Meet the new chief executives

Fepulea'i Margie Apa

Kia ora koutou, talofa lava, mālō lava le soifua. My name is Fepulea'i Margie Apa. I am a New Zealand born Samoan. I'm the proud child of immigrant parents. My father, matter of fact, my Fepulea'i title comes from my father's village of Sala'ilua in Samoa, and my mother from Faleāsao.

I'm married to Riki Apa who is from the rugby playing village of Moata'a in Samoa. Proud mum of Sapati, who is 24-years-old. And she's called Disciple Pati, that's her entertainment name, so there's a free plug for her, and Hinauri who is a 21-year-old university student.

They, and my family, and the aspirations that they had when they came to New Zealand for a better life for themselves and their extended family, is the motivation that I have in working in the public sector.

I'm really proud to be in the public sector and health, and it is a inspiration every day to see what my colleagues do to improve the health of their patients and their families and communities. And that's what's exciting to me and why I'm still here.

Riana Manuel

Kia ora, ko Riana Manuel toko ingua.
No Pare Hauraki ahau.
Ki te taha o toku papa, ko Ngati Pukenga, Ngati Maru, Ngāti Kahungunu o ko iwi.
Ki te taha o toku mama, ko ate tangata Pākehā.
Engari nge rā te mihi, kia ora koutou katoa.

My name's Riana, I hail from the tribes of Ngati Pukenga, Ngati Maru and Ngāti Kahungunu, and on my mum's side, from a rich and very, very long history of Pākehā who came over here many years ago. So that's my kind of story.

I'm a mama to a big crew that includes the babies I gave birth to and the babies that I gave rise to, as I like to say, so seven all together and I have, at the moment, twelve grandchildren who remind me every day of what I'm here to do.

Big believer in service, love my village, love my marae and love being able to make sure that people all around me get to do the best jobs they can do every day, so really looking forward to the challenge and the journey with my Te Tiriti partner over here.

Yeah, thank you very much for the opportunity.

[Question: How are you going to work together?]

Fepulea'i Margie Apa

We are going to be joined at the hip.

Riana Manuel

Literally.

Fepulea'i Margie Apa

I think this is the really exciting thing about re-imagining a partnership and having Māori perspectives and decision making at all levels of the organisation, starting at the top.

We want to acknowledge that our boards have set the tone for how we do work together.

There will be times where we, the Māori health authority, need to be able to give us, as Health New Zealand, friendly and constructive criticism where we're not doing things fast enough or heading in the right direction.

I think it's a bit like ‘within our whānau’.

Riana Manuel

Yeah.

Fepulea'i Margie Apa

We've got to be able to be critical of each other but actually, importantly, move together and support our sector to do the right thing for our communities, so it's very exciting.

Riana Manuel

Yeah, absolutely, and of course we want to do all this in a mana enhancing way.

So we seldom get result when we work in opposition of each other, and I think you can see examples of that throughout every system, so the aim here is that we work in a way that's pono, tika, it keeps our values and our vision in sight, and that we move toward that goal of oranga whanau for all our people.

It's an aspirational view.

It's something that we want to make sure that as good partners, that we constantly work on that.

So like all good journeys, there'll be bumps in the track but I think making sure that we, and again we know that this is demonstrated in our boards, it'll be demonstrated in the relationship that Margie and I have and that will flow down into the localities as they describe their partnerships as well.

[Question: Isn't this a challenging time to do health reform?]

Now, it's always going to be a challenging time to do a reform, a health reform.

This is the first time in 30 years that we've gone down this path and of course it's timely.

We have to make the changes now, it's urgent.

We know that there are all of these tensions around COVID et cetera but we've got to get this health system back up and moving and fit for purpose.

Fepulea'i Margie Apa

We're going to have to be really mindful of the pace of change and listening to our colleagues, the sector and stakeholders who might be saying things like, "Actually some of  what we're doing is okay," or "It's not broken."

And so let's preserve what's working well but also not miss the opportunity to improve and move on the things that again, many in the sector have been talking about that we do need to simplify and unify the way that we do things in the sector.

Riana Manuel

What I'm most excited about is that this is a real demonstration of how Te Tiriti can work in partnership and it's the first of our public sectors to come out there and say, "Let's give partnership a real go" and address the issues around inequities.

So that's what's exciting me at the moment.

The opportunity to be a good tupuna and make sure that we forge a way forward that will leave our tamariki and our mokopuna in a much better place than we currently find ourselves.

