From the Minister's Desk

The New Zealand Health Strategy

Implementation of the Strategy

DHB Committees

The New Zealand Health Strategy, launched last week at Parliament, will ensure New Zealand uses its available health resources more effectively in the future.

The Strategy provides the framework for what we want to achieve in health, and will provide the short to medium term focus for the new District Health Boards (DHBs) and the Ministry of Health.

The Strategy highlights 13 population health objectives chosen on the basis of the degree to which they can improve the health status of the population and reduce health inequalities between different population groups, including Maori and Pacific peoples. As with the priority population health areas, the Government has identified five service priority areas for the sector to concentrate on.

DHBs will be provided with toolkits to help them address the 13 population health objectives. The toolkits will incorporate best practice and contain indicators for measuring performance.

The Strategy also specifically discusses quality issues. If we are to restore a public health system in which people can have confidence and trust, we must commit to a culture of continual quality improvement.

We must also work across sectors, including health, education, housing and social welfare, in terms of health promotion and disease and injury prevention, if New Zealand is to become a healthier country.

This issue of Health Moves summaries the key aspects of the Strategy and also provides some information about the new DHB committees.

I would like to take this opportunity to wish you and your families a very happy and safe Christmas and holiday period, and I look forward with working with you in the New Year.

Hon Annette King
Minister of Health

The New Zealand Health Strategy sets the platform for the Government's action on health. It identifies the Government's priority areas and aims to ensure that health services are directed at those areas that will ensure the highest benefits for our population, focusing in particular on tackling inequalities in health.

Principles
This Strategy identifies seven fundamental principles that should be reflected across the health sector. Any new strategies or developments that are carried out should relate to those seven principles.

The principles are:

• acknowledging the special relationship between Maori and the Crown under the Treaty of Waitangi
• good health and wellbeing for all New Zealanders throughout their lives
• an improvement in health status of those currently disadvantaged
• collaborative health promotion and disease and injury prevention by all sectors
• timely and equitable access for all New Zealanders to a comprehensive range of health and disability services, regardless of ability to pay
• a high-performing system in which people have confidence
• active involvement of consumers and communities at all levels.

Goals and objectives
The Strategy goes on to highlight key goals and objectives. The goals and objectives were chosen according to a variety of criteria including, crucially, the degree to which they can improve the health status of the population and their potential for reducing health inequalities.

Out of a total of 10 goals and 61 objectives, the Government has highlighted 13 population health objectives for the Ministry of Health and District Health Boards to focus on for action in the short to medium term.

The 13 population health objectives are to:

• reduce smoking
• improve nutrition
• reduce obesity
• increase the level of physical activity
• reduce the rate of suicides and suicide attempts
• minimise harm caused by alcohol and illicit and other drug use to both individuals and the community
• reduce the incidence and impact of cancer
• reduce the incidence and impact of cardiovascular disease
• reduce the incidence and impact of diabetes
• improve oral health
• reduce violence in interpersonal relationships, families, schools and communities
• improve the health status of people with severe mental illness
• ensure access to appropriate child health care services including well child and family health care and immunisation.

To reduce inequalities in health status the Strategy will work to:

• ensure accessible and appropriate services for people from lower socioeconomic groups
• ensure accessible and appropriate services for Maori
• ensure accessible and appropriate services for Pacific peoples.

Service delivery priority areas
In addition to the above priority objectives, the New Zealand Health Strategy highlights five service delivery areas on which the Government wishes the health sector to concentrate in the short to medium term.

They are:

• public health
• primary health care
• reducing waiting times for public hospital elective services
• improving the responsiveness of mental health services
• accessible and appropriate services for people living in rural areas.

Key quality issues
The Strategy also focuses on key issues concerning quality that are needed to ensure that the performance of health services, and the health system as a whole, results in better health outcomes and a reduction in health inequalities.

These include issues concerning:

• sector-wide continuous quality improvement mechanisms and initiatives
• individual rights
• consultation
• co-ordination
• information management and technology
• workforce development
• evaluation of the New Zealand Health Strategy.

The New Zealand Health Strategy will be implemented:

• by developing toolkits to identify the action that different types of organisations or providers can take to address priority objectives
• by developing more detailed action-oriented strategies for specific health issues, services or population groups
• through performance and/or funding agreements with the Ministry of Health, District Health Boards and providers.

Toolkits
Toolkits are currently being developed by the Ministry of Health to help DHBs implement the 13 priority objectives in the Strategy.

The toolkits will give detailed information on each priority objective and will contain summaries on how to achieve health gains in that particular area. This will be broken down by population group as well as by organisation. Toolkits will also contain indicators by which progress towards improving health in the priority areas may be measured.

The initial work on indicators will be undertaken over the next few months. Given the diverse nature of the priority objectives each toolkit will be developed at different times and with different content. This also reflects the fact that some toolkits will already have existing strategies and action plans to work from.

The New Zealand Public Health and Disability Act 2000 requires the board of each DHB to establish three committees within three months of the commencement of the Act (ie, by 31 March 2001). The boards must provide for Maori representation on each of the committees.

Community and public health advisory committees
Previously known as the Health Improvement Advisory Committees, their functions are to give the DHB boards advice on:

• the needs, and any factors that the committee believes may adversely affect the health status, of the resident population of the DHBs
• priorities for use of the health funding provided.

The aim of a community and public health advisory committee's advice must be to ensure that the following maximise the overall health gain for the population the committee serves:

• all service interventions the DHB has provided or funded or could provide or fund for that population
• all policies the DHB has adopted or could adopt for that population.

A community and public health advisory committee's advice may not be inconsistent with the New Zealand Health Strategy.

Disability support advisory committees
The functions of the disability support advisory committees are to give the DHB boards advice on:

• the disability support needs of the resident population of the DHB
• priorities for use of the disability support funding provided.

The aim of a disability support advisory committee's advice must be to ensure that the following promote the inclusion and participation in society, and maximise the independence, of the people with disabilities within the DHB's resident population:

• the kinds of disability support services the DHB has provided or funded or could provide or fund for those people
• all policies the DHB has adopted or could adopt for those people.

A disability support advisory committee's advice may not be inconsistent with the New Zealand Disability Strategy.

Hospital advisory committees
The functions of the hospital advisory committees of the DHB boards are to:

• monitor the financial and operational performance of the hospitals) (and related services) of the DHB
• assess strategic issues relating to the provision of hospital services by or through the DHB
• give the board advice and recommendations on that monitoring and that assessment.

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.