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Annual Report for the year ended 30 June 2001

Director-General’s Report

Date of publication: October 2001

Health sector change
The successful establishment of District Health Boards (DHBs) has been a key focus of the 2000/01 year. The establishment phase involved considerable work by DHBs and the Ministry for the planned staged managed implementation. The Health Funding Authority Due Diligence Report completed by Audit New Zealand concluded that the merger between the Ministry of Health and the Health Funding Authority had been effectively managed.

On 1 January 2001 the functions and responsibilities of the Health Funding Authority integrated with those of the Ministry of Health. On 1 July the Ministry transferred the first health service delivery funding agreements to DHBs. The 21 DHBs have assumed responsibility for funding and managing a large number of Personal Health, Māori Health, and Mental Health Service agreements. From August 2001 these providers will be negotiating with, monitored by and accountable to their local DHB rather than a central health-funding agency.

The transfer of responsibility to DHBs for overall management of these key health services provides a local mechanism for addressing local population health and disability inequalities. DHBs will be able to encourage local collaboration between providers to deliver better services. DHB establishment will also increase professional and public involvement and collaboration in health decision-making at a local level and, as a result, allow community leadership to be more clearly demonstrated in the sector.

DHBs themselves will collaborate regionally to ensure sound regional mental health networks, and that ‘Roadside to Bedside’ personal health linkages work even more effectively.

Cabinet has recently decided that the Ministry of Health will retain overall responsibility for the funding and planning of public health services. DHBs will progressively assume responsibility for an agreed range of public health services where this will lead to better outcomes for the populations they serve.


Planning for the future
Following the implementation of the health sector changes, the Ministry of Health has begun the process of developing a new Ministry strategic business plan for the next three to five years. The Ministry has taken a clean slate approach to this and is structuring its strategic business plan in accordance with best practice guidelines from the State Services Commission and in discussion with other central agencies and DHBs.

Developing a strategy for the Ministry means first of all articulating:
  • the current state of the sector and the challenges ahead
  • what the Ministry intends to achieve over the longer term
  • what the Ministry should do in order to achieve its goals
  • the relative priorities for policy and work programmes
  • how the Ministry will assess its progress towards its goals
  • the risks that will need to be managed.
Work on the Ministry’s plan began in April 2001 and a final plan is anticipated by December 2001. The Ministry has adopted this timeframe to allow for in-depth consultation across the Ministry, as well as externally, and to ensure the first formal draft of the plan for stakeholder comment is as comprehensive as possible.

The model developed by the States Services Commission focuses on capability, accountability and performance. In addressing these issues, the Ministry will provide assurance to the Government and key stakeholders that the organisation is well placed to meet the current and future challenges involved in ensuring the health and disability sector can deliver on the principles, goals and objectives of the New Zealand Health Strategy.


The New Zealand Health Strategy
The Minister of Health formally launched the New Zealand Health Strategy in December 2000. The Strategy provides the overarching framework within which the health sector should develop.

Development of the Strategy involved an intensive period of public consultation including public meetings at all 21 District Health Board areas, focus groups, hui and fono. It is estimated that almost 1500 members of the public attended consultation meetings – the majority of whom were supportive of the direction of the Strategy.

Epidemiological work was undertaken to produce a goals and objectives framework and in addition a Sector Reference Group and an Expert Advisory Group gave advice and input to the Ministry of Health. Over 400 submissions were received during the consultation.

The New Zealand Health Strategy contains underlying principles that the whole sector should seek to adopt. In addition 13 priority population health areas have been highlighted for action in the short to medium term. There are also five service priority areas and three inequalities areas highlighted.

The New Zealand Health Strategy gives a focus for the work of the Ministry of Health, the DHBs and the wider health sector. A number of important pieces of work have already been completed to ensure the strategy is a success, including the Primary Health Care Strategy, the draft Māori Health Strategy. Work has almost completed on 13 toolkits which give detailed guidance on how to achieve health gain in each of the population health priority areas.


The New Zealand Disability Strategy
The New Zealand Disability Strategy was published in April 2001. The Strategy provides a long-term plan for changing New Zealand from a disabling to an inclusive society.

The Ministry and the Minister for Disability Issues’ sector reference group developed a discussion document, which was released in September 2000. A comprehensive eight-week public consultation process was undertaken, including 41 workshops, five hui, four fono and 18 other group meetings. A dedicated website was also created.

Over six hundred formal submissions were received. The Ministry and the sector reference group considered the public feedback and developed their recommendations which informed the final New Zealand Disability Strategy. An implementation process was established, consisting of annual implementation plans being developed by government departments over the next two years.

The New Zealand Public Health and Disability Act 2000 requires the Minister for Disability Issues to report annually on progress in implementing the Strategy. Progress reports will be made publicly available. There will also be full reviews of progress on the Strategy after five and ten years.


Health information
In New Zealand, as in other developed countries, the expansion of health information systems has resulted in information being scattered, incomplete or difficult to access when and where it is most needed. The Ministry of Health has therefore initiated a programme to develop the Health Information Management and Technology Plan (HIMTP). The plan will have a three- to five-year focus, but, where possible, actions for improvement will begin earlier. Specific objectives include:
  • improving the way information is managed so providers have all the information necessary to meet a client’s health needs
  • expanding provider access to national and international electronic knowledge, including best practice, clinical guidelines and pharmaceutical advances
  • providing DHBs with more flexible options to help them administer health care delivery.
The Ministry’s draft Health Knowledge Strategy, an update of the 1996 Health Information Strategy, is oriented to establishing an environment that encourages, maintains and delivers quality health information. The draft Health Knowledge Strategy is centred around three themes: a nationally coherent and consistent approach to health information infrastructure, improving access to and sharing of information, and the development of a knowledge culture.

The Health Knowledge Strategy will be used as a vehicle to stimulate debate about information management that will be channelled into the HIMTP report. The HIMTP provides a project structure and resources to integrate the Health Knowledge Strategy across all agencies in the sector.


Ministerial servicing
The volume of draft replies to ministerial correspondence, parliamentary questions and official information requests continued to increase over the 2000/01 year. There was a 6 percent increase in the number of draft responses to ministerial correspondence provided to the Minister of Health, and a 100 percent increase in the number of draft replies to parliamentary questions provided.


Revised Departmental Forecast Report
The Ministry prepared a Revised Departmental Forecast Report to reflect the enhanced accountability acquired on 1 January 2001. The changes to the health and disability sector have had a significant impact on the role and function of the Ministry. The complexity of the transition period is reflected in this Annual Report, which is a more substantive document than in previous years. The 2000/01 financial year has been demanding and I wish to thank all staff who, not only delivered on expectations, but also effectively managed the sector change process.


Karen O Poutasi (Dr)
Director-General of Health
Ministry of Health



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