The health system reforms have set out an ambitious agenda for Te Whatu Ora and Te Aka Whai Ora to engage with communities to design and plan more equitable health services.
Work on nine pilot localities - geographic-based models for primary and community-based services - has already begun. But Māori experience of the health system has led to deep distrust, and even if this can be overcome, the system itself is riddled with long-standing distrust between funders, providers and health professionals.
Building and rebuilding trust is critical to productive engagement with communities and to system change that can deliver more equitable outcomes. Economic research provides some advice on how trust can be rebuilt, but the road ahead is long and risky and the upcoming election creates pressure for short-term wins.