WAI 2575 principles of Te Tiriti
Tino rangatiratanga Equity Active protection Options Partnership
Definition of tino rangatiratanga (as per WAI 2575)
Māori self-determination
Mana motuhake in design, delivery, monitoring
Equity (as per WAI 2575)
Commit to achieving equitable outcomes
Active protection (as per WAI 2575)
Crown must act to fullest extent practicable to achieve equitable outcomes
Options (as per WAI 2575)
Provide and properly resource kaupapa Māori alternatives
Partnership (as per WAI 2575)
Work in partnership in governance, design, delivery and monitoring
Fundamental basis of Te Tiriti (as per WAI 2575)
Crown gets kāwanatanga (right to govern; to create laws); in exchange Māori get tino rangatiratanga (autonomy)
Where the position fits in the system
COVID-19 Health System Response directorate
National Public Health Operations group
Public Health Team
Why do you want this job?
Frustrated by fragmentation PHUs do their own things or criticise without helping Creates duplication and incoherence Potential to reolve this with NPHS Want to be part of the mahi
Example of innovating solution
Helped set up virtual team to support ARPHS during Delta
Seconded to ARPHS in 2020
Used this experience to understand the model being used
Took this back to RPH
Learning: take opportunities when presented
Example of working with Te Tiriti / whanau ora
Delta outbreak Maori community gang connections
Utilised trusted relationship with whanau
Ngati moe hapu; Ngati kahungunu
RPH supported Whaiora to provide this service: staff, technical support
Learnings: active protection; partnership
Team leadership
- Clinical lead for Australasian Tuberculosis Conference
- Involved developing and implementing scientific committee; corralling group and developing recommendations
- Undertook the lead work for contacting speakers; developing content
- Lesson: if you’re working in a group select your group carefully; create expectations for undertaking the actual work
What is your leadership style
Transparency I don’t have all the answers Give team clarity about direction and purpose Democratic Coaching
How have you managed conflict
- Response manager felt that my team members made inappropriate comments with stakeholders
- Spent time gathering information and different perspectives
- Recognised that there were different perceptions of same incident
- Addressed issue with response manager
- Needed to ensure that team knew that I had their backs
What skills would you bring to the role?
Technical expertise with communicable disease control and outbreak management
Approaching 17 years experience as MOoH
Experience working in central government; ESR
Written communication
Adaptability, problem-solving, openness
Innovative tactics
Top priorities on starting in role
- Develop agreement with PHUs around areas of responsibility - in particular, ARPHS. How do we avoid duplication of policy-making and operational guidance?
- Support development of integrated system for case-contact management
- Ensure we are ready for emerging threats in winter
- Ensure that the lessons around equity learned from COVID become intrinsic to our response models
Future development of COVID-19
- WHO three scenarios
- Worst case - more virulent; highly transmissible variant; immune escape
- Base case - continued evolution of virus with variable escape from immunity but not greater severity
- Best case - future variants emerge but less severe
Likely demands on health sector from COVID-19
Long COVID; inequity
Maintaining surveillance
Maintaining public engagement
Maintaining public health service capacity for addressing future spikes
How to deal with conflict between science advice and political considerations
- Understand political realities
- Ensure the downsides of not following best practice are well understood by decision-makers
- Be realistic about uncertainties
- Recognise that even the precautionary principle has limits
Example: hepatitis A and packaged berry fruit; solution is around risk communication
STEC change management due to PCR
- Evidential basis
- Consultation
- Policy paper; potential impacts; range of options
- Implementation
