National Party leader Christopher Luxon made claims about health outcomes that were clearly false. Why was he left unchallenged?

In the TVNZ leaders’ debate last night, Luxon and Labour’s Chris Hipkins had a testy exchange over Māori healthcare.

Hipkins held firm on the creation of a Māori Health Authority, established last year, arguing strongly that the persistent gaps in health outcomes and care justified it.

• READ MORE: NZ election 2023: Hipkins and Luxon in fast-paced debate but fail to excite pundits
• Other NZ election 2023 reports
• Full RNZ data on Māori healthcare

Luxon was equally clear in opposition to it. He framed his critique of the authority around an alleged complete lack of progress on Māori health outcomes. He was very specific.

“Every single health outcome has gone backwards under Chris’s government,” Luxon said.

“Six years, not one has improved for Māori or for non-Māori.”

While sweeping in nature, Luxon’s claim did not get a direct response from Hipkins.

Luxon repeated a similar line later in the debate.

“Gone backwards. Chris, under your government, every single health outcome for Māori or non-Māori [has gone backwards]. You can’t have that.”

Hipkins did push back on this occasion, citing the ongoing reduction in rates of smoking.

Luxon’s claim was far from true — there are a number of areas where health outcomes for Māori and non-Māori have improved while Labour has been in charge.

But it is perhaps understandable that Hipkins was not quick to correct Luxon because the data — even though it’s better in many respects — is still grim. Maybe Hipkins did not wish to dwell on this.

Improved health outcomes
There are a number of health outcomes where, for Māori, statistics have improved.

Perhaps Labour’s biggest boast is their track record on bringing down lung cancer and smoking rates for Māori.

Lung cancer is the second leading cause of death for Māori in Aotearoa. But according to the Ministry of Health, rates of lung disease for Māori have come down.

In 2017, the rate per 100,000 people was 79.9 for Māori. By 2019, it was down to 68.4. This also aligns with smoking rates among Māori dropping.

Pre-colonisation, Māori did not smoke. However, when tobacco was introduced to Aotearoa in the 18th century that quickly changed.

Smoking has been particularly harmful for Māori who have higher smoking rates than non-Māori and experience greater rates of death and tobacco-related illness.

In 2017/18, the smoking rate for Māori adults was 35.3 percent. By 2021/22, it was down to 20.9 percent (approximately 127,000 people).

Rates were falling under National but they have continued to drop under Labour, which has rolled out a number of initiatives in an effort to reduce nation-wide smoking rates.

As part of the Smokefree 2025 Action Plan, historic and world-leading legislation mandated an annually rising smoking age that will mean that anyone born on or after 1 January, 2009, will never be able to purchase tobacco products.

Other cancers
Overall, cancer registrations rates among Māori fell from 416 per 100,000 people in 2017 to 405.7 in 2019.

Breast cancer registration rates for Māori women fell from 140.7 per 100,000 people in 2010 to 122.5 per 100,000 in 2019. Prostate cancer registration rates for Māori fell from 105.5 for Māori in 2017 to 103.5 in 2019.

For non-Māori, overall cancer registration rates increased slightly from 323.2 (2017) to 332.4 (2019).

Life expectancy
The life expectancy gap between Māori and non-Māori may be the most telling indicator of all when it comes to inequities.

According to the latest available data from 2019, life expectancy at birth for Māori men in 2017-2019 was 73.4 years, up 3.1 years from 2005-2007 data.

The life expectancy for non-Māori men is 80.9 years. For Māori women, it was 77.1 years, up 2 years from 2005-2007. Non-Māori women are expected to live to 84.4 years.

While Māori life expectancy has increased over time, the gap to non-Māori persists.

At the current rate of progress it will be more than a century before Māori and non-Māori have equal life expectancy, a study by the Association of Salaried Medical Specialists found in 2021.

Child immunisation
In the debate, after Hipkins raised smoking as an area of improvement, Luxon said child immunisation was a concern. On this, he was correct.

Over the past six years, child immunisation rates have steadily fallen.

In 2017, 86.2 percent of eligible Māori five year olds had completed all of their age-appropriate immunisations. As of last year, the rate had shrunk to only 71.8 percent. That is an alarming 16 point drop in the period Labour has been in power.

