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Health Research Council of New Zealand
Maori Health Research Knowledge Translation Symposium
Tuesday 8 November 2011, 1.00pm
Thank you to Professor Smith, and our kaumatua, Beau Haereroa, for laying out the whariki by which our korero today can be held.
This is an extremely important forum and I want to acknowledge the commitment of the Maori Health Committee of the Health Research Council, in hosting this hui; and in providing us all with an opportunity to map health research to Maori health gains.
It is now ten years since Linda Tuhiwai Smith and Fiona Cram outlined some key kaupapa that are critical in establishing a respectful research process.
In their paper on the Community Up Model, they referred to a set of foundation principles, such as whanaungatanga, aroha, mana, mahaki, titiro, whakarongo, korero; kia tupato.
One of the concepts in their model was that of manaakitanga – a value that enabled knowledge to flow both ways; a process of giving back, of sharing results; the opportunity to demonstrate a collaborative approach to research.
In the spirit of manaakitanga then, I am proud to be able to speak at this very important symposium; to share some of the ideas I have around Maori health research, with the intention of creating a conversation.
I understand we have in the room a diverse mix of whanau, hapu, iwi, providers, community, and policy makers so I fully expect there to be multiple and dynamic conversations occurring from all quarters, during the progress of this hui.
It is somewhat unnerving to be following in the footprints of two giants of the research agenda – Professor Sir Mason Durie and Moana Jackson. I doubt that there would be anyone at this hui who is not aware of the substantial, long-standing and unique work that these two men have shared with our people.
They epitomise, indeed, the gift of manaakitanga – their wisdom and challenges being shared so generously, for the betterment of all. Tena korua.
The genesis for this hui came from one of the primary goals embedded in the recent Health Research Council publication Nga Pou Rangahau – the Strategic Plan for Maori Health Research 2010-2015.
The third goal of Nga Pou Rangahua – translating research into Maori health gains is inspired by the thinking around what they describe as ‘knowledge translation’ – the thinking around investment return – how will public spending on research translate into immediate health, social and economic benefits – a question that I hope will be uppermost in our minds over this hui.
This afternoon will also see some interesting discussion arise out of the three central questions posed for this hui;
These questions are fundamental to any conversation about research.
We must never resile from the question - in whose benefit is this research being done?
Who will accrue the profit from the funding investment?
Is it the research entity; the sponsoring institution; or the subjects of the research focus?
Do we have the balance right between the overheads and the outcomes?
We have to make sure that the funding isn't skewed in favour of building up institutional empires, and in so doing, siphoning off vital funds which could be more effectively used for the purposes and outcomes of the actual research.
It is also about who controls the research - is it mana whenua, the subjects of the research or the sponsoring institutions? How are the roles worked out? What are the protocols around relationships?
I want to say the process of going through these questions is something we should uphold in every research decision we make.
For instance as Nga Wairiki/Ngati Apa we have a research unit, Te Ropu Rangahau o Ngati Apa, which has been responsible for preparing Treaty of Waitangi claims on behalf of the tribe.
As part of our commitment back to our people the unit produces a newsletter entitled Te Tapikitanga o Apa – the rising up of Apa.
While based on our whakapapa connection to our eponymous ancestor, Apa hapai taketake, there is also the implicit commitment back to the iwi, that as a result of sharing the information, the people themselves will rise up.
At this Maori Health Research Symposium then, what will be the knowledge transition that enables whanau, hapu and iwi to rise up?
How will the findings focus on quality, safety and equity to ensure we create a more connected system, a system that is more responsive to Maori?
What evidence do we have about how whanau are involved in the design and evaluation of care?
Have we normalised the expectation that priority should be placed on disability-centred research?
Can we say, hand on heart, that whanau are at the centre of our thinking; that they have a real voice in the system?
And I want to remind us all that Whanau Ora requires new ways of wrapping services around whanau.
It requires the system to resource innovation; it requires services to change – how they do it, what they do, where they do it - it must all be driven by the aspirations of whanau.
I want to encourage us all to be purposeful and bold; to ensure that high quality research is translated into meaningful and effective policy.
I want to thank you, here and now, for the commitment that each of you make to supporting our whanau to improve their lives. And my challenge to you all – just as I would say to the whanau working for Te Ropu Rangahau o Ngati Apa – is to remind us that no one other than whanau, hapu and iwi hold the mandate to speak for themselves.
I came across a picture the other day which reinforced for me, how vital it is that we get it right. The visual was meant to represent how Whanau Ora would operate in the community. Problem was – they asked the wrong people to draw the picture.
So we have a picture of a waka, with a social worker sitting at the helm, teachers, nurses, counsellors, budget advisors, and a veritable cast of players all perched various levels of the waka.
Right in the middle of the waka sat the whanau – portrayed as nothing more than silent passengers observing the journey of their life.
Now I am absolutely sure that if we had asked the whanau what their ideal waka would look like, they wouldn’t depict themselves as passive recipients of the benevolence of the providers around them.
We must never again treat our whanau as subservient or dependent on the whims of the state.
We must empower whanau with the belief that they can be and can do. Their voices must ring true; their stories must be told.
I want to acknowledge the substantial body of evidence that we have to assist us in our goal of translating research into Maori health gains.
Te Pumanawa Hauora runs the unique Te Hoe Nuku Roa study – a longitudinal study of Maori households which enable cultural, economic and personal factors to be correlated and examined.
Te Roopu Rangahau Hauora a Eru Pomare has presented what is described as landmark research, particularly the series of monitoring reports contained in Hauora: Maori standards of health.
From these reports we have an indisputable evidence base revealing inequalities in health status; health care and outcomes between Maori and non-Maori.
A further example is the Health Research Council Nga Kanohi Kitea grants which focus on developing Maori capability and knowledge.
Some recent examples include:
There are of course many models which could be looked on as a basis for knowledge transition including one that will be discussed later this afternoon – the joint venture research partnership between the Health Research Council and the Ministry of Health.
But I return to the very clear need that exists for Government to support the development and dissemination of the Maori health research agenda.
In order to enable the process of knowledge translation to be embedded in, we must be clear that Maori Health Research will enable high quality policy that will truly make the difference.
And what is the single-minded most important variable to make the difference?
It is the understanding that the strongest whanau and hapu are those who believe that the answers lie in themselves.
I look forward to learning of our stories at the end results of this Symposium, and it there is one question I might pose it would be to ask you all how you can contribute to developing ways to manage health research to achieve tangible and sustainable Maori health gain.
Tena tatou katoa.