Te Āheinga ki Ngā Ratonga Hauora me te Manaaki Niho
He tirohanga rētō ki ngā wheako o te āheinga o ngā ratonga hauora mātāmua me te manaaki niho ki ngā tamariki me ngā rangatahi e manaakitia ana.
He mea whakatū i te tau 2019, ā, ka whakawhānui ake te wāhi ki a mātou i te tau 2023 i raro i te Oversight of Oranga Tamariki System Act. Kei a mātou te haepapa ki te hihira mena kei te whakatutuki ngā rōpū whakahaere e tautoko ana, e tahi ana hoki ki ngā me ngā i ngā hiahia o aua tamariki me aua rangatahi, ā, kei te tika te tuku ratonga me te whakawhanake i ngā hua.
I tēnei aromatawai ka titiro mātou ki te āheitanga ki ngā ratonga hauora mātāmua me te hauora niho ki ngā tamariki me ngā rangatahi e tiakina ana e Oranga Tamariki me Te Whare Kaupapa Āwhina. Ko te tuarua tēnei o ā mātou aromatawai e rētō ana te titiro ki ngā mahi kia mārama, ka mutu, kia whakawhanake ngā hua ka puta ki ngā tamariki me ngā rangatahi e manaakitia ana e ngā umanga e te kāwana rānei.
Ko tā tēnei aromatawai he whakatewhatewha i te National Care Standards (NCS) Regulations e hāngai ana ki te manaaki hauora mātāmua. Ko te te paerewa iti rawa o te manaaki me riro rā ka tika ki te tangata e manaakitia ana. Mō te wāhi ki te hauora mātāmua, e whakahau ana te NCS Regulations i te tumu whakarae o Oranga Tamariki kia mātua whakatūturu te whai wāhitanga o te tautoko ki te anganui i ngā hiahia ā-hauora o ngā tamariki me ngā rangatahi katoa e manaakitia ana, tae atu ki te whakatūturutanga o te tika o te whai i te huarahi e whakauru ai rātou ki ngā whakahaere hauora mātāmua (PHO), kia tirohia te hauora me ngā niho i ia tau, ka mutu, kei te aromatawai, kei te whakatutuki hoki ō rātou hiahia ā-hauora, ā-oranga anō hoki.
Ka titiro tēnei aromatawai ki te momo mahi, ki ngā ratonga, ka mutu, te tautoko e karapoti ana i ngā tamariki me ngā rangatahi e manaakitia ana, ki te whakaū i te whakatutukitanga o te NCS Regulation herenga-hauora. Mā roto mai i ngā hihira ā-tau e taea ana ētahi atu hiahia ā-hauora, ā-niho anō hoki te tautuhi me te rongoā. Hei tauira, ko te rite tonu o te pā o te pirau niho tētahi o ngā tino mate horapa-kore tamarikitanga ki , heoi, i te nuinga o te wā e taea ana te aukati. Ko te kino o te hauora ā-waha ka pā ki te hauora ā-tinana, te hauora ā-hinengaro, te angitu ki te mātauranga, ka mutu, ngā hua ki te whiwhi mahi1.
I tēnei aromatawai, ka titiro mātou ki ngā mea e pai ana, ka mutu, ki ngā mea kāore i te pai hei tohu i ngā mahi whakawhanake kei roto, ka mutu, horapa i te pūnaha oranga tamariki. Tae atu tēnei ki ngā tamariki me ngā rangatahi e manaakitia ana, e tiakina ana hoki e Oranga Tamariki me Te Whare Kaupapa Āwhina2 .
Pērā i tā mātou aromatawai rētō tuatahi, Returning Home from Care, ka whai whakaaro hoki tēnei aromatawai ki te tūranga o ētahi atu umanga kāwanatanga ki te tautoko i ngā tamariki me ngā rangatahi e manaakitia ana. Ehara i a Oranga Tamariki te tūranga ki te tuku ratonga hauora. Nō reira, he mea hirahira te tūhono i ngā kaiwhakarato hauora ki ngā pūnaha e tautoko ana i ngā tamariki me ngā rangatahi e manaakitia ana.
E mōhio ana mātou ki ngā kaupapa hauora e whakahaerehia ana e whai pānga ana ki a Oranga Tamariki Action Plan.3 Inā rā, tā te aromatawai ā-hiahia rētō ki te hauora mātāmua whakarite i tā te kāwana ‘higher duty of care’4 ki ngā tamariki me ngā rangatahi e manaakitia ana.
