Delivering on diversity: The challenges of commissioning for Whānau Ora

Amohia Boulton, Heather Gifford, Tanya Allport, Haze White


As the populations of Western, so-called “first-world” countries grow; so too do the pressures for the funding, purchasing, and provision of high-quality health care for their citizens.  The drive to purchase and monitor outcomes, as opposed to simply accounting for outputs, has grown in strength in New Zealand and elsewhere, as a means of ensuring greater accountability for spending and ensuring every dollar invested in health care has some positive, downstream impact. 

This paper, based on a small qualitative research study, explores a specific model of purchasing for outcomes, namely the Te Pou Matakana (TPM) model of Whānau Ora commissioning. We explore how commissioning as a particular model for purchasing services has fared in terms of delivering for Whānau Ora. The paper provides a brief history of Māori health provider development, as a means of establishing the roots of the TPM commissioning approach. We then explore in greater detail the commissioning approach unique to this case study site before presenting the study itself, our data collection methods, results, and analysis of those results. The paper concludes that in the New Zealand context, commissioning as a purchasing model has benefited from alignment with Whānau Ora principles, to the extent that an Indigenous model of commissioning is apparent in the TPM commissioning approach.


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