The Government will consolidate all 20 District Health Boards into a single, national health service and create a new Māori Health Authority with commissioning powers, Marc Daalder reports
New Zealand will have a single government organisation running its hospitals and other health services, similar to the United Kingdom's National Health Service (NHS).
As part of long-awaited reforms to the health and disability system, all 20 District Health Boards will be condensed into a national health agency called Health NZ, Health Minister Andrew Little announced on Wednesday morning.
Health NZ will have four regional divisions and district offices throughout the country, Little said, "which will ensure it is truly in touch with the needs of all New Zealanders".
"Health NZ will take a nationwide system approach – but importantly, it will also delegate authority, so frontline health workers and communities have a real say in decisions about the health services they need."
A new Māori Health Authority will sit alongside Health NZ, empowered to commission services specifically for Māori and to develop Māori health policy. Both agencies will be monitored by a beefed up Ministry of Health, which will add oversight capabilities to its existing role as a policy shop.
The announcements incorporate the general thrust of a landmark review of the health and disability system released by Heather Simpson and four health system experts in June 2020. That review recommended the number of DHBs be reduced to between eight and 12, while the Government has gone further in eliminating all of them.
The Government's reforms also go further than the review in empowering the MHA to commission services specifically for Māori. While three of the five members of the expert panel endorsed commissioning powers in the review, Simpson and one other opposed it.
"There was no consensus on the extent to which the Māori Health Authority should control the funding and commissioning of services for Māori," the review stated at the time.
Associate Health Minister Peeni Henare, who has responsibility for Māori health, had signalled in the days leading up to Wednesday that the Government would back a commissioning Māori Health Authority.
"Many Māori don't like going to the doctor. And it's not because we don't care about our health, or the health of our whanau. It's because our experiences of the Health system, the experiences of our parents and grandparents have been negative," Henare said Wednesday morning.
"That is why we must change. That is why we must transform our Māori health system. Māori must be enabled to provide effective leadership and partnership throughout the system."
The Authority would have "joint decision-making rights" to agree national strategies, policies and plans that affected Māori, at all levels of the system, Henare said.
It would also be able commission kaupapa Māori services and will have to sign off on planning for general population health services in every locality.
The Simpson review was also criticised by public health experts for not including a standalone public health agency. The creation of such an entity was a Labour Party manifesto commitment, however, and more details about its interface with the broader health system were released by Little on Wednesday morning.
The Health Minister said the Covid-19 pandemic had reiterated the importance of public health and spurred new reforms to that sector as well. A Public Health Agency will sit within the Ministry of Health and fulfil the ministry's roles in relation to public health: strategy, policy development, analysis and monitoring.
A public health equivalent to Health NZ, a national Public Health Service, will sit within Health NZ and absorb the 12 public health units in much the same way that the 20 DHBs will be consolidated.
That means public health will be operationalised on a national basis, allowing for consistency across different regions and for public health officials to draw on extra capacity in one region to aid a different, struggling area.
