d. Increase the provision of free primary health care service to all children aged under 18. e. Increase the provision and accessibility of primary health care services to socioeconomically deprived communities, including primary health care delivered by Whanau Ora providers. f. Ensure that Māori and Pasifika peoples are represented and empowered in decisionmaking processes in health and disability policy, planning and delivery. Health – disabled people 26. In 2011 the Ministry of Health’s report on Health Indicators for New Zealanders with Intellectual Disability noted that people with intellectual disability were more disadvantaged, in terms of their health and life expectancy, compared to people without intellectual disability. Males with intellectual disability have an average life expectancy of more than 18 years below the average for New Zealand males and females with intellectual disability have an average life expectancy almost 23 years below the average.27 Concerns about serious health outcomes for intellectually disabled people have been noted as far back as 2004.28 27. The need to improve access to health services and health outcomes for disabled people, particularly those with intellectual disability, is reflected in the Government’s Disability Strategy and the Disability Action Plan. However, actual progress towards achieving this goal has been minimal and no substantive changes appear to have been made to address this urgent issue. Recommendation 5 Urgently, before December 2018, take substantive and demonstrable steps to improve access to health services and health outcomes for disabled people, particularly those with intellectual disability, in accordance with the New Zealand Disability Strategy and Disability Action Plan. 28. The Commission notes the reference at paragraph 25 of the Government’s report to the case of Atkinson v Ministry of Health. This litigation culminated in 2012 with the New Zealand Court of Appeal’s judgment that the Ministry of Health’s policy of not paying family carers for care provided to dependent adult disabled family members 11