrangement with ProCare .

Te Puna has also offered to be ProCare’s ‘post box’ for Whānau Ora funding flows

It is important to note that there is a total alignment between the ProCare clinical delivery and governance model and the Te Puna Whānau Ora delivery and governance model. They are parallel systems that interface where required to meet the best interests of the individual client and or Whānau grouping. [A classic one plus one equals three scenario]

Governance

governance

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