In April of this year a report commissioned by Te Whatu Ora’s Immunisation Taskforce found that immunisation failed to achieve “adequate on-time immunisation rates in young tamariki” and to immunise Māori, meaning those who were most susceptible to “vaccine-preventable disease” had the lowest immunisation coverage.

The report highlighted the worst rate in the country — just 34 percent of Māori children in South Auckland were fully vaccinated. It attributed part of the problem to vaccinators being diverted to the country’s covid-19 pandemic response.

“This caused childhood immunisation rates to plummet. These rates are now the lowest they have ever been and ethnic disparities have further expanded,” it said.

The report outlined 54 recommendations covering funding, delivery, technology, communications and governance across the programme.

In the debate, Hipkins suggested the anti-vaccine movement was part of the problem, which he sought to link with National.

National has proposed an immunisation incentive payment scheme. The plan would see GP clinics paid a lump sum for achieving immunisation targets, including full immunisation for two-year-olds, MMR vaccines for ages 1-17, and influenza vaccines for ages 65+.

The clinics would have to either achieve 95 percent coverage for their childhood patients, and 75 percent for the flu shots, or achieve a five percentage point increase for each of those target groups, by 30 June 2024 to receive the payment.

Labour’s Dr Ayesha Verrall said a similar scheme already existed.

Labour has also failed to halt type 2 diabetes, the country’s biggest and fastest growing health condition.

Ministry of Health figures show that in 2021 there were 302,778 people with diabetes, predominantly type 2. Since the Labour government came into power in 2017, the estimated rates of the number of Māori with diabetes per 1000 has risen from 66.4 to 70.1 in 2021.

The rates for non-Māori have also climbed from 27.8 in 2017 to 30.1 in 2021. It is also important to note that the rate of diabetes in Aotearoa has been steadily rising over the past 50 years.

Type 2 diabetes can also lead to devastating health conditions and complications, including heart failure, kidney failure, strokes and limb amputation.

According to Ministry of Health data obtained by RNZ under the Official Information Act, since 2011 there has been a 39 percent increase in diabetic limb amputations across the whole population.

For Māori, the number has more than doubled in the past decade from 130 in 2011 to 211 in 2021. Under Labour, the number of Māori diabetic limb amputations rose by 15 percent.

Māori are still 2.8 times more likely to have renal failure, another complication of diabetes.

Mental health
According to Te Whatu Ora, the rate of suspected suicide per 100,000 Māori population in 2021/22 was 16.1. This is not a statistically significant change from the average of the past 13 years.

This article is republished under a community partnership agreement with RNZ.

Iwi leaders in Aotearoa New Zealand have accused opposition parties National and ACT of “fanning the flames of racism”, urging the prime minister to be brave and not walk away from partnership on Three Waters.

With Waitangi events and festivities gearing up for the holiday weekend, Prime Minister Chris Hipkins attended the Iwi Chairs Forum yesterday.

He emerged from the closed-doors meeting saying they had asked the government to continue to work with Māori “to advance the issues that we’ve been working on previously”.

• READ MORE: Other Waitangi Day reports
• Other NZ politics reports

Iwi leaders had also, it seemed, laid down a wero [challenge].

“I have also heard their concern that they don’t want to see ethnicity, race, being used as a way of dividing New Zealanders and I was able to absolutely reiterate my government’s commitment to ensuring that we continue to work together to avoid that happening,” Hipkins said.

“Where there is uncertainty, where there is a lack of clarity, that can lead to fear. Politicians who use that fear or exploit that fear in order to try and gain political advantage need to really reflect on their own actions. That’s something my government will never do.”

He was not afraid to get into specifics, either.

“They don’t want the concept of co-governance to be used to stoke fear, and nor do we,” he said.

“I think it’s been misunderstood and those who seek to use misunderstanding around it for political advantage need to reflect on their own behaviour.

“People can form their own judgments about that but I certainly think the opposition — National and ACT have, as they’ve done in the past — they’ve used uncertainty to try and stoke fear.”

The devastating flooding in Auckland this week may have changed some minds about the need for change in management of drinking, waste and stormwater — something Hipkins will be looking to capitalise on.

