So far, the confirmed reforms are designed to reshape the high-level structures that are the basis of the country’s health system. Other changes focusing in detail on service delivery will come in time, but the plans already laid out will provide infrastructure capable of shepherding through those changes and supporting our front lines.
The resulting system will look substantially different from our current one. The Ministry of Health will still oversee this system, advising the Government on policy and strategy and monitoring the overall performance of the public health system. But the day-to-day running of the health service will be managed by a new organisation: Health New Zealand (Health NZ, for short). Instead of 20 DHBs, a single Health NZ will ensure simplicity, consistency, and quality of care.
Another new organisation, the Māori Health Authority, will be in charge of commissioning health services for tāngata whenua, advising the Government on policy related to hauora Māori, and monitoring how well the system is performing for this community. For the first time, Aotearoa will have health services created by Māori for Māori. This major step seeks to guard against persistent inequities: our health system has failed to perform for tāngata whenua, who suffer from more avoidable deaths and lower life expectancy.
With the Māori Health Authority – and with strengthened Māori-iwi partnership boards acting as influencing and decision-making voices for iwi and whānau in each locality – we embed the principles of te Tiriti o Waitangi into every level of our national health system. Support for Māori health and care providers will also work to expand kaupapa Māori services, increasing reach into these communities and improving health outcomes for all New Zealanders.
A new Public Health Agency within the Ministry will provide national leadership on public health policy, strategy, and intelligence, while a new national public health service within Health NZ will unify our Public Health Units, to ensure they’re quipped to respond to challenges like COVID-19. The Health Promotion Agency will be merged into Health NZ, making sure that population health – and proactive efforts to keep people well for longer – will be enshrined in the heart of our health system.
Changes to the way primary and community care are delivered, and the way hospital and specialist services are run, will give us a fine-tuned balance between national consistency and knowledge sharing, on the one hand, and locally tailored care, designed to best serve specific communities, on the other. The details of this service delivery will be worked through with communities and with the health workers serving them.