Ministry of Health
Manatū Hauora
Agency overview
Formed1903
JurisdictionNew Zealand
Headquarters133 Molesworth Street,
Thorndon
Wellington 6011
Employees1,084 FTE staff[1]
Annual budgetVote Health
Total budget for 2019/20
Increase$19,870,563,000[2]
Ministers responsible
Agency executive
Websitehealth.govt.nz

The Ministry of Health (Māori: Manatū Hauora) is the public service department of New Zealand responsible for healthcare in New Zealand. It came into existence in its current form in 1993.

History

Origins

The Ministry of Health's origins can be traced back to the Department of Public Health, which was first established in 1901 at the advice of the Central Board of Health. The Department of Public Health assumed responsibility for the provision of Māori health services between 1906 and 1909, when Māori medical health services were returned to the-then Department of Native Affairs. In 1910, the Public Health Department resumed responsibility for the control of Māori health. In 1911, a Māori Nursing Service was established as part of the Department of Public Health.[3]

Growing strains

Its structure remained relatively static even when the Social Security Act 1938 was passed where the New Zealand government took a larger role in health purchasing. The department remained actively involved in policy (as opposed to purchasing).

By the 1970s problems had appeared in the health system. The high growth rate in hospital expenditure was occurring at a time when the economy was slowing down. Thus, the government was unable to sustain funding this growth. This led the health system to undergo a series of changes over a 20-year period from the 1980s.

Fourth National Government, 1990–1999

During the 1990s the Fourth National Government attempted to stream-line the system in a series of reforms such as separating the government purchasing and provision of health care services. Four regional health authorities (RHAs) were created to oversee the purchasing of health services while general practitioners, specialists, and hospitals were tasked with delivering health services. Public services were also turned into quasi-commercial Crown health enterprises (CHEs).[4] In 1993, the Department was renamed as the Ministry of Health.[3]

A poster produced by the Ministry of Health for 1962 World Health Day

Fifth Labour Government, 1999–2008

The Labour–Alliance coalition government redefined the role of the Ministry of Health as part of Labour's election promises in the 1999 election.[5]

In December 1999, the separate government health service purchasing entity, the Health Funding Authority, was merged with the Ministry of Health.[6] Critics were anxious as to how the Ministry would perform as a funder, as they commented that the Ministry had in the past only performed as a policy organisation. However, supporters of this move stated that they believed this would make these agencies more accountable.

In February 2001, the Fifth Labour Government also launched the "New Zealand Primary Health Care Strategy" (PHCS) with the goal of improving public access to primary health care and reducing health inequalities.[7] By 2008, the Primary Health Care Strategy had succeeded in reducing fees for doctors' and nurses' visits in "higher need areas" and for patients aged over 65 years. In addition, consultation rates increased across all age, socio-economic, and ethnic groups in New Zealand.[8]

As part of the PHCS programme, the Government encouraged the development of Primary Health Organisations (PHOs) to provide some primary health care services at the local level and to transition health care services from fee-for-service arrangements to capitation funding for health professionals who are members of these organisations.[8] By early April 2003, 34 PHOs had been established throughout New Zealand.[9]

In addition, the Fifth Labour Government established District health board (DHBs) in 2001 as subsidiary organisations of the Health Ministry. They were responsible for providing and funding health services within a defined geographical area. At the time of their dissolution in July 2022, there were twenty DHBs.[10] They were also responsible for running hospitals and funding some health provisions in their respective areas. Funding for these DHBs was allocated according to the Ministry's population-based funding formula.[11]

Sixth Labour Government, 2017–present

In April 2021, the Sixth Labour Government announced that DHB system would be abolished and replaced by three new entities: a centralised agency called Health New Zealand, a Māori Health Authority (MHA) to fund Māori health services, and a Public Health Agency to centralise public health work.[12][13]

In October 2021, the Government introduced a parliamentary bill called the Pae Ora (Healthy Futures) Bill, which created the new public health entities and strengthened the Health Ministry's stewardship role.[14] This bill passed into law on 7 June 2022.[15] On 1 July, the Pae Ora (Health Futures) Act came into effect; with Health New Zealand, the MHA, and the Health Ministry's Public Health Agency assuming the district health boards' former provision of healthcare services.[16][17]

Structure

So-called "business units" of the Ministry include:[18]

  • Evidence Research and Innovation directorate
  • Strategy Policy and Legislation directorate
  • Māori Health directorate
  • Public Health Agency
  • Regulatory Services directorate
  • System Performance & Monitoring directorate
  • Government & Executive Services directorate
  • Corporate Services directorate
  • Chief Clinical Officers
    • Chief Nurse
    • Chief Medical Officer
    • Chief Allied Health Professions Officer

Others

Medsafe carries out medical regulatory functions within the Ministry.