“I think that we have to accept that as a result of climate change we’re going to see more extreme weather events, and stormwater — which is an integral part of the Three Waters system — is going to continue to come under more pressure,” he said.

The iwi leaders were not shy about it either, with Tukoroirangi Morgan telling reporters they wanted co-governance or a similar partnership retained in the Three Waters legislation.

“The challenge we’ve put to the prime minister today is will he succumb to the attack dogs of the National party and ACT as they fan the flames of racism and anti-Māori sentiments, and throw us under the bus for the sake of keeping alive Three Waters?”

Morgan, it must be noted, has been appointed chair of the entity set to oversee Auckland and Northland’s water.

“There is nothing mysterious about Three Waters — it’s all about pipes under the ground. Our view is as it has always been: we stand here at Waitangi, the cradle of the Treaty of Waitangi, and here is the embodiment of partnership,” he said.

“What we seek from this government is an ongoing commitment that partnership will amplified and affirmed through Three Waters, [it is an] opportunity for the Crown and Māori to work together in a meaningful and significant way.”

Jamie Tuuta, an iwi leader from Taranaki, also warned against allowing Māori to become a political football this election.

“One of the key messages we want to give to the prime minister and other ministers is that they need to stand up, they need to step up,” he said.

“It’s unacceptable — because again, the racist and biased attacks on Māori in 2023 are unacceptable.”

A Pou Tikanga of the forum, constitutional law expert Professor Margaret Mutu, said it was essential race rhetoric was removed from electoral debate.

“There’s a need to understand and address racism in this country and over recent times it’s got a lot more urgent,” Professor Mutu said.

“We need to make sure that work doesn’t slow down, particularly as the extreme attacks coming in are very, very hurtful. We want to try and stop that hurt.”

Te Arawa’s Monty Morrison said the meeting went “very well, it was very open.”

Ngāti Kuri’s Harry Burkhardt said they “were clear about our message, and I think Chris received that well”.

Luxon, Seymour respond
Co-governance was a topic National’s leader Christopher Luxon chose to address when he visited Rātana last week. His speech accused the government of failing to make its position on the matter clear, and allowing it to become a “divisive and immature” conversation.

National had been invited to meet with the Iwi Chairs Forum but declined. In a written statement after the kōrero at Waitangi today, Luxon said the party had been clear about its position.

“We support co-management between government and Māori for natural resources in the context of Treaty settlements. We do not support co-governance of public services or separate bureaucratic systems for Māori and non-Māori,” he said.

“Labour has progressed a divisive agenda and continually failed to set out its views clearly. It is disappointing to see the new Prime Minister try to shut down the discussion rather than clearly setting out Labour’s plans for the public to judge.”

Luxon has previously raised as examples National does not support:

• The Māori Health Authority, which sets strategy for overcoming racial health gaps and commissions kaupapa Māori health services
• The Three Waters legislation allowing equal representation between council and iwi appointees on a strategic oversight group which appoints the management board of the four entities set to take over management of water services

ACT leader David Seymour — who has Ngāpuhi roots — has been even more stridently critical of these, arguing they are race-based approaches which only further divide.

“If the prime minister thinks that ACT is making co-goverment divisive, wait till he hears what Labour’s been up to,” he said.

“Their modus operandi is to divide public affairs between two groups of people based on race — that is divisive and it’s unsurprising that opposition parties are raising concerns.”

He bristled at being labelled an “attack dog” by Morgan.

“Again, it’s a shame. The Iwi Chairs Forum were an organisation we’ve enjoyed good relationships with.

“That kind of language, calling people dogs, well it doesn’t exactly sound like they’re coming to the table to make the situation any better, now, does it.”

Three Waters changes yet to be decided
Since taking over as Prime Minister from Jacinda Ardern, Hipkins has promised his government will focus more on the “bread-and-butter” issues, targeting cost-of-living pressures and cutting back some of the government’s work programme.

Media speculation has highlighted the unpopularity of the government’s RNZ-TVNZ merger and the Three Waters projects, and therefore likely on the chopping block.

Hipkins signalled announcements within weeks about the slimmed-down work programme, but when pressed about Three Waters early this week spoke about the need to change the status quo — statements he repeated today.