Fepulea'i Margie Apa

I agree, Riana, the opportunity to really make a change in the many equity challenges that we have in the system is really exciting.

And to learn to be a good partner and re-think the way that we do work with Māori through the authority.

I think the other really great opportunity, and what excites me, is having been a professional working in this sector, in our current design for over 20 years, that actually there are some things that we could simplify.

The way that we make decisions, the way that we engage our staff, our workforce.

I think those opportunities to do that in a unified way across the system is going to be really exciting.

Rather than having lots of decision makers being involved.

There are lots of unifying truths in the way that we do things that most people agree, we could do much simpler. So that's exciting.

Riana Manuel

Indeed.

[Question: What will the changes mean for Māori and Pacific communities?]

Fepulea'i Margie Apa

What these changes mean for Māori, for Pacific, for groups who have not had the benefits of good health outcomes from our system, is that we can be much more flexible, both from a commissioning perspective, but also from the way that we deliver our hospital and specialist services, that we are focused on those areas that we don't want variation.

As a national system, we don't want to tolerate people experiencing difference in access or a difference in health outcomes, but we are also actually encouraging and supporting a diversity of delivery models that actually work best and reach out to those communities in far better ways than if we designed a prescriptive one-size-fits-all model, and I think all up and down across the country, there are lots of innovations, and how we've reached out to rural communities, to Māori, to urban Pacific, that have emerged almost in spite of the way the system works, and in this, the opportunity is to actually enable and encourage those models to really thrive because they do reach out to our communities.

Riana Manuel

Absolutely, and I think COVID is an opportunity. It's been a massive learning opportunity and it really gives us some key signals, and I know for myself, out on the front line is, I'll be out there this weekend, just as an aside, but having been there a few weeks ago, there is an opportunity here whereby whanau voice and localised responses have been the best responses and the best way to get services, to get clinical care, and of course, to get those social services into our families as need.

I want to also point out too that it's been an opportunity to work collectively and collaboratively across the sector.

And that's one of the things that I also get excited about.

The opportunity, for often health is most affected by those other social determinants, if you like.

So, taking the opportunity inside this reform to make sure that we don't lose that opportunity will be important as well.

[Question: What are your top priorities?]

Fepulea'i Margie Apa

So the top priorities, particularly over the next few months will be to get right people around us.

Build our leadership teams that get the best of what we can out of the experience and the skills and the expertise we have in our system.

And then as a team, we are communicating and engaging with our colleagues on what the next steps look like as we flow change through the system.

It's certainly important that we are building a team that people can look to with trust and confidence, but that we're also managing the pace of that change to not be tone deaf to the pressures that are happening at the front line.

Riana Manuel

Yeah, absolutely, and of course, to make sure that we've got the right plans ready to go, fit for purpose and well communicated all the way down into our communities, so that people understand what it is we are doing at any given time.

I think communication is key and it's something that we'll be doing often and that we'll be doing together as well.

[Question: What gets you out of bed in the morning?]

Fepulea'i Margie Apa

What gets me out of bed in the morning is actually just knowing that in the next day or the weeks ahead, engaging and talking to people about what their vision and aspirations are for the system.

I think that even within the pressures that our teams see every day, just that there's still exciting conversations about what's possible and how we can do things better and having a listening ear to that.

So I'm really looking forward to getting out and talking to people in the sector in services, at the front line on what you are experiencing but also what you see as opportunities to just make things better for ourselves and for our communities.

Riana Manuel

Yeah, tautoko.

What gets me out of bed every day, other than an alarm clock is, because the day starts pretty early in these new jobs.

But the other thing too is being mindful all the time of being a good tupuna.

I'm a grandmother, I'm a mother, as is Margie.

One of the things that will always get me out of bed is making sure that I turn up and that every decision that I make is leaning toward what would the future look like? How will this impact on their future, and how can we make the current settings just right to create that oranga whanau?

Fepulea'i Margie Apa

Kia ora koutou, talofa lava, mālō lava le soifua. Ko Fepulea'i Margie Apa tōku ingoa. He Hāmoa au, i whānau ki Aotearoa nei. He tamaiti whakahī au nā ōku mātua manene nei. Ko tōku pāpā, ka mutu, ko tōna taitara i ahu kē mai i te papakāinga o Sala'ilua ki Hāmoa, nō Faleāsao tōku māmā.