The former National Health Board (NHB), which was set up in November 2009, dealt with issues such as rising costs, increased demand, an aging population and shortages of staff with a view to improving the quality, safety and sustainability of health care.[19]

Health New Zealand exists as a separate Crown agent while the Māori Health Authority exists as an independent statutory entity.[20]

Ministers

The Ministry serves 1 portfolio and 4 ministers.

OfficeholderPortfoliosOther responsibilities
Hon Shane RetiLead Minister (Ministry of Health)
Minister of Health
Hon David Seymour Associate Minister of Health (Pharmac)
Hon Matt DooceyAssociate Minister of Health
Hon Casey CostelloAssociate Minister of Health

References

  1. ↑ Annual Report for the year ended 30 June 2015 (PDF), Ministry of Health, October 2015
  2. ↑ "Total Appropriations for Each Vote". Budget 2019. The Treasury.
  3. 1 2 "Chronology of the New Zealand Health system 1840-2017" (PDF). Ministry of Health. 6 September 2017. Archived (PDF) from the original on 20 March 2022. Retrieved 9 July 2022.
  4. ↑ James 2016, p. 93.
  5. ↑ Piercy, Gemma; Mackness, Kate; Rarere, Moana; Madley, Brendan (2017). "Investigating commentary on the fifth Labour-led government's Third Way approach" (PDF). New Zealand Sociology. 32 (1): 51–75 – via University of Waikato Research Commons.
  6. ↑ King, Annette (21 December 1999). "Health Funding Authority". Beehive.govt.nz. New Zealand Government. Archived from the original on 10 February 2019. Retrieved 11 July 2022.
  7. ↑ King, Annette (1 February 2001). "Launch of Primary Health Care Strategy". Beehive.govt.nz. New Zealand Government. Archived from the original on 11 April 2022. Retrieved 11 July 2022.
  8. 1 2 Cumming, Jacqueline; Mays, Nicholas; Gribben, Barry (6 November 2008). "Reforming primary health care: is New Zealand's primary health care strategy achieving its early goals?". Aust New Zealand Health Policy. 5 (24): 24. doi:10.1186/1743-8462-5-24. PMC 2588611. PMID 18990236.
  9. ↑ King, Annette (1 April 2003). "Twenty two new Primary Health Organisations begin". Beehive.govt.nz. New Zealand Government. Archived from the original on 23 January 2015. Retrieved 11 July 2022.
  10. ↑ "District health boards". Ministry of Health. Archived from the original on 22 April 2022. Retrieved 11 July 2022.
  11. ↑ "Population-based funding formula". Ministry of Health. Archived from the original on 7 June 2022. Retrieved 14 June 2021.
  12. ↑ 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 11 July 2022.
  13. ↑ 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 11 July 2022.
  14. ↑ "Hopes and doubts as health system overhaul kicks in". 1 News. Retrieved 14 August 2022.
  15. ↑ "New Health System Act passes third reading in Parliament". 1 News. TVNZ. 8 June 2022. Archived from the original on 7 June 2022. Retrieved 11 July 2022.
  16. ↑ "Health and disability system reforms". Ministry of Health. 5 July 2022. Archived from the original on 3 July 2022. Retrieved 11 July 2022.
  17. ↑ 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 11 July 2022.
  18. ↑ "Ministry business units". Ministry of Health – Manatū Hauora. 1 July 2022. Archived from the original on 10 July 2022. Retrieved 11 July 2022. The Ministry is made up of directorates and business units, each with its own functions and areas of responsibility.
  19. ↑ "National Health Board: About us". Ministry of Health. 2012. Archived from the original on 25 February 2013. Retrieved 6 March 2013. The public health and disability system faces serious challenges which range from rapidly rising costs to increased demand for services, an aging population and international shortages of skilled clinical specialists.[...] The National Health Board (NHB) was established by the Government in November 2009, to address these issues and improve the quality, safety and sustainability of health care, for New Zealanders. [...] The NHB is made up of a Ministerial appointed Board and a branded business unit within the Ministry of Health.
  20. ↑ "New Zealand's central government organisations". Public Service Commission. Retrieved 11 July 2022.

Further reading

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