Care
EXPLAINER: THE NEW HEALTH REFORMS Massive changes to our health system are under way. Here’s an overview.
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n 2021, Health Minister Andrew Little announced that the Government was working towards an overhaul of Aotearoa New Zealand’s health system. On 1 July 2022, the new health system was launched. It came into effect through new legislation: the Pae Ora (Healthy Futures) Act 2022. THE OLD SYSTEM
Over the past two decades, New Zealand has had an increasingly complicated and inconsistent health system, where 20 district health boards (DHBs) planned and funded local services and owned public hospitals. At the same time, 30 primary health organisations (PHOs) coordinated GP services and other primary health care services – those are your first port of call. The DHB system has long been a problem for people with diabetes and other conditions, leading to what’s sometimes been called ‘the postcode lottery’. That is, the health care we receive has depended on what DHB area we live in. On top of this, there have been issues with patient/client information not being shared between DHBs, meaning that people travelling between areas haven’t always been able to access healthcare from providers who
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DIABETES WELLNESS | Spring 2022
know their medical histories. It’s also recognised that the New Zealand health system has led to widespread inequity. It has under-served Māori, Pacific people, disabled people, those living on low incomes, and those living in rural areas. So how does the new system aim to address these and other issues? AIMS OF THE NEW SYSTEM
The inconsistent regional DHB system has now been replaced by one national health system. The Government says that the new system will be ‘nationally planned, regionally delivered and locally tailored’. Some of the key goals and principles that the new system is based on are that: • Centralising the system will make it more efficient, meaning more money can be spent on actual healthcare rather than administration. • Māori will have a greater role in designing health services that better meet the needs of Māori. • Health services will better reflect community needs and preferences, as well as have a focus on prevention, rather than being ‘the ambulance at the bottom of the cliff’. The aim is to improve wellness for everyone, while reducing the pressure on specialist and hospital care. • Digital technology such as video conferencing will be used more and in better ways to provide
people with better services closer to home, as well as when they are away from home. HOW THE NEW SYSTEM WORKS
The new system involves three national bodies working together to plan and deliver health services: • Te Whatu Ora – Health New Zealand • Te Aka Whai Ora – the Māori Health Authority • The Ministry of Health, which now has a new unit – the Public Health Agency. Te Whatu Ora – Health New Zealand
This new central health agency absorbs and replaces local DHBs to co-ordinate hospital and other health services nationally. Fepulea‘i Margie Apa has been appointed as Chief Executive. Te Aka Whai Ora – the Māori Health Authority
This is an entirely new entity that will work on behalf of Māori, planning and funding services, and managing Māori health policies, services, and outcomes. Riana Manuel (Ngāti Pukenga, Ngāti Maru, and Ngāti Kahungunu) has been appointed as Chief Executive. The Public Health Agency
The Public Health Agency is a new unit established within the Ministry of Health to lead and strengthen public health strategy, policy, and monitoring and to advise the Director-General and
