A surprise gifting to Ngāti Pikiao of the Ōwhata Medical Centre in Rotorua “lock stock and barrel” by not-for-profit primary health organisation Pinnacle is now official after the handover at Pounamanui, Houmaitawhiti, Marae in Rotorua.

It is believed to be a New Zealand first by a PHO that typically services a large population of non-Māori.

“Gifting the medical centre was an initial surprise to us, although we had negotiated for some time around how and what this might look like,” says Mapihi Raharuhi, chair of Te Rūnanga O Ngāti Pikiao Trust.

Having a relationship built on aroha and trust between Ngāti Pikiao and Pinnacle CEO Justin Butcher, regional manager and board anchored the deal in her view that achieves the best health outcomes alongside maintaining tino rangatiratanga.

“It will enable us to work in a way to provide the best care for our whānau. At the end of the day, it really it is about the relationship that we had with both the board of Pinnacle and the kaimahi that deliver the service for Pinnacle.”

Te Rūnanga O Ngāti Pikiao, after receiving the whole organisation and the business as a going concern, now operates an established medical centre with its own patient list and kaimahi.

How the medical centre is run is a responsibility that now sits with the Ngāti Pikiao board.

Dr John Armstrong, left, looks on as Butcher addresses the gathering at Pounamanui (Houmaitawhiti) Marae in Rotorua. Photo: Sarah Sparks/Stuff.

“That's a huge, courageous thing for a Pākehā organisation to do that for Māori iwi organisation, so it's a really big deal for us,” says Raharuhi.

Despite the sector facing ongoing health workforce challenges, the chair confirmed the iwi has the required number of GPs to operate both Ngāti Pikiao’s current medical centre and Ōwhata.

Ngāti Pikiao is in negotiations with other general practitioners who are interested in what it’s doing, and how it operates.

“Yes, we have clinical standards and responsibilities to uphold. However, we operate according to our own values, especially manaakitanga and whakapapa. These unique ways mean we operate the centres differently, which is what our clinical workforce are interested in,” she says.

Pinnacle operates GP clinics in rohe extending from Te Tai Rāwhiti, Taranaki, Rotorua, Thames Coromandel, and down to Waikato.

Pinnacle boss Butcher oversaw the nine-month negotiation.

“It's a challenging place for Pākehā to come into. I must admit, my lesson that I have learned is to be authentic, to be humble, and to listen,” he says.

“It's not about me, injecting how I think or my way of thinking, it really is listening and waiting for the opportunity to become involved. Being patient and respectful.”

Butcher attended the pōwhiri with his team, who shared kōrero and sung waiata in the wharenui alongside Ngāti Pikiao.

The sharing of resources and management support was the “right thing to do” Butcher says, so Ngāti Pikiao can achieve its aspirations for its people.

“We see the coming together of the medical centres as a first step from a clinical perspective and we really look forward to strengthening that relationship as the opportunities arise as we go forward.”

“For us, we do want to strengthen our relationships with iwi and kaupapa providers around the area that we support,” Butcher says. “I wouldn't want to prejudge that, but there's certainly opportunities to do things differently. We need to do things differently if we want to achieve hauora outcomes for Māori.”

The Te Arawa Iwi Māori Partnership Board, Te Taura Ora O Waiariki, supports more mana motuhake initiatives happening in the region in line with the government health reforms.

Dr Grace Malcolm, chair of the Te Arawa Iwi Māori Partnership Board and Ngāti Pikiao Health Services GP. Photo: Sarah Sparks/Stuff.

“This arrangement empowers iwi and enables the health sector to boost accessibility to quality services for Māori and address historic inequities,” says Dr Grace Malcolm, chair of the Te Arawa Iwi Māori Partnership Board and GP for Ngāti Pikiao Health Services under the umbrella of Te Rūnanga O Ngāti Pikiao.

The board views the ownership change as a win-win for iwi, Māori, and the general population within Te Arawa.

The pōwhiri attracted whānau from across the rohe including former co-leader of Te Pāti Māori Te Ururoa Flavell and one of the previous owners of the Ōwhata Medical Centre Dr John Armstrong, fondly known as a “generational GP” by Ngāti Pikiao.

He commended Pinnacle’s courage, setting an example to other PHOs and business owners of what it means to form a deep and true partnership to address inequity.

“To my knowledge, this is the first time this has happened in Aotearoa, and I hope it won't be the last. It was a brave step by Pinnacle,” says Armstrong.

“Justin has been driving significant change within the organisation since taking over as CEO. Today is the realisation of one aspect of that significant change.

“Let’s acknowledge that Māori are the best people to have governance over the delivery of health care to their own people. Something that iwi have been saying for years.”

From left, Mapihi Raharuhi, Dr Grace Malcolm and Pare Merito at Pounamanui, Houmaitawhiti, Marae in Rotorua. Photo: Sarah Sparks/Stuff.

At the hākari afterwards, Pare Merito, general manager of Te Rūnanga O Ngāti Pikiao Trust, had the last word when sharing kōrero about the months invested with Pinnacle to negotiate the handover.

“I remember that time. They’d come down from Hamilton. It was August 4th, on a cold winter’s morning, and we would have our meetings at half past seven in the morning.

“We said, ‘We've been on this journey for nine months. It's as long a time as it takes for a woman to carry. We need to deliver this child. Hopefully, it won't be a Caesar.’

“That’s the beauty of us as people, we draw from our own physical experiences to describe the places that we are in at a point in time,” she says.

- Stuff.