Executive summary
This briefing provides you, as the incoming Minister, with information on challenges and opportunities facing the New Zealand health and disability system, and how the Ministry can advise and support you to implement your Government’s priorities for health. The Ministry looks forward to discussing with you how to progress your health policies, including: providing high-quality health services; healthy communities; a strong and engaged health workforce; quality aged care and mental health services.
The New Zealand health and disability sector provides world-class services, is driven by a trusted, passionate and skilled workforce, across a spectrum of public, NGOs and private providers, and serves a population that can generally access the care it needs, when it needs it. There are, however, many pressures and environmental changes that require both immediate management and longer-term strategic change. As Minister, you have a number of levers at your disposal to guide system change through setting policy direction, legislation and regulations, funding models and performance management, as well as influencing culture and leadership.
Every New Zealander will, at some point in their lives, rely on our health and disability system. It is a large and complex system with multiple decision-makers and mixed public and private ownership models. It operates in a dynamic, continually changing environment characterised by well-known global and local challenges, including:
changing population health needs and burden of disease (especially the rising impact of long- term conditions and risk factors, such as diabetes and obesity)
the growing impact of health-care associated infections, antimicrobial resistance and emerging infectious diseases, eg, Ebola
rapid advances in technology, developments in personalised medicine and changing public expectations
an ageing population, and a workforce that is ageing along with the population
a constrained funding environment for the foreseeable future
a growing fiscal sustainability challenge as health consumes an increasing proportion of total government expenditure.
These challenges are placing pressure and new demands on the way public health and disability services are currently delivered. Significant gains in the overall health of New Zealanders could be achieved by concentrating on people who have poorer health outcomes, complex health needs or who need a stronger voice. These might include vulnerable children, older people, people with long-term conditions, people with mental health and addiction problems and people with disabilities.
Health and disability services need to build on current progress and adapt to future needs. The health system’s ability to provide a sustainable, quality public health service depends on keeping ahead of the challenges. This briefing provides some suggestions for where we could work with you to meet these challenges.
There are opportunities to make better use of existing resources, people, facilities and funding, through new ways of delivering services that keep people well with better prevention and early
Briefing to the Incoming Minister of Health v
intervention. Significant gains could be made by developing a longer-term focus on preventing disability and illness in the first place.
There are new opportunities for the health workforce to work in different ways with a broader range of colleagues across the health and wider social sectors, and with partners in the community.
To better equip the New Zealand health and disability system for the future, we suggest focusing on four areas.
1 Better integrate services within health and across the social sector: Strengthening integration within health and across government to support the most vulnerable, reduce inequities and address issues outside the health and disability system that impact on health.
2 Improve the way services are purchased and provided: Ensuring funding models support change, building and supporting the key enablers and drivers of change: workforce, health information and capital.
3 Lift quality and performance: Driving performance through measuring and rewarding the right things to improve quality.
4 Support leadership and capability for change: Supporting strong governance, clinical and executive leadership and capability across the health sector. 