E whakamiha ana mātou he mahi kē atu e whakahaerehia ana kia noho tōmua te āheinga o tēnei rōpū ki te hauora manaaki. Ko tā tēnei aromatawai he whakahira i ngā wāhanga kē atu hei whakawhanake.
Ko ngā whakamihi o te ngākau ki ngā tamariki, ngā rangatahi, ngā kaitiaki, ka mutu, ngā kaimahi i tuari i ō rātou wheako me ō rātou mōhiotanga ki a mātou.
Arran Jones
Chief Executive
Nova Banaghan
Chief Monitor
Ko tā tēnei aromatawai he aro ki te National Care Standards (NCS) Regulations e hāngai ana ki te kuhunga me te āheinga o ngā me ngā e manaakitia ana ki ngā ratonga hauora mātāmua me te manaaki niho. E mataara ana mātou ki ngā āwangawanga whānui mō te kuhu ki ngā ratonga hauora mātāmuri pēnei me te hauora ā-hinengaro, ka mutu, ko ētahi o ēnei kua kapi i tā mātou rīpoata Experiences of Care.
Kua kitea e mātou kāore i te pai te whakamahia o te herenga-hauora. Ko ngā wheako o ngā tamariki me ngā rangatahi kua ranu. Heoi, ara noa atu ngā kaupapa i mārama te puta.
E rehurehu ana te māramatanga ki ngā herenga e hāngai ana ki te NCS Regualations-he aha te hihira hauora ā-tau, ka mutu, hei āhea whai wāhi te whakaaetanga o ngā mātua, te rānei. I rongo mātou i roto i ō mātou toronga aroturuki e rehurehu ana te māramatanga ki ngā kaupapa here, ka mutu, ngā tohutohu ki ngā tauwhiro Oranga Tamariki, nā tēnei, ka ririo mā ngā kaitiaki te haepapa i ētahi wā ki ngā whakaritenga manaaki-hauora, ka mutu, i ētahi wā kāore i a rātou ngā pārongo matua herenga-hauora o ngā tamariki me ngā rangatahi e tiakina ana e rātou. Kāore mātou i rongo i ngā kaimahi, i ngā kaitiaki rānei mō ngā whakangungu, ahakoa tonu, kua whakamōhio mai a Oranga Tamariki e wātea ana ngā pārongo me ngā whakangungu ki ngā kaitiaki rāua tahi ko ngā tauwhiro. Nō Oranga Tamariki ka tohu ki tā rātou aratohu hei taunaki i te mārama o te whakatako i ngā kawatau, i rongo hoki mātou i te tari ā-motu o Oranga Tamariki kāore te aratohu mahi i whakauruhia puta noa i te rōpū whakahaere. E tohu ana ō mātou toronga aroturuki kāore i mārama tā te tari ā-motu o Oranga Tamariki whakatakoto i ngā kawatau ki te whakatūturu i te āheinga o ngā tamariki me ngā rangatahi ki ngā ratonga hauora mātāmua me te manaaki niho.
E whakahau ana te NCS Regulations kia āta whakaritea te ara ki te whakaurutanga o ia o ngā tamariki me ngā rangatahi e manaakitia ana ki tētahi whakahaere hauora mātāmua (PHO) ka mutu, kia whiwhi hihira ā-tau ki ngā niho me te hauora. Kua whakaritea ēnei ture, inā hoki, e putuputu ana ngā hua hauora aukino ki ngā tamariki me ngā rangatahi e manaakitia ana. E tuku ana te hihira hauora ā-tau i te āheinga ki te tautuhi wawe i ētahi atu hiahia ā-hauora, ka mutu, ki te tika te o whakamōhiotanga ki ngā mahere me te āheinga ki ngā ratonga.
I roto i te tau ka hori, kua āta whakarite a Oranga Tamariki kia pai ake te māramatanga ki te pāpātanga o te kuhunga o ngā tamariki me ngā rangatahi ki ngā ratonga hauora mātāmua mā te whakataurite raraunga ki a Te Whatu Ora. Kua kitea mā te whakataurite raraunga he 93 ōrau o ngā tamariki me ngā rangatahi e manaakitia ana kua kuhu ki tētahi PHO, i te 30 o Hune, 2023. Kua tātari hoki a Oranga Tamariki i ngā raraunga mā te Intergrated Data Infrastructure (IDI) kia mārama ki ngā toronga tākuta arowhānui (GP). Ko ngā raraunga IDI nō te 30, o Hune 2021 e tohu ana kua āhua 70 ōrau o ngā tamariki e manaakitia ana kīhai i neke atu i te kotahi wā kua kitea e te GP i roto ngā marama-tekau mā rua kua hori.
