The National-led coalition disestablished Te Aka Whai Ora — the Māori Health Authority — on 30 June 2024, just 18 months after it was created. The move reversed one of Labour's signature health reforms and triggered legal challenges, a damning Waitangi Tribunal finding, and a debate that will run to the 2026 election.

The Policy: National-ACT-NZ First Coalition Agreement — Nov 2023 →

The scale of the health gap

• Māori life expectancy at birth was 73.4 years for males and 77.1 years for females in 2017–2019, against 80.9 and 84.4 years for non-Māori — a 7.5 and 7.3-year gap. It has narrowed from around 8–9 years in the 1990s and 2000s, but progress has been slow (Ministry of Health).
• Māori are hospitalised for cardiovascular disease at roughly 1.6 times the non-Māori rate (3,186 vs 1,939 per 100,000 adults aged 35+), with a stroke-related rate of 366 vs 208 and a heart-failure rate of 546 vs 136 (Ministry of Health).
• Cancer mortality is more than 1.5 times higher for Māori, who are also more likely to be diagnosed with harder-to-treat cancers (stomach, liver, lung) and have poorer survival once diagnosed, across 23 of the 24 most common cancer types (Ministry of Health).
• Diabetes affects Māori adults at close to double the non-Māori rate, with around 1.5–2 times the risk of a diabetes-related amputation or kidney failure (Ministry of Health).
• Only 69.7% of Māori infants were fully immunised at 8 months old in 2024, against 88.6% of non-Māori infants — both rates have fallen since 2015, but the Māori rate has fallen further (New Zealand Doctor).
• Access barriers compound the outcomes gap: Māori children are about four times more likely to miss a GP visit for lack of transport, Māori adults roughly 1.5 times more likely to carry unpaid clinic debt, and twice as likely to skip collecting a prescription because of cost (New Zealand Doctor).
• More Māori report experiencing discrimination in health settings — 36.5% in 2020/21, up from 27.5% in 2015 — and Māori women are about four times more likely than non-Māori women to report unfair treatment by a health professional (New Zealand Doctor).

This was the scale of inequity Te Aka Whai Ora was created in 2022 to address — and the scale that remains today, whichever side of the disestablishment debate one takes on how best to close it.

What's happening:

• Te Aka Whai Ora was established in 2022 under the Pae Ora (Healthy Futures) Act to commission Māori health services and embed Treaty-based governance in the health system. The coalition passed the repeal bill under urgency in February 2024, with the authority fully wound up by 30 June 2024.
• In November 2024, the Waitangi Tribunal found the Crown breached Treaty principles: it failed to consult Māori, did not follow its own policy guidelines, and did not inform Māori about what would replace the authority — all while knowing Māori face "grave health inequities."
• By August 2025, a High Court challenge brought by four Māori health providers — Te Kōhao Health, Te Puna Ora, Papakura Marae, and Ngāti Hine Health Trust — concluded hearings seeking a declaration that the disestablishment was inconsistent with the Treaty and the Bill of Rights Act. The judge reserved their decision.
• The government says Māori health funding has been maintained, pointing to $749 million allocated to Hauora Māori services in 2024/25 — an increase of $39 million — with functions absorbed into Health New Zealand and the Ministry of Health.
• Separately, proposed legislation in late 2025 would strip almost all functions from regional Māori health boards, leaving them only an advisory and communication role — a further erosion, critics say, of Treaty-based health governance.

Where the parties stand:

National, ACT, and NZ First all campaigned explicitly on abolishing Te Aka Whai Ora, framing a separate Māori health body as duplication and arguing that one integrated system serves everyone better. Health Minister Shane Reti has spoken of "devolved decision-making" as the replacement model, though critics note the actual devolution has been limited.

Labour, the Greens, and Te Pāti Māori opposed the disestablishment. Labour argues the authority was just beginning to deliver results when it was removed; sector leaders say it had started closing commissioning gaps that the mainstream system routinely missed. For Te Pāti Māori, reinstating and properly funding a standalone Māori health body is a non-negotiable 2026 election commitment.

The health sector broadly raised alarm: hundreds of doctors signed a letter calling the scrapping "devastating," and Ngāti Kahungunu announced it would set up its own regional Māori health authority to fill the void — a sign of how seriously iwi are treating the gap left behind.

What to watch:

• The High Court decision on whether disestablishing Te Aka Whai Ora was inconsistent with the Treaty could set a landmark precedent and force the government to act, regardless of political preference.
• Māori health outcome data over the next year will test the government's claim that one integrated system can close persistent equity gaps without a dedicated Māori-led body.
• The 2026 election will bring a sharp contrast: a centre-left win would likely see a new Māori health authority created; a returning coalition would embed the current model further through legislative changes already in progress.