Innovation that listens: How strategic leadership transforms health systems

Imagine if our health system truly listened. If every whānau felt seen, valued, and supported, not just by compassionate individuals, but by a system designed to uphold their mana. Imagine a future where healthcare wasn’t something done to people, but something created with them.

That is the vision driving the mahi with Healthy Families Whanganui, Rangitīkei, Ruapehu.

In a world grappling with complex and persistent social challenges, climate crisis, intergenerational poverty, mental distress, systemic racism - innovation is no longer a luxury. It’s a necessity. Many people enter public service, healthcare, or social work to make a difference. To serve. Yet too often, they find themselves trapped inside systems that quietly betray the very values they hold dear.

This is what structural racism looks like, not just prejudice between individuals, but deeply embedded practices and norms that deliver unequal outcomes, no matter how good the intentions of those within them.

As one healthcare practitioner put it:

“I show up every day to help people get well, but the system I work in makes them sick.”

Māori researchers Dr. Donna Cormack and Professor Papaarangi Reid describe it clearly:

“Racism is not simply an attitude or belief; it is a system of advantage based on race that is maintained through institutional structures and social norms.”

If we are to realise Pae Ora and healthy futures for all, we must move beyond reform. We must transform.

This transformation is being led by whānau and endorsed and supported by three Strategic Leadership Groups (SLGs). Growing Collective Wellbeing, Mokopuna Ora, and Smokefree Futures SLG’s who are prioritising whānau voice and placing their insights and ideas at the centre of strategy development. 

Their collective leadership has created space for new models of innovation to emerge, innovation that is community-led, values-driven, and grounded in Te Ao Māori. Each group focuses on a different system lever, yet they share one purpose: to drive equity, connection, and transformation at every level of the health ecosystem.

And the results are already visible. 

Hapū māmā, pāpā and whānau have reimagined the hapūtanga journey not as a clinical process, but as a cultural and relational rite of passage. Whānau have designed a Kaupapa Māori maternal hub anchored in tikanga and whanaungatanga, alongside a Kaupapa Māori antenatal pathway that includes wānanga, pūrākau, and matauranga Māori. These whānau-led prototypes like Hapūtanga Wānanga, Te Whare Piringa maternal hub and Whānau Design Villages have all been endorsed and supported. A regional leadership group now drives change across services, governance, and policy. 

The outcomes speak for themselves. Whānau are gaining confidence to advocate for their care. Practitioners are working together across silos. Pāpā are finding belonging in the birthing space.

“I didn’t realise how much I needed to talk about the birth until I heard another dad talk,” one pāpā shared. “That gave me permission. Now I know I belong in the room too — not just as support, but as a parent with a role of my own.”

This is not service improvement; it’s system redesign, anchored in whakapapa, guided by collective wisdom, and aligned with Te Tiriti. True innovation doesn’t just ask ‘What’s the problem?’ It asks ‘Who holds power?’ ‘What future’s can we co-design?’

Indigenous innovation is how we move from rhetoric to reality,  from systems that manage disadvantage, a ‘one-size-fits-all’ to systems that create wellbeing. It’s how we heal structures that have forgotten how to listen, and build new ones that finally do.