04 / WHERE DECISIONS GET MADE
SYSTEMS
CHANGE
SYSTEMS
CHANGE
SYSTEMS
CHANGE
SYSTEMS
CHANGE
WHO’S AT THE TABLE?
WHO’S AT THE TABLE?
WHO’S AT THE TABLE?
WHO’S AT THE TABLE?
I’ve spent a lot of my career working alongside whānau and seeing what happens when health services don’t quite fit the people they’re supposed to serve.
I’ve spent a lot of my career working alongside whānau and seeing what happens when health services don’t quite fit the people they’re supposed to serve.
But eventually you have to ask another question:
But eventually you have to ask another question:
WHO DESIGNED THE SYSTEM IN THE FIRST PLACE?
WHO DESIGNED THE SYSTEM IN THE FIRST PLACE?
WHO DESIGNED THE SYSTEM IN THE FIRST PLACE?
That’s taken me into governance, clinical networks and advisory spaces, places where decisions are made about how healthcare is designed, delivered and evaluated.
That’s taken me into governance, clinical networks and advisory spaces, places where decisions are made about how healthcare is designed, delivered and evaluated.
I try to bring what I’ve learned from whānau, pharmacy, research and Māori health into those conversations.
I try to bring what I’ve learned from whānau, pharmacy, research and Māori health into those conversations.
I DON’T SIT AROUND THESE TABLES
JUST TO BE AT THE TABLE.
I DON’T SIT AROUND THESE TABLES
JUST TO BE AT THE TABLE.
I DON’T SIT AROUND THESE TABLES
JUST TO BE AT THE TABLE.
I DON’T SIT AROUND THESE TABLES
JUST TO BE AT THE TABLE.
I choose these spaces because decisions made there shape what whānau experience on the other side of the health system.
I choose these spaces because decisions made there shape what whānau experience on the other side of the health system.
My reason for being there is pretty simple: to help shift systems so they better align with the aspirations of whānau Māori.
My reason for being there is pretty simple: to help shift systems so they better align with the aspirations of whānau Māori.
Sometimes that means bringing a Māori perspective into a conversation where it might otherwise be missing.
Sometimes that means bringing a Māori perspective into a conversation where it might otherwise be missing.
Sometimes it’s questioning the data.
Sometimes it’s questioning the data.
Sometimes it’s asking who a service was designed for, whose definition of success we’re using, or what the decision in front of us will actually mean for whānau.
Sometimes it’s asking who a service was designed for, whose definition of success we’re using, or what the decision in front of us will actually mean for whānau.
WHAT WILL THIS ACTUALLY MEAN FOR WHĀNAU?
WHAT WILL THIS ACTUALLY MEAN FOR WHĀNAU?
WHAT WILL THIS ACTUALLY MEAN FOR WHĀNAU?
WHAT WILL THIS ACTUALLY MEAN FOR WHĀNAU?
FROM THE CLINIC
TO THE TABLE.
FROM THE CLINIC
TO THE TABLE.
FROM THE CLINIC
TO THE TABLE.
FROM THE CLINIC
TO THE TABLE.
I didn’t start out wanting a collection of governance roles. I started getting involved because I wanted to understand how decisions were made and how those decisions could better serve whānau.
I didn’t start out wanting a collection of governance roles. I started getting involved because I wanted to understand how decisions were made and how those decisions could better serve whānau.
2017–2021
2017–2021
2017–2021
LEARNING HOW SYSTEMS WORK
MĀORI CAUCUS
MĀORI CAUCUS
MĀORI CAUCUS
Canterbury Clinical Network
Canterbury Clinical Network
Some of my earliest experiences sitting inside health-system decision-making spaces. I still reflect on this time and the caucus members who took me under their wing, such an insightful experience.
Some of my earliest experiences sitting inside health-system decision-making spaces. I still reflect on this time and the caucus members who took me under their wing, such an insightful experience.
