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The New Zealand Government is radically rethinking its Health and Disability Sector
The Government yesterday announced its commitment to a long-term equity programme for health and disability. In part, the report was a response to the past lack of planning around digital technology.
The final report of the Health and Disability System Review makes a series of far-reaching recommendations, speaking to a long-overdue need for modernisation of health services.
The review, commissioned by the Ministry of Health, the report is geared towards making healthcare equitable – with several bold areas of change for a health system historically dependant on legacy systems.
The Review panel comprises respected members from diverse backgrounds, including once-Chief of Staff to then Prime Minister Helen Clark, Heather Simpson, MercyAscot’s Dr Lloyd McCann, and ex-New Zealand Post Group CEO Sir Brian Roche.
Heather Simpson, Chair
The vision in the Report covers:
- A greater focus on population health
- A new Crown Entity, provisionally called Health NZ, focused on operationalising delivery of health and disability services and financial performance
- Reduced number of DHBs from the current 20 down to 8-12 within five years, and a move to fully appointed Boards
- A Māori Health Authority to advise on all aspects of Māori Health policy and to monitor and report on the performance of the system with respect to Māori
- Greater integration between primary and community care and hospital/specialist services
The Report’s ‘Digital and data’ recommendations include to move from an “ecosystem of tens of thousands of systems that do not easily connect, to a system that routinely shares data and more effectively supports all those working in or using the system will require a staged approach”.
Three major technology issues were raised: 1) the quality of New Zealand’s digital infrastructure, 2) the ability to transfer data securely, and 3) the interconnectedness of national systems.
The Report was conducted partially in response to the changed health behaviours of COVID-19, such as increased virtual consultation use, e-prescribing and renewed national focus on Public Health. At a press conference yesterday, Health Minister Dr David Clark detailed the pandemic had been something of a wakeup call to government. “The Review makes it clear we have a very good health and disability system – as has been shown by the outstanding performance of our health services in response to COVID-19,” he said.
“But it also confirms that our health services and workforce are under considerable stress and our system is complex and fragmented.”
The report’s programme is also notably community focused, aimed towards “Refocusing the system on people”. Broad scale district health plans, with services unique to communities, will be key in the programme to enable greater community responsiveness.
“It sets out a path towards a better, more sustainable health system with clear lines of accountability,” Clark said. “One that is more responsive to the needs of local communities and that better tailors services to the way that people live their lives.
“This is particularly important when it comes to improving health outcomes for those most in need including Māori, Pacific people, the disabled and rural communities.”
“We need our health and disability services to work well for everyone”.
“Make no mistake, reforming our health and disability system is a massive undertaking, and will not happen overnight. Meaningful change and improvement will take concerted effort over many years.
The report details that the “detailed policy and design work” will be driven by a Ministerial Committee of experts, including the Finance Minister, Health Minister and Associate Health Minister Peeni Henare.
While some are calling out the reduced DHBs as possibly giving the ministry too much power, Clark sees now as a “once-in-a-generation opportunity” to “deliver a truly national health and disability system”.
The Health and Disability System Review is available at https://systemreview.health.govt.
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