From The Minister's Desk

Advisory Committees

Health and Disability Strategies

District Health Boards

New Ministry of Health

As you will no doubt be aware, the New Zealand Public Health and Disability Bill has been successfully passed and is now known as the New Zealand Public Health and Disability Act 2000.

We now have a piece of legislation that will move the health and disability sector forward to being more comprehensive, more transparent and above all more accountable. Most significantly, important decisions will be made at a local level, and people will be able to have their say about how they want services to be delivered in their area.

Although the Act establishes the changes in law, the health and disability sector has been moving its focus towards a population-based approach for some time. The way in which organisations and individuals in the sector have worked together to begin implementing the changes has been very positive, and bodes very well for the new system.

Open communication and accountability at all levels is essential to enable communities to be actively involved in their health services. This has been emphasised in the new Act.

This issue of Health Moves summarises some of the main changes to the structure of the health system that the Act brings.

A further issue of Health Moves will discuss the recently launched New Zealand Health Strategy, which sets the platform for the Government's action on health.

Hon Annette King
Minister of Health

Under the Act, a number of committees are to be established to provide independent advice to the Minister of Health.

A national advisory committee on health and disability support services ethics will be appointed by the Minister to advise on ethical issues of national significance. The Minister may also appoint committees to advise on specific ethical issues of national, regional or public significance.

A public health advisory committee of the National Health Committee will provide independent advice on:

• public health issues, including factors underlying the health of people and communities
• the promotion of public health
• the monitoring of public health
• any other matters specified by the National Health Committee.

A health workforce advisory committee will advise the Minister of health workforce issues specified by the Minister.

A national health epidemiology and quality assurance advisory committee will advise the Minister on any health epidemiology and quality assurance matters.

Mortality review committees may be established to review and report to the Minister of Health on specified classes of deaths of persons, or deaths of persons of specified classes, with a view to reducing the numbers of deaths of those classes or persons, and to continuous quality improvement through the production of ongoing quality assurance programmes, and to advise on any other matters related to mortality that the Minister specifies.

Each mortality review committee that is established will establish strategic plans and methodology to prevent morbidity and mortality.

The New Zealand Health Strategy and the New Zealand Disability Strategy will provide frameworks for the Government's overall direction for the health and disability sectors in improving the health of people and communities.

The Act establishes 21 District Health Boards (DHBs), each of which covers a geographical area. The DHBs take over the roles of the current hospital and health services and some of the functions of the Health Funding Authority. They are currently developing the capability to undertake health service funding and will start funding some services from 1 July 2001. They will then follow a planned, staged and managed process in taking over additional funding responsibilities from the Ministry.

The DHBs will focus on keeping the population healthy and on early intervention for those in need of services. Board meetings will be held in public. DHBs will also be building relationships with consumers and providers to deliver coordinated services. This will enable the DHBs to immediately go to work on the priority areas set down by the New Zealand Health Strategy. This work will be further strengthened when elected members join the Boards in November 2001.

The geographical areas for the DHBs are constructed from District Council and City Council areas. A few boundary changes are still being considered, but the DHB areas are currently as follows:

Northland DHB covers Far North District, Whangarei District, Kaipara District

Waitemata DHB covers North Shore City, Rodney District, Waitakere City

Auckland DHB covers Auckland City

Manukau DHB covers Manukau City, Papakura District, Franklin District

Waikato DHB covers Hauraki District, Thames-Coromandel District, Waikato District, Waipa District, Hamilton City, South Waikato District, Matamata-Piako District, Otorohanga District, Waitomo District, Ruapehu District (Ohura, Taumarunui and National Park Wards only)

Lakes DHB covers Taupo District, Rotorua District

Bay of Plenty DHB covers Tauranga District, Western Bay of Plenty District, Whakatane District, Kawerau District, Opotiki District

Tairawhiti DHB covers Gisborne District

Taranaki DHB covers New Plymouth District, Stratford District, South Taranaki District

Hawke's Bay DHB covers Wairoa District, Hastings District, Napier City, Central Hawke's Bay District, Chathams Islands Territory

Whanganui DHB covers Wanganui District, Rangitikei District, Ruapehu District (Waiouru and Waimarino Wards only)

MidCentral DHB covers Manawatu District, Palmerston North City, Tararua District, Horowhenua District, Kapiti Coast District (Otaki Ward only)

Hutt DHB covers Upper Hutt City, Lower Hutt City

Capital and Coast DHB covers Kapiti Coast District (Paraparaumu, Waikanae and Paekakariki-Raumati Wards only), Porirua City, Wellington City

Wairarapa DHB covers Masterton District, Carterton District, South Wairarapa District

Nelson Marlborough DHB covers Tasman District, Nelson City, Marlborough District

West Coast DHB covers Buller District, Grey District, Westland District

Canterbury DHB covers Kaikoura District, Hurunui District, Waimakariri District, Banks Peninsula District, Selwyn District, Christchurch City, Ashburton District

South Canterbury covers Timaru District, Mackenzie District, Waimate District

Otago DHB covers Waitaki District, Queenstown-Lakes District (Wanaka Ward only), Central Otago District, Dunedin City, Clutha District

Southland DHB covers Southland District, Gore District, Invercargill City, Queenstown-Lakes District (Arrowtown and Queenstown Wakatipu Wards only).

From 1 January 2001, the Ministry of Health and the Health Funding Authority will integrate functions. The new Ministry of Health will be responsible for:

• funding District Health Boards
• providing policy advice
• providing advice on performance of the sector
• monitoring standards and performance
• ministerial servicing
• information services
• regulatory matters
• national frameworks.

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.