2018–2021
2018–2021
2018–2021
HELPING DESIGN SERVICES
INTEGRATED DIABETES SERVICE DESIGN GROUP
+
INTEGRATED RESPIRATORY SERVICE DESIGN GROUP
INTEGRATED DIABETES SERVICE DESIGN GROUP
+
INTEGRATED RESPIRATORY SERVICE DESIGN GROUP
INTEGRATED DIABETES SERVICE DESIGN GROUP
+
INTEGRATED RESPIRATORY SERVICE DESIGN GROUP
Canterbury Clinical Network
Māori and Pharmacy Representative
Canterbury Clinical Network
Māori and Pharmacy Representative
Bringing Māori and pharmacy perspectives into decisions about how clinical services were designed. I thought this was how the health system worked, little did I know we were just miles beyond our years in Waitaha.
Bringing Māori and pharmacy perspectives into decisions about how clinical services were designed. I thought this was how the health system worked, little did I know we were just miles beyond our years in Waitaha.
2020–2021
2020–2021
2020–2021
STRENGTHENING MĀORI PHARMACY
KĀ KAITIAKI o TE PUNA ROKOĀ -
MĀORI PHARMACISTS’ ASSOCIATION
KĀ KAITIAKI o TE PUNA ROKOĀ -
MĀORI PHARMACISTS’ ASSOCIATION
KĀ KAITIAKI o TE PUNA ROKOĀ -
MĀORI PHARMACISTS’ ASSOCIATION
Executive Member
Executive Member
A short stint helping a very important organisation. I'm excited to return one day soon.
A short stint helping a very important organisation. I'm excited to return one day soon.
2023–PRESENT
2023–PRESENT
2023–PRESENT
SHAPING THE FUTURE OF PHARMACY
NEW ZEALAND PHARMACY EDUCATION AND RESEARCH FOUNDATION
NEW ZEALAND PHARMACY EDUCATION AND RESEARCH FOUNDATION
NEW ZEALAND PHARMACY EDUCATION AND RESEARCH FOUNDATION
Board Member
Board Member
Contributing to governance around pharmacy education, research and the future of the profession. NZPERF funds and supports education and research that advances the study and practice of pharmacy and benefits pharmacy in Aotearoa New Zealand.
Contributing to governance around pharmacy education, research and the future of the profession. NZPERF funds and supports education and research that advances the study and practice of pharmacy and benefits pharmacy in Aotearoa New Zealand.
CURRENT
CURRENT
CURRENT
REGIONAL CLINICAL GOVERNANCE
WELLSOUTH CLINICAL GOVERNANCE COMMITTEE
WELLSOUTH CLINICAL GOVERNANCE COMMITTEE
WELLSOUTH CLINICAL GOVERNANCE COMMITTEE
Bringing an equity lens into clinical governance, including asking what overall results might be hiding about outcomes and experiences for Māori.
Bringing an equity lens into clinical governance, including asking what overall results might be hiding about outcomes and experiences for Māori.
2024–PRESENT
2024–PRESENT
2024–PRESENT
CHANGING DIABETES CARE NATIONALLY
MAHITAHI MATEHUKA
MAHITAHI MATEHUKA
MAHITAHI MATEHUKA
National Diabetes Network
National Diabetes Network
Bringing clinical experience, research and whānau perspectives into national conversations about diabetes care.
Bringing clinical experience, research and whānau perspectives into national conversations about diabetes care.
2024–PRESENT
2024–PRESENT
2024–PRESENT
MĀORI CLINICAL VOICE AT SYSTEM LEVEL
TE WHIRI KAHA
TE WHIRI KAHA
TE WHIRI KAHA
Māori Clinical Senate
Health New Zealand
Māori Clinical Senate
Health New Zealand
Contributing Māori clinical perspectives within national health-system conversations.
Contributing Māori clinical perspectives within national health-system conversations.
THE QUESTIONS I KEEP BRINGING INTO THE ROOM
WHAT AM I ACTUALLY
TRYING TO CHANGE?
