This morning the government announced major changes in the strategic direction and composition of the New Zealand health sector.
The changes include
- Establishment of a Māori Health Authority separate from the Ministry of Health to advise on hauora Māori, workforce development and provision of Kaupapa Māori services
- A new Crown Entity tasked with an implementation mandate with oversight of funding and operational direction nationally with equal numbers of Māori and Crown representatives on the board
- DHBs will reduce from 20 to 8-12 within five years and move to fully appointed boards who will be recruited against competencies including tikanga Māori
- Overall strategic emphasis on population health and prevention
- Funding for health and disability to be indexed to inflation
CEO of Hāpai Te Hauora Selah Hart responded to the announcement this morning "An overall emphasis on population health and prevention and the establishment of a new Māori health agency reporting directly to the Minister of Health represent a potential paradigm shift for the health of New Zealanders." However she warns that this massive overhaul of the health system must ensure to keep whānau and communities included and at the centre of all decisions made, so as to ensure we don't just replace or add new layers of bureaucracy with the establishment of these new entities.
"The success of this plan will be determined by the people appointed to lead it. Māori public health is known for the strength of its community leaders and for its staunch advocates and researchers, we hope to see these new agencies populated by the people who have the expertise and mana to make these changes a success."
The programme emphasises more equitable, community-specific allocation of funding and services. Funding will be linked to deprivation as well as population numbers, so those with the greatest need will have proportional resources allocated. There is also a commitment to increasing the availability of Kaupapa Māori services.
"This is a plan that has the opportunity to transform health outcomes for our people. We recognise that it is an election year but we urge bipartisan support from other parties for this evidence-based and transformative plan to turn around our most intractable health inequities."
In 2019, Hāpai provided a number of recommendations in its submission to the Health and Disability System Review. The full submission can be found here.