Heoi anō, kāore e taea e Oranga Tamariki te kite i ngā raraunga whakauru tika i tōna anō pūnaha, inā hoki, kāore i oti ngā pūkete. Ka whai pānga tēnei ki te āheinga ki te tūhura pārongo matua ki ngā kaitiaki, ki ngā whānau me ētahi o ngā tauwhiro e mahi tahi ana pea ki ngā tamariki me ngā rangatahi. Kei te ngoikore tonu te wawe o te whakatūturu i te kohia o ngā raraunga e ngā tauwhiro.
I rongo hoki mātou ehara i te mea kei te rite tonu te kohia o ngā raraunga tūtohu herenga-hauora e Oranga Tamariki i ō rātou hoa manaaki, ka mutu, me mau i tēnei e whai wāhi ai ki te manaakitanga e tukuna ana e ngā hoa manaaki ki ngā tamariki me ngā rangatahi. Nā te ngoikore o ngā pārongo, kāore e taea e Oranga Tamariki ngā pārongo te tūhura ki ngā kaiwhakarato hauora ki te whakawhanake i te āheinga ki te manaaki hauora mātāmua. Koia tēnei te āhuatanga ahakoa tā mātou i rongo mō te hiahia o ngā mātanga hauora ki te whakaū i te āheinga o ngā tamariki me ngā rangatahi e manaakitia ana ki ngā ratonga hauroa e hiahiatia ana.
Ahakoa tā mātou kite i ētahi wāhi e pai ana te mahi, ka mutu, i rongo mai i a Oranga Tamariki e whānui ana te āheinga o ngā tamariki me ngā rangatahi ki te manaaki hauora i te wā e hiahiatia ana, me pai kē atu te whakatinanatanga me te whakahaere puta noa i a Oranga Tamariki. He mea hirahira te āheinga ki te hauora manaaki mātāmua, inā hoki, he kino kē atu ngā hua hauora ki ngā tamariki me ngā rangatahi e manaakitia ana i ngā mea kāore e manaakitia ana. Mā roto mai i te hauora mātāmua e taea ngā hiahia ā-hauora te tautuhi me te whakatutuki, ko te hua ka puta, ko te pai kē atu o ngā hua ā-hauora ki tēnei rōpū.
Kei tā mātou rīpoat Experience of Care in Aoteroa ā-tau ka whānui te whakatewhatewha i te tūtohu ki te NCS Regulations. Tae atu tēnei ki te whānuitanga o ngā tamariki me ngā rangatahi e manaakitia ana kei te tautokohia, ka mutu, kei te aromatawaingia i tua atu i te āheinga ki te manaaki hauora mātāmua.
1 www.health.govt.nz/system/files/documents/publications/good-oral-health-strategic-vision-2006.pdf
2 Kāore mātou i āpiti i a Barnardis ki tēnei aromatawai nā te iti rawa o ngā nama ki ngā kei te manaakitia e Barnardo me te whakataurangi kua taea e Barnardos te whakarato mō te wāhi ki ngā tūtohu ki te .Kāore mātou i āpiti i a Barnardis ki tēnei aromatawai nā te iti rawa o ngā nama ki ngā rangatahi kei te manaakitia e Barnardo me te whakataurangi kua taea e Barnardos te whakarato mō te wāhi ki ngā tūtohu ki te NCS Regulations.
3 Ko tā te Oranga Tamariki Action Plan he whakarite ka pēhea tā ētahi umanga kāwana tahi ki te whakawhanake i ngā hua ki ngā me ngā rangatahi e “whai pānga ana” ki a Oranga Tamariki. Koinei aua tamariki me ngā rangatahi kei te tūpono ka kuhu ki te rokiroki o te kanawa, kei te rokirokihia e te kāwana, ka mutu, rātou katoa kua puta i te rokiroki o te kāwana pakeke iho i te 25 tau.
4 Oranga Tamariki Action Plan (OTAP) In-depth Needs Assessment Report, Primary Health Needs of Children and Young People in Care (June 2023), whārangi 4