From the Minister's Desk

Changes to the Bill After Second Reading

DHB Establishment Plans

DHBs' Governance

Other Changes

DHBs Get Clear Signal on Working With Others

In the next few weeks the Government will put in place some of the key building blocks of the new public health system - a system, which, when all its parts are put together, will provide New Zealanders with a directed, well structured, and co-operative health system.

I refer, of course, to the passing of the New Zealand Public Health and Disability Bill into law, which is going through the House at the moment. Also within the next fortnight, we will launch the New Zealand Health Strategy, which will provide the working framework for all those in the health sector.

In the new year, the newly formed District Health Boards and the new Ministry of Health, incorporating the Health Funding Authority, will be able to build on these foundations.

This will take a little time - people should not expect DHBs to make changes immediately - but, by the time majority-elected boards are elected in November next year, they will have the infrastructure and tools to improve the health of people in their communities.

The passing of the Bill and the launch of the New Zealand Health Strategy represent the beginning of a new era of population-focused health in New Zealand. This change in direction is significant. It is not simply a change of administrative structures, but a fundamental change for the sector.

Rather than focusing just on dealing with the effects of people's illness, we want to create a system that works with other sectors to ensure we tackle the underlying problems that affect our nation's health.

The Ministry of Health and the Health Funding Authority will be combined to form one strong Ministry with the strength and ability to put in place the policies and strategies to deal with specific health issues. DHBs will be able build their community networks, include their people in their initiatives and give the national strategies an effective local base.

Everyone in the sector must be involved to make this work. With the profit motive now firmly banished, I have put great emphasis in the DHB establishment process on engaging with communities. Engagement, and inclusion, must continue and increase in the coming months. No one in our health sector should stand back from being involved and improving the health of New Zealanders.

The build up to Christmas is an exciting time for the New Zealand health and disability sector, and I will keep you informed of any new developments through this newsletter.

Hon Annette King
Minister of Health

After the first reading of the New Zealand Public Health and Disability Bill, Treaty of Waitangi references were amended.

Clause 3 of the Bill now makes it clear that the intention of the Bill is to 'reduce health disparities by improving the health outcomes of Maori and other population groups'.

However, it also states explicitly that nothing in the Act entitles a person to preferential treatment because of their race, nor does the Act limit section 3 of the Human Rights Act 1993 which relates to measures to ensure equality among all New Zealanders.

The Bill is undergoing its third and final reading and the Committee of the Whole House this week.

New Zealand's 21 Health and Hospital Services have completed plans for the establishment of DHBs.

The establishment plans have provided a basis for the drafting of transitional funding agreements. These agreements, when signed by the Chairs and the Minister of Health, allow DHBs to start getting the people on board that they need.

In the months ahead, the Ministry of Health will work closely with DHBs to ensure that they do not start from scratch. A programme of activity has already commenced to provide DHBs with the skills, tools, frameworks, information and experience sharing that they will need to help them build capacity.

It will be very important to have clearly defined ways of measuring whether the system is meeting its targets to improve the health of the New Zealand population. DHBs, in particular, will need to be very open to scrutiny and measurement.

The Ministry of Health is currently finalising the ways in which the work of DHBs will be measured.

DHBs will have to have their first strategic plans completed for the 2002/2003 financial year, which commences on 1 July 2002. By that time the process of devolving funding of health and disability support services will be completed.

In completing their strategic plans and having them agreed with the Ministry of Health, DHBs will have to consult with their providers and community.

DHBs will also have to agree an annual plan and a Statement of Intent with the Minister of Health, which align with their strategic plans and which also contain performance measures.

The passing of the New Zealand Public Health and Disability Bill will signal the beginning of a period of intense activity for the public health sector.

In December the Minister will be launching the New Zealand Health Strategy, which will set out the key priorities in improving the health of New Zealanders.

In the meantime the newly designated DHBs will begin to meet in public and will also begin appointing staff to undertake their wider responsibilities.

With the passing of the legislation, the Ministry of Health and the Health Funding Authority (HFA) will be merged in to one organisation. This follows a year of planning to ensure a smooth bringing together of functions.

The HFA's regional offices will become Ministry of Health offices. As, over time, functions are devolved to the DHBs, some staff from the new Ministry will move to the DHBs.

Despite these changes, providers will continue to liaise with the staff they currently liaise with.

The Government has provided clear guidelines to DHBs on how they will deal with non-government and private health sector organisations.

Two recent Cabinet papers ('DHBs and the Non-government Health Sector' and 'Use of Legal Structures and Other Arrangements by DHBs'), set out protocols for provider selection and private provider involvement and the sorts of structures DHBs can set up to perform their functions.

Currently more than half of total public spending on health and disability support services goes to providers that are not government-owned. For many types of providers (eg, rest homes or GP organisations) there are no publicly owned alternatives. Under the protocols, the paramount consideration will be that the provider chosen to deliver publicly funded services is the most effective option to achieve gains in health and independence for New Zealanders and close gaps within available funding.

There are also a number of other guidelines, including one to ensure that DHBs continue to build the capacity of Maori providers and Pacific providers, and another to guard against poor decisions arising from conflicts of interest.

People who were concerned that hospitals might dominate services in the future should be reassured by these decisions.

The Cabinet papers are on the Minister of Health's website here.

To respond to this newsletter, receive it, or have your name taken off the mailing list, please e-mail: healthmoves@moh.govt.nz or write to: Annette King, Minister of Health, Health Moves, Parliament Buildings, Wellington.