“We’ve been doing so many different things, actually we probably haven’t created the space to make sure people understand what we’re doing and why we’re doing it and that is absolutely, I think, a lesson for us over the last five years and it’s something we have all reflected on and you’ll see some change in that regard.

“I haven’t said a lot in terms of ruling things in and out, but one thing I will rule out is no reform . . .  we can’t continue with the status quo — it is not delivering New Zealanders the water services they need and that they deserve.

“If we leave it just with the status quo, one thing it will deliver is significantly higher rates for households, and I’m not willing to just stand back and say ‘that’s a council problem to deal with’.”

He has, to date, refused to outline what any of the changes to the project might be — saying those decisions are yet to be made by the full Cabinet — but speculation has centred on the co-governance aspect.

“I think everybody acknowledges that what we’re doing now or around the way we manage our water infrastructure in New Zealand is not sustainable, and it has left us with a pretty disgraceful legacy, frankly, of that core infrastructure being run down.”

Taranaki iwi leader Jamie Tuuta said whatever changes came, they expected the same level of engagement and partnership.

“By and large what we ask is that we are respected and that [Hipkins] and his ministers engage openly with us in the event that there are any changes.”

With an election in October, Morgan and the other leaders present at today’s forum are clear: they want bold leadership and partnership, and however this year’s election plays out — they will still be there.

“This is a ongoing journey for us,” Morgan said. “Absolutely, we would want a very clear and unfettered response and commitment from this government that they’re not going to walk away, nor are they going to throw us under the bus for their own political means.

“Iwi will be at this side of the table come the election, we’ll deal with whoever the government is. What is clear in this situation is we are enduring, iwi will remain as the Treaty partner.

“Whether we deal with Hipkins after the election or the National Party, we will see, but all we say is that we want an equitable share in the major decisions that affect our people – that’s our bottom-line expectation.”

This article is republished under a community partnership agreement with RNZ.

Iwi leaders warn Hipkins not to bow on Three Waters co-governance https://t.co/upsPqJEbMm

— RNZ News (@rnz_news) February 3, 2023

A number of Māori wāhine have put their hat in the ring to become mayor at this year’s Aotearoa New Zealand local body election across the motu in October.

Georgina Beyer is believed to be the first and only Māori woman ever elected as mayor in New Zealand’s history when she became mayor of Carterton in 1995.

Arama Ngāpō had been a councillor for six years before putting her hand up for mayor of South Waikato this election.

• READ MORE: Other NZ local body elections reports

Ngāpō said she was confident things would be different after the vote.

“The face of democracy at a local government level is going to change after this October election.”

Diversity was the best representation of a community, Ngāpō said.

However, it was often not seen at a governance level, she said.

‘Indicative of where we stand’
“I don’t think this country has ever seen such a high proportion of Māori people stand but that really is just indicative of where we stand in society.”

No one should look at council and wonder whether they belong there, she said.

But as a practising lawyer, she had experienced that feeling before, she said.

“I guess I am used to being in places that aren’t traditionally comfortable, but we most definitely belong there.”

Tania Tapsell (Te Rarawa, Ngāti Whakaue) is standing for mayor of Rotorua for the first time.

She received more votes as a councillor than the elected mayor, Steve Chadwick, in the two previous elections.

Racist and ageist backlash only fuelled her, she said.

Facing challenging times
“It was almost a challenge where I go, ‘I’m going to prove you wrong’ and I am going to work so hard that there will be no doubt that … Rotorua, for us, or the country for others, was not better off through our involvement.”

Tapsell believed the strong number of wāhine Māori standing for mayor had crystallised from the challenging times the whole country had experienced.

“We now require a different style of leadership. A leadership that is actually connected to all parts of our community because we know only four out of 10 people actually bother to vote.

“That’s why we have had the councils that we’ve had in the past, that haven’t been focused on all areas of the community.”

In the Far North, Kelly Stratford (Ngāpuhi, Ngāti Wai, Ngāi Te Rangi) is also standing for mayor for the first time.

Strong Māori leadership was needed across the motu, Stratford said.

“Society has changed, we have the Māori Health Authority and Māori Wards.

“Some people feel like something has been taken from them and, most of all, Māori feel they are more empowered. We need diverse Māori leadership to lead in these new times of challenge.”

