Significant change coming to the shape of Health services

Today (Wednesday 21 April 2021) the Government announced decisions around the future shape and structure of the New Zealand health and disability system.  The changes are based on the Health and Disability System Review that was completed in June last year.  

 Could you please share the following information from Hauora Tairāwhiti Chief Executive Jim Green and Board Chair Kim Ngarimu with Maanaki Tairawhiti?

If you are looking for more information today have a look at the Transition Unit’s new website(external link).
(external link)

Significant changes are coming to the structure of New Zealand’s health system, says Hauora Tairāwhiti Chief Executive Jim Green. “It is important to reassure people that in the short term our health services will continue as these changes are put into place.  You will still see your GP, your local medical centre will continue to operate as will your optometrist, physiotherapist and, dentist. Gisborne Hospital will still be here. 

It will take 15 months to stand up the new system. Before that, legislation will be passed.”

The government says that the reforms aim to improve the quality, consistency and equity of care through a health system that is both closer to communities and more nationally connected. It is also to remove the obstacles that too often get in the way of nationally consistent and coordinated services.

In Tairāwhiti demand for healthcare continues to grow which is placing pressure on already stretched resources, says Hauora Tairāwhiti Chief Executive Jim Green. “Inequity of health outcomes for our Māori population is a feature of health in Tairāwhiti that we are constantly working to address. Many of the changes will support Māori decision-making, and direct commissioning of more kaupapa Māori and te ao Māori-grounded services, and co-commissioning of other health services. We have seen in Tairāwhiti that this has been very effective.”

Hauora Tairāwhiti Board Chair Kim Ngarimu says “the commitment to Tiriti partnerships and a new way of working through the Māori Health Authority is an exciting development, providing for a much stronger iwi and Māori influence across the system as a whole”.   

 Key changes in the system will be:

  1. All DHBs will merge into a single nationwide health service. Health NZ, it will take responsibility for the day-to-day running of our health system including hospitals and primary health care.
  2. Health NZ will plan and commission health services for the whole population.  It will set up four regional divisions, a range of district offices with Population Health and Wellbeing Networks in DHB localities
  3. A new Māori Health Authority will have dual responsibilities; support the Ministry and Health NZ in shaping system policy and strategy; directly commission Kaupapa Māori services and work in partnership with Health NZ to co-commission other health services
  4. Public Health Units will be brought together into a national public health service within Health NZ.   The Ministry will host a new Public Health Agency to provide national leadership on public health policy, strategy and intelligence.
  5. The Ministry will remain as the steward and leader of the health system as a whole, but its operational functions will become the responsibility of Health NZ and the Māori Health Authority.  The Ministry will no longer have a direct funding or commissioning role. 
  6. The change will be rapid.  It is intended that the new structures will be operational from 1 July 2022.  In the meantime, interim agencies and governance arrangement to support those agencies will be established by the Minister.  The Board of the DHB will continue in the meantime, to support the transition to the new structures.  Similarly, our iwi/Māori partnership board Te Waiora o Nukutaimemeha, will continue its role while the form of partnership mechanisms are worked up to support the new structures.  It is intended to strengthen  Iwi-Māori Partnership Boards to act as a influencing and decision making voice for iwi and Māori in each locality so that Te Tiriti partnership operates at every level of our health system.


For Tairāwhiti the early signalled benefits will be:-

  • Even greater focus on Māori health equity and support for this through the Māori Health Authority, guided by our Iwi partners
  • There will be a locality network of healthcare providers in our community that includes local GPs, maternity carers, district nurses and optometrists, Māori health providers, other health providers, linked to Iwi, other government agencies and the Council to enable more joined up and responsive approaches to the health needs of our population;
  • We will have access to a nationwide network of resources to assist with service planning and delivery, including access to a larger pool of workforce and a broader service mix to support our community health needs.
  • There will be a better coordinated plan for infrastructure and IT improvement, including enabling technology to bring health services closer to people. Development will be faster and more connected.

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