A health provider in Marlborough is struggling to secure long-term funding after a decision to pull out of a newly formed Maori health coalition.
Blenheim's Te Hauora O Ngati Rarua lost all its district health board contracts when it decided not to join the new Te Piki Oranga coalition in November.
It relies on a few Ministry of Health contracts and its own cash reserves, which could dry up in six months.
Te Piki Oranga was established in July and is comprised of six Maori health providers across the top of the south to deliver Maori personal health, Maori mental health and tamariki under the umbrella of one organisation.
The focus of the whanau ora model places greater emphasis on the needs of whanau to improve health outcomes for the next two generations.
Te Hauora O Ngati Rarua's board chairman Dr Rod Bird said they pulled out of the coalition because they did not want to compromise their values or philosophical approach.
"We were in there for a long time and did our best to stay [in the coalition] but in the end the key value positions we felt were going to be undermined and were not sustainable."
With the loss of health board contracts, Bird said they were in a process of change and were looking to other funding streams to support the organisation.
"We are still in business but it is an uncertain time for us because we have to reinvent ourselves and establish an income stream that is independent of the health board.
"At the moment we are going through a period of exploration and redefinition of how we are going to survive."
Te Hauora O Ngati Rarua has 527 clients. For the remainder of the year, it will be able to self-fund from its cash reserves, whanau ora, palliative care, tane ora services, kaumatua care, nursing services and health checks.
"We are using that money because we do believe the organisation has a future and to get some space until we can organise some other income streams," Bird said.
Te Hauora O Ngati Rarua will continue to provide Ministry of Health contracts for smoking cessation, an alcohol harm minimisation project with the Health Promotion Agency and cervical screening with the Public Health Unit.
Bird said it was not clear what the new services would look like but they were broadening their scope to the social and economic determinants of health.
They would continue their relationship with Marlborough Hospice and build links with government agencies including the Department of Corrections and Work and Income.
"It's an uncertain but exciting time because it frees us up to think outside the square, which you don't really get when you are under a prescribed funding stream.
"We are looking into the future to be bigger and better. We could turn around in six months and have failed but at this stage we remain optimistic."
Te Hauora O Ngati Rarua is one of only five Maori health providers nationally to have been accredited with the EQUIP 5 Australasian standard.
The accreditation, which focuses on quality of care, runs for four years.
"It makes a public statement about our commitment to quality. To get at this level you have to be working at excellence all the time," Bird said.
Te Hauora O Ngati Rarua's main ambition was to redress inequities in the health system.
Maori men had the worst health of any population group, he said.
"The lack of responsiveness of mainstream medicine to deal with the equity gap between Maori and non-Maori is the single biggest challenge.
"Whichever disease you are looking at many of the gaps between Maori and non-Maori continue to widen.
"While the Crown has for many years recognised the validity of the treaty and its obligations, we still get tokenistic consultation or tokenistic input that hasn't resulted in a change to the system."
- The Marlborough Express