S T A T I S T I C S

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The New Zealand health and disability system

The organisation of health and disability support services in New Zealand has undergone a number of changes in the last decade. These have ranged from a ‘purchaser/provider’ market-oriented model introduced in 1993, to the more community-oriented model that is currently in place. The current system was implemented through the New Zealand Public Health and Disability Act 2000 which allowed for the creation of District Health Boards – a key step in moving to a population based health system.

All parts of the health and disability sectors are responsible for improving Māori health outcomes and reducing inequalities. The key players, Ministry of Health directorates, District Health Boards (DHBs) and the Māori health sector engage with each other and other sectors to improve Māori health outcomes and reduce inequalities. Within the Ministry of Health all directorates and teams include responsibility for Māori health outcomes as part of their work programmes and operational activities. The DHBs similarly take responsibility for Māori health outcomes. The District Strategic Plans and District Annual Plans of DHBs describe their plans for improving Māori health and reducing inequalities.

Estimated funding specifically for Māori health providers accounts for only about 3 percent of health and disability expenditure with the overwhelming proportion of health and disability funding going to mainstream providers (Ministry of Health 2005b).

District Health Boards

District Health Boards (DHBs) are responsible for providing, or funding the provision of, health and disability services in their district. There are 21 DHBs in New Zealand and they have existed since 1 January 2001.

The activities of District Health Boards are guided by two overarching strategies for the health and disability sector: the New Zealand Health Strategy (Minister of Health 2000) and the New Zealand Disability Strategy (Minister for Disability Issues 2001). The District Health Boards are supported by the Ministry of Health, which provides national policy advice, regulation, funding, and monitoring the performance of agency.

Primary health care

Primary health care covers a broad range of out-of-hospital services, although not all of them are Government funded. It aims to improve the health of the people in communities by working with them through health improvement and preventative services, such as health education and counselling, disease prevention and screening.

Primary health care includes first level services such as general practice services, mobile nursing services and community health services targeted especially for certain conditions, for example maternity, family planning and sexual health services, mental health services and dentistry, or those using particular therapies such as physiotherapy, chiropractic and osteopathy services. Chronic diseases, such as diabetes are best managed by primary health care services so that complications can be prevented or mitigated.

The way primary health care is delivered to New Zealanders is covered in the Primary Health Care Strategy (Minister of Health 2001). A key part of the strategy is the creation of Primary Health Organisations (PHOs).

PHOs (Primary Health Organisations)

A PHO is a new way of arranging health care in the community to make sure people get the first level health care they need. It’s a group of health providers whose job it is to look after all the people enrolled with them.

A PHO is a team of doctors, nurses and other health professionals (such as Māori health workers and health promotion workers) who are working with communities to ensure a better health service.

Structure of the New Zealand health and disability sector



Text description: This diagram outlines the structure of the New Zealand health and disability sector. The diagram shows the flow from: Central Government to Minister of Health, the Ministry of Health, 21 District Health Boards and their provider arms, the private and NGO providers and New Zealand health and disability support services consumers and New Zealand population and business enterprises. Also linked into the diagram at the Minister of Health level are the Ministerial advisory committees, Accident Compensation Corporation and other Health Crown Entities.

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References:
Ministry of Health. 2005b. The Annual Report 2004/05 Including The Health and Independence Report: Annual Report for the Year Ended 30 June 2005: Director General of Health's Annual Report on the State of Public Health 2005. Wellington: Ministry of Health.
Minister of Health. 2000. New Zealand Health Strategy. Wellington: Ministry of Health
Minister for Disability Issues. 2001. The New Zealand Disability Strategy. Wellington: Ministry of Health.
Minister of Health. 2001 The Primary Health Care Strategy. Wellington: Ministry of Health.

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