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Ministry of Health (New Zealand)

(Redirected from New Zealand Department of Health)

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. The organisation was founded in 1901 as the Department of Public Health in 1901, and was renamed to Department of Health in 1922.

Ministry of Health
Manatū Hauora

133 Molesworth Street, Ministry of Health NZ headquarters
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

History

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Origins

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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

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Under the Health Act 1920, major organisational changes were mandated. Seven separate divisions were created within the department, each headed by its own director. The department was renamed the Department of Health in 1922, dropping the word public.[4][5] The 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).[3]

In 1947 the department assumed responsibility for the administration and operation of psychiatric hospitals after the Mental Hospitals Department was abolished and became the division of mental hygiene at the department.[6]

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.[3]

Fourth National Government, 1990–1999

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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).[7] 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

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The Labour–Alliance coalition government redefined the role of the Ministry of Health as part of Labour's election promises in the 1999 election.[8]

In December 1999, the separate government health service purchasing entity, the Health Funding Authority, was merged with the Ministry of Health.[9] 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.[citation needed]

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.[10] 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.[11]

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.[11] By early April 2003, 34 PHOs had been established throughout New Zealand.[12]

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.[13] 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.[14]

Sixth Labour Government, 2017–2023

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In 2018, the government launched the He Ara Oranga inquiry into mental health and addiction.[15] In 2021, this resulted in the creation of Te Hiringa Mahara, an independent Crown entity that promotes mental health and wellbeing.[16]

On 10 September 2019, Prime Minister Jacinda Ardern and Health Minister David Clark announced the establishment of a Suicide Prevention Office within the Health Ministry to address the country's suicide rate. Key changes include shifting from a mental health service model to a community-based one and supporting people bereaved by suicide. There were also plans to later establish the Suicide Prevention Office as a separate standalone government service.[17]

The Ministry of Health was the agency responsible for the New Zealand government response to the COVID-19 pandemic.

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.[18][19]

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.[20] This bill passed into law on 7 June 2022.[21] 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.[22][23]

Sixth National Government, 2023–present

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In March 2024, the Health Ministry proposed slashing 180 jobs following a cost-saving directive from the National-led coalition government.[24] In early April 2024, the Public Service Association expressed concerns that proposed job cuts at the Health Ministry would lead to the closure of the Suicide Prevention Office and other specialist roles. The PSA's statement was disputed by the Minister for Mental Health Matt Doocey, who said he had not been briefed about the closure of the Suicide Prevention Office. Doocey said he had spoken with the Director-General of Health to ensure the Office would remain open. Doocey reiterated that mental health and suicide prefention remained a priority for the New Zealand Government.[25]

Organisational structure

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The directorates and business units of the Ministry include:[26][27]

  • 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

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Medsafe carries out medical regulatory functions within the Ministry.[citation needed]

The former National Health Board (NHB), which was set up in November 2009, dealt with issues such as rising costs, increased demand, an ageing population and shortages of staff with a view to improving the quality, safety and sustainability of health care.[28]

Health New Zealand exists as a separate Crown agent while the Māori Health Authority exists as an independent statutory entity.[29]

List of directors-general

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Directors-General of Health (Chief Executive) are:

No. Name Portrait Term of office
1 James Mason   December 1900 June 1909
2 Thomas Valintine   June 1909 December 1930
3 Michael Watt   December 1930 March 1947
4 Thomas Ritchie   March 1947 February 1950
5 John Cairney   February 1950 October 1959
6 Harold Turbott   October 1959 December 1964
7 Doug Kennedy January 1965 December 1972
8 John Hiddlestone January 1973 March 1983
9 Ron Baker April 1983 March 1986
10 George Salmond   March 1986 March 1991
- Ian Miller
(acting)		 April 1991 January 1992
11 Chris Lovelace January 1992 June 1995
12 Karen Poutasi   June 1995 July 2006
13 Stephen McKernan   July 2006 July 2010
- Andrew Bridgman
(acting)		 July 2010 January 2011
14 Kevin Woods January 2011 January 2013
15 Chai Chuah March 2015 February 2018
16 Ashley Bloomfield   June 2018 July 2022
17 Diana Sarfati   July 2022 present

Ministers

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See also: Minister of Health (New Zealand)

The Ministry serves 1 portfolio and 4 ministers.

Officeholder Portfolios Other responsibilities
Hon Shane Reti Lead Minister (Ministry of Health)
Minister of Health
Hon David Seymour Associate Minister of Health (Pharmac)
Hon Matt Doocey Associate Minister of Health
Hon Casey Costello Associate Minister of Health

References

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  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. ^ a b c d "Chronology of the New Zealand Health system 1840–2017" (PDF). Ministry of Health. 6 September 2017. Archived from the original (PDF) on 20 March 2022. Retrieved 9 July 2022.
  4. ^ "Health Act 1920" (PDF). New Zealand House of Representatives. 1920. Retrieved 20 November 2024.
  5. ^ Pollock, Kerryn. "Public health – Managing public health". Te Ara - the Encyclopedia of New Zealand. Retrieved 21 November 2024.
  6. ^ "Mental Hospitals – Abolition of Separate Department". Otago Daily Times. No. 26622. 19 November 1947. p. 2.
  7. ^ James 2017, p. 93.
  8. ^ 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.
  9. ^ 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.
  10. ^ 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.
  11. ^ a b 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?". Australia and New Zealand Health Policy. 5 (24): 24. doi:10.1186/1743-8462-5-24. PMC 2588611. PMID 18990236.
  12. ^ 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.
  13. ^ "District health boards". Ministry of Health. Archived from the original on 22 April 2022. Retrieved 11 July 2022.
  14. ^ "Population-based funding formula". Ministry of Health. Archived from the original on 7 June 2022. Retrieved 14 June 2021.
  15. ^ "He Ara Oranga Inquiry". Te Hiringa Mahara—Mental Health and Wellbeing Commission. Retrieved 23 May 2024.
  16. ^ "Who we are". Te Hiringa Mahara—Mental Health and Wellbeing Commission. Retrieved 23 May 2024.
  17. ^ Devlin, Collette (10 September 2019). "Government sets up Suicide Prevention Office as part of national strategy". Stuff. Archived from the original on 1 October 2019. Retrieved 10 September 2019.
  18. ^ 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.
  19. ^ 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.
  20. ^ "Hopes and doubts as health system overhaul kicks in". 1 News. Retrieved 14 August 2022.
  21. ^ "New Health System Act passes third reading in Parliament". 1News. TVNZ. 8 June 2022. Archived from the original on 7 June 2022. Retrieved 11 July 2022.
  22. ^ "Health and disability system reforms". Ministry of Health. 5 July 2022. Archived from the original on 3 July 2022. Retrieved 11 July 2022.
  23. ^ 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.
  24. ^ Howell, Azaria (21 March 2024). "Public service cuts: Ministry for Primary Industries, Health confirm hundreds of jobs to be slashed". The New Zealand Herald. Archived from the original on 21 March 2024. Retrieved 27 March 2024.
  25. ^ Hendry-Tennant, Ireland; Lynch, Jenna (4 April 2024). "Suicide Prevention Office could close if proposed Ministry of Health job cuts go ahead – PSA". Newshub. Archived from the original on 6 April 2024. Retrieved 10 April 2024.
  26. ^ "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.
  27. ^ "Statutory entities, boards and committees". Ministry of Health NZ. Retrieved 23 May 2024.
  28. ^ "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.
  29. ^ "New Zealand's central government organisations". Public Service Commission. Retrieved 11 July 2022.

Sources

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