Te Puna Hauora
posted by Alastair McLean on 4 April 2012
In the inaugural Whānau Ora Awards in 2004, Māori health and social services provider Te Puna Hauora won its category with its kaupapa Māori health and disability service model ‘Harakeke – I MAP’.
Te Puna Hauora also won Te Tohu Kahukura, the Supreme Award for the model it began to articulate as early as 1997. That’s when it set up as a primary health provider addressing health inequalities for Māori, Pacific Island, immigrant and refugee people, and those with lower socio-economic status on Auckland’s North Shore.
Just one year after the Whānau Ora Award achievement, Te Puna Primary Health Organisation (PHO) was established, with 5742 enrolled clients.
Today, Te Puna Hauora services are delivered from two Northcote clinics and a Birkdale clinic to over 12,000 enrolled clients. It has a childcare centre in Northcote, and mobile mental health iwi support services based in the Rodney area.
Te Puna Hauora was effectively built on its ‘Harakeke – I MAP’ model. In this model, the heart of the flax is the individual and the whānau weave the harakeke into the shape it wants for its own health and wellbeing. Te Puna Hauora provides a service encompassing the individual and the whānau, helping them to set priorities for their health and social needs. Beyond Te Puna’s team are the external organisations that may be called upon in an integrated management plan.
‘I’ stands for individual, for interdisciplinary and for integrated. The model is about giving individuals and whānau the ability to 'map' their own road toward health and well-being, putting them at the centre of the organisational kaupapa.
In 2004, ‘I’ also referred to innovation, which was evidenced for example in rent free reception and accommodation for lawyers, doctors, dentists and budget advisors at Te Puna Hauora who would, in turn, discount services to Te Puna Hauora clients and support the complete delivery of the ‘Harakeke - I MAP’ model.
Te Puna Hauora chief executive officer Lyvia Marsden said no one was more blown away than she when they won the Supreme Award.
‘While for most it was a celebration, I experienced wehi – a reverent fear – because I knew how much there was still to do.
‘The essence was exactly as it is today. I had been a nurse working in mainstream for many years and that was all about control and us knowing best. I was so systemised that I didn’t see my own culture and my own spiritual side. It took time for me to connect whanaungatanga with collective thinking and allowing whānau to take the real control and restore themselves.
‘At that stage we had Mason Durie’s Te Whare Tapa Wha framework. We had Rose Pere’s Te Wheke. What I wanted to do was to put together a proper practice system that worked from beginning to end for individuals and their whānau. With the amount of experience I had in primary care, setting up a medical practice was not a problem. But the real challenge was creating something that worked for Māori whānau. Early in 1997 I attended ‘The Dynamics of Whanaungatanga’, a two-day seminar designed and led by catholic priest Pa Henare Tate. The effect on me was profound and it was here the I MAP model began to be formulated in my mind.
‘At the time, once I started talking about it, I thought everyone at Te Puna Hauora was on the same page. I was wrong about that and so one of the really important things for me was my daughter Lisa Chant’s ability to write. As I talked and walked, she wrote, able to capture what I was meaning.
‘We worked together on it until we got it right. We wanted to do things right, with integrity and compassion. We wanted to be able to help whānau to help themselves. It was all about restoring the mana of people. Essentially the values and principles are embedded in the constitution of the organisation and it is who we are today, but it has been a constant battle – in the clinical and non-clinical areas – to hold it true to its form. We have worked really hard from board level through to whānau in our communities to ensure we are all on board and commit to transforming lives.
‘It has been a 15-year journey to go from paper, to computer to web-based. The ‘I’ has become ‘WE’ because many in our organisation are practicing what we have learned, encouraged by witnessing the changes in the whānau we are serving.
‘Our people tell us that being heard, being respected, and being included in the process means they can begin to lead the transformation. They are able to cope with things in life that have not changed, but they’ve changed.’
Te Puna Hauora is still largely North Harbour based, and with a pharmacy also now incorporated into the service, clients up to 16 years old get a free medical service. Livvy said that was another huge challenge, but getting children free access to doctors and medicines was worth it.
‘The model is based on relational values and focuses on joint efforts to get the best outcomes for all parties in an indigenous integrated care model while ensuring that the health of our children is not impacted negatively by poverty.
‘We’ve got dentists and physiotherapists in Te Puna using the same model to support whānau ora. But the bigger whānau ora picture goes deeper than that. Ultimately whānau ora is about transformational changes in a whānau.’
In 2012, Te Puna PHO is in the process of winding down to make way for the new Te Puna Whānau Ora Network Alliance, which will align Te Puna with New Zealand's largest network of qualified GPs and general practice teams, ProcCare. ProCare and Te Puna Hauora will work together to develop and deliver Whānau Ora services to ProCare’s patients.
Te Puna Hauora provides health and social services in the community of Te Raki Paewhenua, in Auckland's North Shore City. For more information, go to: http://www.tepuna.org.nz/