BACKGROUND

2. The New Zealand Public Health and Disability Bill will contain a provision that enables the Minister of Health to set up advisory committees for any purpose relating to the Bill, with functions as determined by the Minister of Health.

3. I propose that the Bill also make explicit provision for the NHC and a HWAC, to signal their importance. Specific legislative status will assist in getting co-operation from health providers and the public in undertaking their advisory roles.

NATIONAL HEALTH COMMITTEE

4. Section 6 of the Health and Disability Services Act 1993 (as amended in 1996) established a national advisory committee (currently known as the NHC) to advise the Minister on:
   1. the kinds, and relative priorities, of public health services, personal health services and disability services that should, in the Committee's opinion, be publicly funded

   2. other matters relating to public health including personal health matters relating to public health and regulatory matters relating to public health and such other matters as the Minister specifies by notice to the Committee.

5. On 8 May 2000 [CAB (00) M 15/3B refers], Cabinet considered the future role and functions of the NHC and agreed that:
   1. the current role and functions of the NHC remain unchanged

   2. NHC continue to be an independent advisory committee to the Minister of Health

   3. NHC functions not be specified in legislation.

6. The key arguments raised at the time by Officials in relation to 5(c) above were:
   1. specifying functions in legislation is inflexible, while it is desirable that the functions of NHC can adapt to an ever-evolving sector

   2. the need for legislatively-based functions when, as the Core Services Committee, the NHC was tasked to specify the core services that should attract public funding are no longer imperative, as the Committee's role today is much more as an influencer of decisions regarding publicly funded health services

   3. the general provision to set up Ministerial Committees allows the NHC to continue unchanged as an independent advisory committee to the Minister of Health.

7. I have now reconsidered this issue and propose that Cabinet rescind part of its previous decision on the NHC and agree that the New Zealand Public Health and Disability Bill will include a specific provision for the NHC, rolling over the provisions and conditions in the current Health and Disability Services Act 1993 (as amended in 1996).

8. The key reasons for reconsidering this matter are that:
   1. having the NHC specifically identified in legislation signals its independence and the ongoing importance of its function. A change in its legislative status at this time would be seen as directly diminishing the role of the committee, thereby undermining its credibility as a source of advice or its usefulness to me in influencing the wider health sector

   2. the NHC's statutory status has helped achieve co-operation from health providers and the public in undertaking its role

   3. the current legislative provisions give enough leeway to evolve the NHC's tasks in response to changes in the sector. The committee has had three changes to its terms of reference, within existing legislative wording.

HEALTH WORKFORCE ADVISORY COMMITTEE

9. The ongoing development of a health and disability workforce that is capable of meeting current and future service needs is one of the crucial inputs into the sector. A Health Workforce Advisory Committee (HWAC) will be established to provide advice on health workforce issues.

10. The current Act has a provision (as will the new Bill) for the Minister of Health to appoint advisory committees and determine terms of reference. Such a clause had been used in the past to establish the Committee Advising on Professional Education (CAPE).

11. I propose, however, that the new legislation includes an explicit provision for a Health Workforce Advisory Committee to provide advice on health and disability workforce issues. Although arguments against an explicit provision are the same as those outlined in paragraph 6 above, the key reasons for an explicit provision are that this will:
    1. signal the ongoing importance of health workforce issues

    2. give a mandate to ensure co-operation from health providers, education and training providers, and the public in undertaking its role.

12. The role of HWAC is to consider health and disability workforce issues to ensure an adequate and appropriately trained workforce to meet current and emerging health and disability sector needs. HWAC is to influence and guide the funding and provision of education and training programmes. Specific legislative recognition will signal the importance of workforce activities to the Government and underline HWAC's credibility in influencing workforce development. HWAC will work with the Ministry of Health (and its Clinical Training Agency), the District Health Boards, and other agencies with an interest in workforce development issues (such as the Mental Health Commission and education and training providers) to ensure its independent advice is coordinated with the work of those other agencies.

13. I have recently appointed a reference group to provide expert advice on terms of reference for the HWAC, required skill sets and backgrounds of members. Once that reference group has reported back to me I will establish HWAC and advise it on the precise terms of reference in writing.

CONSULTATION

14. The following agencies were consulted in preparation of this paper: Crown Company Monitoring Advisory Unit, Department of the Prime Minister and Cabinet, Ministry of Pacific Island Affairs, the Treasury, Te Puni Kokiri, the State Services Commission, and the National Health Committee Secretariat.

TREASURY COMMENT

15. The Treasury does not support setting up either the NHC or the HWAC under a specific clause in legislation, because the benefits of statutory status, as outlined in this paper, can be provided in other ways, avoiding the disadvantages of using specific statutory provisions (including inflexibility in an evolving sector).

16. An alternative option Ministers may wish to consider is a reference to these committees in legislation, stating only their general roles and gives the Minister of Health the ability (but not a requirement) to set them up. This kind of reference could easily be included in the section of the Bill relating to the general power to set up advisory committees. Such a reference would provide a legislative signal of the importance of the committees while retaining future flexibility.

FINANCIAL IMPLICATIONS

17. The costs of both committees will be met from baselines. The June 2000 Budget included $1.8m over four years for the new Health Workforce Advisory Committee.

LEGISLATIVE IMPLICATIONS

18. If agreed, the proposals will be included in the New Zealand Public Health and Disability Bill.

COMPLIANCE COSTS STATEMENT

19. There are no compliance cost implications.

REGULATORY IMPACT STATEMENT

20. A regulatory impact statement is attached, in compliance with Cabinet Office requirements.

HUMAN RIGHTS IMPLICATIONS

21. The proposals do not have Human Rights Act 1993 implications.

PUBLICITY

22. Publicity on matters related to this paper is managed as part of the wider Health & Disability Sector Change Communications Strategy.