What is changing in our health system?

In the coming years, the most significant changes you’ll see, are:

  1. Te Tiriti o Waitangi will be honoured in our new health system. Te Aka Whai Ora will empower Māori to design, prioritise and deliver health services that best meet whānau needs. Māori communities and other Kiwis accessing kaupapa Māori health services will also help shape these services. Everyone will benefit.
  2. The healthcare you need will be closer to home and reflect your community. There’ll be more focus on preventing illness and all the factors that support hauora.
  3. High quality emergency and specialist care will be available to everyone who needs it. Healthcare professionals and community services will work together to educate and keep you well, so there’s less need for medical care.
  4. Technology will keep you connected with more services in your home and community.
  5. Our future health workforce will be trained and developed, so our healthcare workers have the skills they need to care for all Kiwis.

Why do we need health reforms?

In Aotearoa New Zealand, people currently have different levels of health that are unfair, unjust – and avoidable. The Government has recognised that this needs to change.

The system has failed to look after Māori.

  • Māori die at twice the rate as non-Māori from cardiovascular disease.
  • Māori tamariki have a mortality rate one-and-a-half times the rate of non-Māori children.
  • Māori are more likely to be diagnosed and die from cancer.
  • Māori die on average seven years earlier than non-Māori.

The Waitangi Tribunal investigated claims (Wai 1315 and Wai 2687) dating back to 2005 around longstanding inequity, institutionalised racism in the health system and worsening Māori health statistics. Its Wai 2575 Health Services and Outcomes Kaupapa Inquiry Stage One Report, released in 2019, revealed that our primary healthcare legislation and policy breaches Te Tiriti o Waitangi and fails to care for Māori health and wellbeing.

A full Health and Disability System Review in 2019-2020, which included DHBs, health providers, communities and stakeholders, reinforced the Waitangi Tribunal’s findings and set the scene for the major changes needed.

The review confirmed that Aotearoa has:

  • Unacceptable Māori health inequities
  • Institutional racism
  • General health systems that have not improved Māori health outcomes
  • Approaches to design, purchasing and contracting of health services that have worsened inequity.

To make positive change, the review recommended that we:

  • Embed mātauranga Māori (Māori knowledge systems) in our health system
  • Invest more in kaupapa Māori health services and providers
  • Further develop our Māori health workforce, including strategies and funding for Māori providers to increase innovation
  • Create stronger leadership and direction at the highest system level.

This is the basis for the health reforms and the exciting new health system we have ahead of us.

What has happened to the previous entities, like District Health Boards?

On 21 April 2021 the Minister of Health announced our new health reforms. Legislation has now passed and from 1 July 2022:

  • All DHBs are merged to form Te Whatu Ora | Health New Zealand
  • Te Aka Whai Ora | Māori Health Authority is established to work alongside Te Whatu Ora and the Ministry of Health
  • All Public Health Units and the Health Promotion Agency are merged into a National Public Health Service within Te Whatu Ora
  • Iwi-Māori Partnership Boards are established to reflect Te Tiriti partnerships in the governance structures of Te Aka Whai Ora and Te Whatu Ora.

How is Te Whatu Ora different to Te Aka Whai Ora?

Te Whatu Ora | Health New Zealand is the operational leader of our health system, with the functions and assets of the previous 20 district health boards.

It is responsible for funding and commissioning health services and owns and operates our public hospitals

Te Whatu Ora represents our new national approach that will create efficiency and enable us to make better use of our health resources and workforce.

How do Te Aka Whai Ora | Māori Health Authority and Te Whatu Ora | Health New Zealand work together?

We are currently exploring and defining our partnership, which will be close and in the spirit of Te Tiriti. We know that working together to bring about pae ora is central to both organisations’ success.

Te Aka Whai Ora works across all levels of Te Whatu Ora health services – from strategy and planning through to commissioning and delivery of community and hospital healthcare in all regions.

We will share more information about our collaboration as plans are confirmed.

Will Te Aka Whai Ora have any power to ensure Te Tiriti is adhered to?

Te Aka Whai Ora | Māori Health Authority is a legal entity and an equal partner at the heart of our new health system.

We have a range of tools to hold the system accountable for the way it plans, strategises, funds, commissions and procures health services. We can apply consequences and impose penalties for non-performance or non-delivery.

What role does the Ministry of Health play?

The Ministry of Health plays a kaitiaki role, in that it oversees the policy and direction of our health system.

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