Ko Riki Apa tōku hoa rangatira, nō te papakāinga tākaro whutupōro o Moata'a ki Hāmoa. He māmā whakahī au ki a Sapati, e rua tekau mā whā ōna tau. Ko tōna ingoa hoki ko Disciple Pati, he ingoa whakangahau tēnei nōna. Ā kāti, he paku whakatairanga noa tēnei i a ia. Tae noa rā ki a Hinauri, e rua tekau mā tahi ōna tau, he tauira ia ki te Whare Wānanga.

Ko rātou, ko tōku whānau me ō rātou tūmanakotanga i te taenga mai ai rātou ki Aotearoa nei ki te rapu i te oranga mō rātou me te whānau whānui, koinei te tino whakaweawenga mōku kia uru au ki ngā mahi i te rāngai tūmatanui.

E whakahī ana au i tōku noho ki te rāngai tūmatanui me ngā mahi hauora, ka mutu, e whakamīharo ana au i tōku kitenga i ōku hoa mahi e whai nei ia rā, ia rā ki te whakapiki i te hauora o te hunga tūroro, ō rātou whānau, me ngā hapori hoki. Nō konei au i hiamo rawa ai.

Riana Manuel

Kia ora, ko Riana Manuel tōku ingoa.
Nō Pare Hauraki ahau.
Ki te taha o tōku pāpā, ko Ngāti Pūkenga, Ngāti Maru, Ngāti Kahungunu ōku iwi.
Ki te taha o tōku māmā, ko ia te tangata Pākehā.
Engari, nei rā te mihi ki a koutou katoa.

Ko Riana tōku ingoa, nō ngā iwi o Ngāti Pūkenga, o Ngāti Maru me Ngāti Kahungunu, ā, ki te taha o tōku māmā, he uri au nō ngā kāwai hekenga Pākehā i tau mai ki konei i ngā tau maha ki muri. Ā, ko au tēnei.

He māmā au ki te tokomaha; ko ngā pēpi i whakawhānauhia mai e au, me ngā pēpi i whakatipuria mai e au. Nā reira, tokowhitu katoa rātou, ā me te aha, nā aku mokopuna tekau mā rua nei au i tauwhiro kia uru ai au ki ēnei mahi.

E ngākau pono ana au ki ngā mahi tuku ratonga. He kaingākau ki tōku papakāinga, ki ōku marae, ka mutu, he aroha hoki nōku ki te tautoko i te hunga kei tōku taha e mahi ana kia tutuki pai katoa ā rātou mahi ia rā, ia rā. Nā reira, e hīkaka ana au ki ngā wero, me te whai i tēnei huarahi ki te taha o tōku kōtuinga ā-Tiriti nei.

Āe rā, e mihi nui ana i tēnei āheinga nui.

[Ka pēhea māua e mahi tahi ai]

Fepulea'i Margie Apa

E rua, e rua.

Riana Manuel

Āna.

Fepulea'i Margie Apa

Koinei tētahi āhuatanga whakahirahira o roto i tēnei kaupapa pupuru i tētahi kōuitanga. Kia tūturu ai te tirohanga me ngā tikanga whakataunga Māori puta noa i tēnei wāhi mahi, kia tīmata mai i runga.

Me te whai whakaaro hoki ngā Poari e whakatau nei i ngā whakahaerenga ka pēhea māua e mahi tahi ai.

Ka tae tonu te wā mō Te Mana Hauora Māori ki te tuku mai i āna tapitapinga ki a mātou o Hauora Aoteroa i ngā wā e pōtatutatu ana, e kotiti haere ana.

He pērā anō pea ki ‘ō mātou ake whānau.’

Riana Manuel

Āe.

Fepulea'i Margie Apa

E tika ana, me whakaaro nui tā māua arohaehae i a māua, heoi, ko te mea nui me kōkiri tahi, me tautoko i tā māua rāngai i runga i te tika mō ā tātou hapori. He mea hirahira tēnei.

Riana Manuel

Āe marika, mātua rā hoki he kōkiri i ēnei mahi kia whai mana ai.

E kore noa ngā mahi e whai hua i te noho wehewehe, inā noa te nui o ngā tauira puta noa i te pūnaha. Nā reira, ko te aronga kia aratakina ngā mahi mahi i runga i te pono, i te tika, kia mārama ai ā mātou uara me te tirohanga anga whakamua hei oranga mō ngā whānau, me te iwi whānui hoki.

He tirohanga whakangākau tēnei.

Koinei tētahi āhuatanga me whakamātauria e tēnei kōtuitanga, haere ake nei.

