Health New Zealand

Te Whatu Ora – Health New Zealand (often shortened to Health NZ) is a public health agency established by the New Zealand Government to replace the country's 20 district health boards (DHBs) on 1 July 2022. Health NZ will work alongside the Māori Health Authority (MHA) and Public Health Agency to manage the provision of healthcare services in New Zealand.[1][2] Its chief executive Margie Apa was appointed in December 2021.[3]

Health New Zealand
Formation1 July 2022
Websitehttps://www.tewhatuora.govt.nz

Mandate and responsibilities

Health New Zealand is responsible for the planning and commissioning of health services as well as the functions of the 20 former district health boards. The Ministry of Health will remain responsible for setting health policy, strategy and regulation. Health NZ also works with the proposed Māori Health Authority to improve Māori health outcomes and services.[4]

As of 2022, the agency is New Zealand's largest employer, consolidating the DHBs' combined work force of 80,000, with an estimated annual operating budget of NZ$20 billion and an asset base of about NZ$24 billion.[5]

Leadership and structure

Health New Zealand is headed by Chief Executive Fepulea'i Margie Apa and Dr. Nick Chamberlain, the National Director of the National Public Health Service.[6] The organisation's board members include Chair Rob Campbell, former National Party Member of Parliament Amy Adams, Tipa Mahuta, Dame Dr Karen Poutasi, Vanessa Stoddart, and Medical Council of New Zealand Chair Dr Curtis Walker.[7]

Health New Zealand consists of four regional divisions, with regional commissioning boards overseeing the provisioning of primary and community health services, in coordination with the Māori Health Authority.[8] These four new regional divisions consisted of:

As the successor to the district health boards, Health New Zealand is responsible for running all hospitals and health services including the DHB's 12 public health units and the former Health Promotion Agency. These public health units dealt with areas such as drinking water, infectious disease control, tobacco, and alcohol control.[10][8]

History

Announcement

On 21 April 2021, Minister of Health Andrew Little announced plans to replace the country's 20 district health boards with a new public health agency called "Health New Zealand," which will be modelled after the United Kingdom's National Health Service. Health NZ will work alongside the proposed Māori Health Authority, which will be responsible for setting Māori health policies and overseeing the provision of Māori health services. In addition, a Public Health Authority will also be established to centralise public health work.[1][2]

In response, the National Party's health spokesperson Shane Reti criticised the Government's plan to replace the district health boards with a new centralised agency. He claimed that centralisation took away autonomy from local regions and suggested that the Government instead explore the consolidation of some functions such as asset management across the DHBs rather than abolishing them entirely. Reti claimed that the public was unaware of the cost of the Government's planned restructuring and the potential disruption it would cause.[11]

Formation

In mid-September 2021, the Government announced the interim board members of Health New Zealand. The agency will be chaired by Rob Campbell. Other board members include Sharon Shea (co-chair of the interim Māori Health Authority and current chair of the Bay of Plenty District Health Board), former National MP Amy Adams, chartered accountant and lawyer Cassandra Crowley, former Labour Member of Parliament Vui Mark Gosche, former Director General of Health Dame Karen Poutasi, senior executive Vanessa Stoddart, and general practitioner and kidney specialist Dr Curtis Walker.[5][12][13]

On 19 May 2022, the Government allocated NZ$13.2 billion to facilitate the establishment of the Health New Zealand and the Māori Health Authority over the next four years. This amount included NZ$11.1 billion to address the cost pressures of the previous district health board system and NZ$2.1 billion to set up the two new health entities.[14][15]

In October 2021, the Government introduced the Pae Ora (Healthy Futures) Bill which formally entrenched various health reforms including the replacement of the district health board system with Health New Zealand. The bill passed its third reading on 7 June 2022.[16]

Launch

On 1 July 2022, Health New Zealand formally launched; with the new entity assuming responsibility for all hospitals and health services formerly run by the district health boards. In addition, the 12 public health units, which operated within the DHBs, and the former Health Promotion Agency were transferred into Health NZ. The new entity also assumed the commissioning functions of the Health Ministry and the commissioning and delivery functions of the DHBs.[10][8]

