HPF welcomes review

The publication of a report this week recommending some of the most wide-sweeping reforms to New Zealand’s healthcare in a generation has been welcomed by the Health Promotion Forum of NZ. (HPF) The Health and Disability System Review led by former Prime Minister Helen Clark’s chief-of-staff Helen Simpson was charged with recommending system-level changes that would be sustainable, lead to better and more equitable outcomes for all New Zealanders and shift the balance from treatment of illness towards health and wellbeing. In her introduction to the review Simpson says she firmly believes the changes proposed by the review ‘have the potential to deliver a system which is a truly New Zealand system … which embeds Te Tiriti principles throughout, where Māori have real authority to develop and implement policies which address their needs in ways which respect te Ao Māori, and a system where all New Zealanders, Māori, Pacific, European, Asian, disabled, rural or urban, understand how to access a system which is as much about keeping them well, as it is about treating them when they become sick’. Among the recommendations proposed by the review, which has been two years in the making, are the creation of a new agency called Health NZ, for leadership of health service delivery both clinical and financial, as well as the establishment of a Māori Health Authority. The review suggests that the Māori Health Authority would need to partner with Health NZ to develop commissioning models that would work for Māori, whether for general, taha Māori or kaupapa Māori services. It would also lead the development of a strengthened Māori workforce.  HPF’s Executive Director Sione Tu’itahi says shifting the balance from treatment of illness towards health and wellbeing, addressing equity and the rights of Tangata Whenua as one of the Te Tiriti partners are all moves in the right direction. ‘However, it should be noted that the health of the planet, our one common home, is the most urgent and determining factor. So, it’s the fact that health is a societal effort and all sectors are equally important. The public health system is a part of the bigger whole,” says Mr Tu’itahi. The review also calls for the country’s 20 District Health Boards (DHBs) to be reduced to between eight and 12 within the next five years and move to fully appointed boards who will be recruited against competencies including tikanga Māori. Regarding the disability sector the review acknowledges that disabled people have not been well served by the existing health and disability system and that change is needed to ensure that disability is no longer treated as an exception or managed separately. ‘The increasing number of disabled people have the right to expect equitable outcomes from the system.’ It is recommended that home-based support, in particular, should be assessed by need rather than having eligibility determined by diagnosis and that needs-assessment processes need to be more streamlined and less repetitive. Other major recommendations include: Greater focus on population health and prevention; Funding for health and disability to be indexed to inflation and greater integration between primary and community care and hospital/specialist services. The decision on whether or not the recommendations will be implemented now falls on the Government and Health minister David Clark has indicated that: “Cabinet has accepted the case for reform, and the direction of travel outlined in the review.” The review acknowledges that the proposed changes cannot happen all at once and to realise the benefits of a new system would require a determined change programme over a number of years. Read the full review here.