I ngā ara takahi katoa, kei reira ōna uauatanga. E kitea nei i ngā mahi a ngā Poari nei, ka kitea i roto i ā māua ko Mārgie mahinga ngātahitanga, ka kitea hoki i ngā hapori me ā rātou whakaritenga kōtuitanga hoki.

[He wā whakapātari mō ngā whakahoutanga hauora]

Kāo, ka pēnei tonu ngā wero arataki haere i ngā whakahoutanga hauora, ao noa, pō noa.

Kua aua atu te toru tekau tau i kore ai tātou e para i tēnei momo huarahi. Āe ka tika hoki, kua tae te wā.

Me mātua kōkiritia e tātou ngā panonitanga ināianei nā.

Kei te mārama katoa tātou ki ngā whakararu mai a te KOWHEORI, aha atu. Engari, ko tā tātou mahi he whakaara ake anō i tēnei rāngai hauora i runga i te ara tika.

Fepulea'i Margie Apa

Me whai whakaaro nui tātou ki te ahunga o ngā panonitanga, me whakarongo hoki ki ō tātou hoa mahi, ki te rāngai me te hunga whai pānga hoki pea e whakapae nei, “tēnā, kei te pai noa ā tātou mahi,” āe rānei kei te kī, “kāore te mea nei i te raruraru.”

Nā reira, me tiakina ngā whakahaerenga pai, engari, me kaua tātou e huri tuara noa ki ngā mahi whakapaipai, kōkiri hoki i ngā kaupapa e kōrerotia ana e te tokomaha, arā, kia māmā ake, kia kotahi ngā whakahaerenga o te rāngai.

Riana Manuel

Ko tāku e hiamo rawa nei, koinei te whakatauiratanga mai o te mahinga ngātahi o Te Tiriti, ka mutu, koinei te tuatahi o ā tātou rāngai tūmatanui kua tahuri mai me te kī, “me whakamātauria tēnei mea te kōtuinga,” ka whakatika haere i ngā take e pā ana ki te mana ōrite.

Nō konei tōku ngākau hiamo i tēnei wā.

Ko te āheinga kia tū hei tupuna mana nui, me te whai hoki kia parangia he huarahi anga whakamua e pai ake ai te ao e noho mai ā tātou tamariki me ngā mokopuna i te ao o mohoa e noho nei tātou.

Fepulea'i Margie Apa

E tautoko ana, Riana. He āhuatanga rikarika tēnei āheinga ki te tapitapi haere i te nui o ngā uauatanga mana ōrite o te pūnaha.

He ako hoki pēhea te mahi tahi hei kōtuinga pai, me te whakaaro anō ki ngā whakaritenga mahi tahi me ngāi Māori i roto i te rōpū nei.

Ko tētahi atu āheinga pai e whakahīkaka ana i au nei nā, kua neke atu i te rua tekau tau au e mahi ana ki tēnei rāngai me āna whakahaerenga, āe marika he whakahaerenga kei konei konei hei whakamāmā ake mā tātou.

Ko te āhua o tā tātou whakatau kaupapa, ko te āhua o tā tātou mahi tahi me ngā kaimahi,
ohu mahi hoki.

Ki au, e whakarikarika ana kia whai āheinga ēnei kaupapa i runga runga i te whakaaro kotahi puta noa i te pūnaha.

Engari anō te tokomaha o te hunga whakatau kaupapa ka whai wāhi atu.

E whakaae ana te katoa, inā noa te nui o ā mātou whakahaerenga me āhua māmā ake. Nā reira, he āhuatanga pārekareka tērā.

Riana Manuel

Ka tika hoki.

[Ngā hua o ēnei panonitanga mō ngā hapori Māori, Pasifika hoki]

Fepulea'i Margie Apa

Ko te hua o ēnei panonitanga ki a ngāi Māori, ki a ngāi Pasifika me ērā rōpū kāore anō kia taka he hua hauora ki a rātou, ko te pīngoretanga i roto i ā tātou tirohanga huahoko, ko ngā mahi tautoko me te whakatutuki haere i ngā ratonga hohipera me ngā ratonga mātanga hoki. Kia aro pū ake tā tātou titiro ki ngā ritenga mahi me kaua e whakarerekētia.

