Annual Report for the year ended 30 June 2004

Annual Report for the year ended 30 June 2004

Date of publication: October 2004

ISBN 0-478-25733-3 (Book)
ISBN 0-478-25734-1 (Internet)

HP 3898

This Annual Report sets out the Ministry’s financial and non-financial performance for the year ended 30 June 2004. The report on non-financial performance, the ‘Statement of objectives and service performance’, focuses on our performance in the seven priority areas agreed with the Minister of Health, the Hon Annette King, and on the delivery of outputs (goods and services) purchased by the Minister.

Details of these outputs are set out in the ‘Statement of objectives’, which is contained in our 2003/04 Statement of Intent a copy of which can be downloaded from our website www.moh.govt.nz.

The Minister of Health purchases a wide range of outputs from the Ministry and from our eight business units, which provide services to the health and disability support sector. These business units employ just over 43 percent of our staff. It is important to understand that the Ministry of Health is not just a policy agency: we also act as the Minister’s agent, monitor the performance of District Health Boards (DHBs) and Crown entities, provide health information, process payments for the sector, implement, administer and enforce regulations and legislation, provide nationwide planning and service frameworks, facilitate collaboration and co-ordination within and across the sectors, and have a significant funding role in services retained centrally. This report will explore in some detail our roles and functions.

Reporting on our performance in all of our outputs in this Annual Report would have resulted in a document considerably larger than the one we have produced, and would have clouded the significant achievements we have made in relation to the delivery of the seven priority areas. This is why the report focuses on those priority areas, other significant project work and reports by exception on the bulk of our activities, which are detailed in the 2003/04 Statement of Intent.

I am taking this opportunity to provide some overview comment on our seven service priorities and on our progress in developing an integrated approach to workforce development.

Diabetes

The Ministry completed a best practice evidence-based guideline on the Management of Type 2 Diabetes, which was released in December 2003. Work was also commissioned on developing a national model for electronic decision support for diabetes management in primary care. A diabetes integrated care pilot has been successfully inplemented in South Auckland. This leading edge initiative was the topic of a recent international presentation and has been published in the journal of Health Information Management.

Elective services and radiotherapy

The Ministry developed a data warehouse for the National Booking Reporting System. This work included the creation of new reporting data sets that provide key information on the management of patients by DHBs. The most visible of these are the Elective Services Performance Indicators, which are used to monitor, and report progress in implementing, the elective services policy.

During the year the Ministry worked closely with the sector on an orthopaedics proposal. Through this work the Government was able to announce on Budget day a decision to double the number of major joint replacement operations to take place in 2004/05. This initiative commenced on 1 July 2004 and will be phased in over a four-year period. Policy development work was also undertaken on the funding and implementation of a second in vitro fertilisation (IVF) cycle.

This work culminated in the announcement by the Minister of Health that, as from 1 October 2004, the Government will start funding a second IVF cycle for eligible couples. The Ministry has also worked over the year on the development of an implementation plan for the Cancer Control Strategy, which focuses on cancer treatment services and palliative care. Please refer to the ‘Statement of objectives and service performance’ for further information, and to the website www.electiveservices.govt.nz.

He Korowai Oranga (Māori Health Strategy)

Over the year the Ministry has continued to strengthen relationships between Māori communities and the health and disability support sector. All DHBs have developed Māori health plans and most DHBs have, or are entering into, formal agreements to work with Māori to improve Māori health and wellbeing. DHBs are completing Māori health plans that identify and action local Māori health and disability priorities within a common framework and vision provided by He Korowai Oranga.

A full report on the implementation of He Korowai Oranga may be found in the ‘Statement of objectives and service performance’ in this Annual Report. For further information on Māori health initiatives and publications, please refer to www.maorihealth.govt.nz.

Mental Health Blueprint

The key goals and principles established in Looking Forward (1994) are seen as being essentially sound, but they do require updating to take into account developments in the sector since 1994, including the new health environment, new policy initiatives, new service delivery and clinical developments, the growth of consumer and family participation, and the importance of intersectoral actions and barriers that support or inhibit recovery. Work therefore commenced this year on the preparation of a second National Mental Health Plan. Once Cabinet has approved the draft plan for release, public consultation will commence.

New Zealand Disability Strategy

Responsibility for the implementation of the New Zealand Disability Strategy has passed to the Ministry of Social Development. Performance of the Ministry and other agencies in respect of their 2003/04 implementation plans will be reported on by the Ministry of Social Development in an annual report to Parliament, to be tabled in December 2004.

Primary Health Care Strategy

The 2003/04 financial year has seen rapid growth of Primary Health Organisations (PHOs) and in the range of initiatives PHOs have implemented to improve primary health care for their enrolled populations. As of 30 June 2004 there were 68 PHOs around New Zealand. Around 3.16 million New Zealanders have enrolled in PHOs, with more than 1.06 million of those enrolled in Access PHOs. More than two-thirds of all Māori, virtually all Pacific peoples and about 80 percent of people living in the most deprived areas (ie, deprivation deciles 9 and 10) are now enrolled in a PHO.

Low patient fees are being extended across the New Zealand population through the establishment of Access PHOs, increasing funding to particular age groups through the interim formula, and increasing the number of High User Health Cards and the roll-out of Care Plus.

Further information on the Primary Health Care Strategy and PHOs can be found in this report and on the Ministry’s website (www.moh.govt.nz/primaryhealthcare).

Reducing inequalities

Reducing inequalities is a whole-of-government policy encompassing both social and economic initiatives. Reducing inequalities represents the Government’s key initiatives that aim to reduce disadvantage, promote equality of opportunity and improve outcomes for all. The Ministry’s reducing inequalities work programme crosses all Ministry directorates.

The work focuses on reducing inequalities in health status across population groups through policy advice, raising awareness, training for policy advisors, planners and managers, promoting an equality focus across the health and disability support sector, and developing systems for monitoring ongoing inequalities. A full report on the Ministry’s work on reducing inequalities can be found in pages 47 to 63 of this report.

Workforce development

I am also taking this opportunity to comment on workforce development. The health and disability workforce is an essential component of delivering high-quality services across the sector, and accounts for 65 to 70 percent of the cost of delivering public health and disability services. Pressures on the health and disability workforce include:

an ageing and ethnically diverse population
the need to plan for emergent diseases and trends (eg, a rise in obesity)
the effects of an international market on most of our health practitioners
the attractiveness of various specialties, settings or locations
advancing technology, and people’s knowledge of it
lifestyle choices, and new ways and conditions of working for health practitioners.

Actively supporting the development of a skilled and competent workforce that can respond to future needs is a priority for the Ministry and the sector.

During 2003/04 significant progress was made in developing a more integrated approach to workforce development. The Health Workforce Advisory Committee’s report, The New Zealand Health Workforce Future Directions: Recommendations to the Minister of Health 2003, established priorities for the sector for workforce development. By developing a Workforce Action Plan with District Health Boards New Zealand Inc (DHBNZ), DHBs have taken clear responsibility for implementing workforce development and developing a national collaborative approach on workforce issues.

The Workforce Action Plan establishes a strategic framework for DHBs to develop workforce plans at local, regional and national levels, and recognises that workforce development is a function that DHBs are responsible for if they are to successfully develop services to meet local consumers’ needs. The Ministry supports DHBs’ implementation of their workforce action plans, as well as undertaking specific workforce projects in specific national priority areas. Further information on workforce development may be found in the ‘Statement of objectives and service performance’.

Karen O Poutasi (Dr)
Director-General of Health

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