WHAT AM I ACTUALLY
TRYING TO CHANGE?
WHAT AM I ACTUALLY
TRYING TO CHANGE?
WHAT AM I ACTUALLY
TRYING TO CHANGE?
01
WHO ARE WE NOT REACHING?
WHO ARE WE NOT REACHING?
WHO ARE WE NOT REACHING?
WHO ARE WE NOT REACHING?
Are good overall results hiding different experiences or outcomes for Māori?
Are good overall results hiding different experiences or outcomes for Māori?
02
WHO WAS THIS DESIGNED AROUND?
WHO WAS THIS DESIGNED AROUND?
WHO WAS THIS DESIGNED AROUND?
WHO WAS THIS DESIGNED AROUND?
Is the service genuinely accessible to whānau, or are we expecting whānau to fit the service?
Is the service genuinely accessible to whānau, or are we expecting whānau to fit the service?
03
WHO GETS TO DEFINE SUCCESS?
WHO GETS TO DEFINE SUCCESS?
WHO GETS TO DEFINE SUCCESS?
WHO GETS TO DEFINE SUCCESS?
Are we only measuring clinical outcomes, or are we also listening to what matters to whānau?
Are we only measuring clinical outcomes, or are we also listening to what matters to whānau?
04
WHO HAS AUTHORITY TO ACT?
WHO HAS AUTHORITY TO ACT?
WHO HAS AUTHORITY TO ACT?
WHO HAS AUTHORITY TO ACT?
Can the people closest to the problem actually change anything?
Can the people closest to the problem actually change anything?
05
WHAT HAPPENS AFTER THE PILOT?
WHAT HAPPENS AFTER THE PILOT?
WHAT HAPPENS AFTER THE PILOT?
WHAT HAPPENS AFTER THE PILOT?
How does something useful become part of the system rather than disappearing when a project or funding contract ends?
How does something useful become part of the system rather than disappearing when a project or funding contract ends?
HEALTH IS SHAPED OUTSIDE HEALTHCARE TOO
THE SYSTEM IS BIGGER THAN THE HEALTH SYSTEM.
THE SYSTEM IS BIGGER THAN THE HEALTH SYSTEM.
THE SYSTEM IS BIGGER THAN THE HEALTH SYSTEM.
THE SYSTEM IS BIGGER THAN THE HEALTH SYSTEM.
Housing. Transport. Environment. Infrastructure. Education. Community.
Housing. Transport. Environment. Infrastructure. Education. Community.
The conditions that shape hauora extend far beyond clinics and hospitals.
The conditions that shape hauora extend far beyond clinics and hospitals.
That’s one reason I’ve also contributed in spaces outside healthcare, including representing Kāi Tahu perspectives in spatial planning, where decisions about communities today can shape wellbeing for generations.
That’s one reason I’ve also contributed in spaces outside healthcare, including representing Kāi Tahu perspectives in spatial planning, where decisions about communities today can shape wellbeing for generations.
KĀI TAHU REPRESENTATIVE
QLDC Spatial Plan working group
2023–2025
THE DIFFERENT ROOMS
INFORM EACH OTHER.
THE DIFFERENT ROOMS
INFORM EACH OTHER.
THE DIFFERENT ROOMS
INFORM EACH OTHER.
THE DIFFERENT ROOMS
INFORM EACH OTHER.
Sitting around governance tables means more to me because I still spend time thinking about what happens around kitchen tables.
Sitting around governance tables means more to me because I still spend time thinking about what happens around kitchen tables.
What I hear from whānau influences the questions I ask in research.
What I hear from whānau influences the questions I ask in research.
Research gives me evidence to take into system conversations.
Research gives me evidence to take into system conversations.
And governance helps me understand what it actually takes for an idea to become part of healthcare.
And governance helps me understand what it actually takes for an idea to become part of healthcare.
None of those perspectives is enough on its own.
None of those perspectives is enough on its own.