I te mea he rāngai ā-motu tēnei, ko te whāinga kia kaua ngā ara torotoronga a te iwi e rerekē, kia kaua rānei ngā putanga hauora e rerekē, engari, kei te whakaaweawe, kei te tautokona te huhua o ngā mahere e tika ana kia pai ake ngā ara toro ki ngā hapori, kia kaua e ū noa ki te ara kotahi. Me te aha, he nui ngā auahatanga huri noa i te motu i ā mātou toronga ki ngā hapori, ki a ngāi Māori, ki a ngāi Pasifika hoki ahakoa ngā toimaha o te pūnaha. Mā tēnei, ka hua ake he āheinga ki te whakatinana i aua mahere whai hua nā te mea he nua nui ka puta i ēnei ki ngā hapori.

Riana Manuel

Āe marika. Ki au, he āheinga tonu te KOWHEORI. He nui ngā akoranga kua puta, he maha ngā tohu pai mai. Mōku ake, i tae au ki te mura o te ahi i ngā wiki tata kua huri, he āheinga kei konei nā runga i te reo o ngā whānau me ngā hapori kia riro ai i a rātou ngā ratonga, ngā haumanutanga, tae noa ki ngā ratonga pāpori ki ngā whānau e tika ana.

Me te aha, he āheinga hoki tēnei e taea ai tātou katoa te whakakotahi i runga i te wairua mahi tahi puta noa i te rāngai.

Koinei hoki tētahi āhuatanga e whakahīkaka ana i au.

Me kī, ka whai hāngaitanga ngā ētahi atu pānga ā-pāpori nei ki te āheinga hauora nei.

Nā reira, he āhuatanga nui hoki te pīkau i te āheinga mō tēnei whakahoutanga mō te tūpono ka ngaro noa atu i a tātou tēnei āheinga.

[Ā māua whāinga tōmua]

Fepulea'i Margie Apa

Ko ngā whāinga tōmua hei ngā marama e tū mai nei, ko te whakahuihui mai i ngā tāngata tika hei mahi tahi me māua.

He whakakao mai i ētahi rōpū hautū e ekea ai ngā taumata o ēnei tūmomo mahi mā roto i ngā pūkenga kei tō tātou pūnaha.

Waihoki, ko tā tātou he whakapā, he āta kōrero mō ngā kawenga mahi ka whai mai kia rere tika ai ngā panonitanga puta noa i te pūnaha.

Ka tika hoki, he mea nui te whakakao i tētahi rōpū ngākau pono, ngākau titikaha hei whai mā te nuinga, me te aha, me āta whakamātauria te āhua o ngā pānonitanga kia kaua rā tātou e kuare ki ngā uauatanga ka pā mai i te hei o ngā mahi.

Riana Manuel

Āe, ka tika hoki. Kia rite mai ngā maheretanga tika, kia hāngai, kia mārama hoki mai i runga tae noa ki ngā hapori, kia mōhiotia he aha ngā kaupapa e kōkiritia ana e mātou.

He mea nui te whakapāpātanga, ā, ka nui rawa hoki tā māua kōrerorero kia kotahi ai.

[Ngā āhuatanga whakaoho mai i a māua i ia ata]

Fepulea'i Margie Apa

Ko te mea e whakaoho nei i au ia ata, ko te titiro ki ngā rā, ki ngā wiki kei mua i te aroaro me te āta kōrero ki te marea e pā ana ki ā rātou hiahia, tūmanako hoki mō te rāngai.

Ki au, ahakoa ngā wero nui ka pā mai ki ā māua rōpū ia rā, he wairua hīkaka tonu e rongohia ana i ngā whakawhitinga kōrero e pā ana ki ngā mahi ka taea, ki ngā āhuatanga me whakapai ake me te areare taringa hoki ki ēnei momo kōrero.

Nā reira, e rikarika katoa ana au te huri ki te kōrero ki ngā kaimahi o te rāngai me ngā ratonga e kōkiri nei i ngā mahi, tae atu hoki ki ā koutou whakaaro mō ngā āheinga e ora ake ai tātou, otirā, ngā hapori.

Riana Manuel

Āe, tautoko.

Atu i te karaka pūoho, ko tōku ohonga ake ia rā, ia rā… i te mea, me moata tonu te oho mai i te ata i ēnei momo mahi.

He whakamātau i au anō kia tū hei tupuna mana nui.

He kuia, he māmā hoki māua ko Margie.

Ko tētahi āhuatanga hoki e oho nei au i tōku moenga i ngā wā katoa he whai kia tika mai āku whakataunga mahi i runga i te āhua ka pēhea te tirohanga hei ngā rā ki tua? Kā pēhea ngā pānga mai? Me pēhea hoki tātou e whakatikatika i ngā whakaritenga o nāianei kia hua ai te oranga o ngā whānau?