In mid August, Radio New Zealand reported that Health New Zealand lacked Asian members on the organisation's 51 leadership roles despite Asians making up 15% of New Zealand's population according to the 2018 New Zealand census. Population and migration researcher Dr Francis Collins advocated legislation ensuring greater minority representation in leadership and decision-making. Asian medical professionals Doctor Carlos Lam and Vishal Niwi of the Asian Network criticised the lack of Asian representation and input within Health New Zealand's leadership. In response, Health NZ's chief executive Margie Apa claimed that the organisation was committed to diversity in its workforce but admitted they had not set targets for representation on the grounds that its employees and management were required to serve all communities equitably.[17]

In late August 2020, Health NZ was criticised by the opposition National Party's health spokesperson Shane Reti for abandoning the previous district health boards' practice of holding public monthly meetings. Health NZ has closed its meetings to the public and media, releasing only brief summaries of its board meetings. The organisation's chair Rob Campbell defended the decision to exclude the public and media from its initial board meetings on the grounds that they dealt with sensitive issues such as staff appointments and Cabinet decisions. Campbell and chief executive Fepulea'i Margie Apa held half-an-hour media briefings following board meetings to discuss the contents of their meetings with the media.[18]

References
  1. Manch, Thomas; Witton, Bridie (21 April 2021). "Government announces radical plan to centralise healthcare, will abolish DHBs". Stuff. Archived from the original on 20 April 2021. Retrieved 16 November 2021.
  2. Quinn, Rowan (21 April 2021). "Major health sector shake-up: DHBs scrapped and new Māori Health Authority announced". Radio New Zealand. Archived from the original on 21 April 2021. Retrieved 16 November 2021.
  3. "Chief executives of interim Health New Zealand and interim Māori Health Authority named". RNZ. 20 December 2021. Retrieved 13 March 2022.
  4. "The new health system". Department of the Prime Minister and Cabinet. Archived from the original on 6 October 2021. Retrieved 15 November 2021.
  5. "Boards announced for interim Māori Health Authority and Health New Zealand". Department of the Prime Minister and Cabinet. 23 September 2021. Archived from the original on 31 October 2021. Retrieved 15 November 2021.
  6. "Our Leadership". Te Whatu Ora – Health New Zealand. 30 June 2022. Retrieved 19 July 2022.{{cite web}}: CS1 maint: url-status (link)
  7. "Our Board". Te Whatu Ora – Health New Zealand. 30 June 2022. Retrieved 19 July 2022.{{cite web}}: CS1 maint: url-status (link)
  8. Young, Audrey (1 July 2022). "Explainer: Major health sector reforms – what you need to know about the changes". The New Zealand Herald. Archived from the original on 10 July 2022. Retrieved 11 July 2022.
  9. Brew, Andy (1 July 2022). "Dissolution Has Begun: DHB member fears 'loss of localism' with Health NZ". Stuff. Archived from the original on 1 July 2022. Retrieved 7 July 2022.
  10. "Health and disability system reforms". Ministry of Health. 5 July 2022. Archived from the original on 3 July 2022. Retrieved 7 July 2022.
  11. Walls, Jason (21 April 2021). "'Reckless' health shake-up could create two-tier health system – says the National Party". The New Zealand Herald. Archived from the original on 28 April 2021. Retrieved 16 November 2021.
  12. "Government announces team leading new Health NZ and Māori Health Authority". Radio New Zealand. 23 September 2021. Archived from the original on 23 September 2021. Retrieved 25 September 2021.
  13. Witton, Bridie (23 September 2021). "Health New Zealand and Māori Health Authority board members announced". Stuff. Archived from the original on 23 September 2021. Retrieved 25 September 2021.
  14. Worthington, Samantha (19 May 2022). "$188m Māori Health Authority boost 'not enough' – experts". 1 News. TVNZ. Archived from the original on 19 May 2022. Retrieved 5 June 2022.
  15. Palmer, Russell (19 May 2022). "Budget 2022 at a glance: What you need to know". Radio New Zealand. Archived from the original on 19 May 2022. Retrieved 5 June 2022.
  16. "New Health System Act passes third reading in Parliament". 1 News. TVNZ. 8 June 2022. Archived from the original on 7 June 2022. Retrieved 10 June 2022.
  17. Quinn, Rowan (20 August 2022). "Questions on absence of Asian New Zealanders in Te Whatu Ora Health's leadership". Radio New Zealand. Archived from the original on 19 August 2022. Retrieved 31 August 2022.
  18. "New national health organisation Te Whatu Ora accused of secrecy". Radio New Zealand. 29 August 2022. Archived from the original on 29 August 2022. Retrieved 31 August 2022.
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