Alongside Stratford, Tapsell and Ngāpo, Māori wāhine are also standing for mayor in Kawerau, Ruapehu and Wellington.

Candidate nominations close at midday 12 August.

This article is republished under a community partnership agreement with RNZ.

Manukau Urban Māori Authority (MUMA) is welcoming the government’s health reforms as an important first step to improving Māori and Pasifika health in south Auckland.

But some in the health sector say the jury is still out on what will be achieved in Counties Manukau.

Under the reforms, the country’s 20 district health boards have now been replaced by Te Whatu Ora (Health New Zealand).

• READ MORE: Other Health New Zealand reform reports

The new Crown entity will be responsible for running hospitals, primary and community health services.

The government says it will allow for more consistent delivery of health services nationwide and help stop the postcode lottery people face accessing healthcare based on where they live.

The reforms also include the establishment of Te Aka Whai Ora (the Māori Health Authority) to improve indigenous health which will work in partnership with Health NZ.

Muma chairman Bernie O’Donnell has seen the country’s district health boards work first-hand, as a member of the now-defunct Auckland DHB.

Greater responsibility for Māori
He said establishing a Māori Health Authority would give Māori greater responsibility for the delivery of their own health services.

“For too long the health system hasn’t addressed the wellbeing of Māori, or those at the bottom of the cliff,” O’Donnell said. “The reality is we couldn’t continue with what we had. Something had to be done and this is it.”

He said critics of the health reforms are defending a system which had to be replaced.

“The old way the DHBs were run didn’t work for our people. For too long it’s been non-Māori telling us what’s best for us.”

He said ongoing issues left by the Counties Manukau DHB, such as Middlemore Hospital’s under-pressure emergency department and its workforce shortages would all have to be addressed under the changes.

“But what we’re expecting is that Māori and Pasifika health in south Auckland will get better under the reforms,” O’Donnell said.

However, he admitted there’s a lot at stake.

‘Time will tell’
“If that doesn’t happen we won’t have achieved anything of significance,” he said. “But only time will tell.”

Yet not everyone is as certain as O’Donnell on what impact the changes will have.

Turuki Healthcare chief executive Te Puea Winiata said there were still a lot of unanswered questions about the reforms.

Winiata said the creation of the new authority dedicated to indigenous health is an important first step.

But she said it was vital that the new entity had the ability to make its own decisions and help support Māori self-determination.

“The resourcing of the Māori Health Authority is going to be critical to its success,” she said.

Many reform attempts
Winiata said she had worked in the health sector for the past 30 years and in that time had seen a number of attempts by the government of the day to restructure the health system.

She said it was hard to predict what impact the health reforms would have in south Auckland.

“But I think in 12 months’ time we will be able to look at what changes have been made and see what’s been achieved.”

Local Democracy Reporting is Public Interest Journalism funded through NZ on Air. Asia Pacific Report is an LDR partner.

The Waitangi Tribunal has released a scathing ruling of the New Zealand government’s covid-19 response and vaccine rollout, saying Māori were put at risk.

The tribunal held an urgent hearing early this month, and released its findings today.

The tribunal says cabinet’s decision to go against official advice and not prioritise Māori in the vaccine rollout breached the Treaty principles of active protection and equity.

• LISTEN TO RNZ MORNING REPORT: ‘It’s an extremely strong report’ – Māori Council national secretary Peter Fraser
• ‘We knew that if we didn’t prioritise Māori, we were going to be having to do what we’ve done for the last five months’ – Interim Māori Health Authority chief executive Riana Manuel

The government has said it instead opted for a whānau-centred approach.

The tribunal, in its report, said it could not understand why it would go for this against all expert advice.

While accepting a shift to the traffic light system was necessary, it found the rapid transition put Māori at risk.

The decision also put Māori health providers under extreme pressure on limited resources — pressure created by a delayed rollout, and years of chronic underfunding by the state.

It also said the Crown did not consistently engage with Māori to the fullest extent practicable on its pandemic response, a breach of the principle of partnership.

Better support recommended
It recommended better ethnicity data collection, better resourcing and support for Māori providers and communities, and a more equitable rollout for booster shots and paediatric vaccines.

Māori Council national secretary Peter Fraser described the Waitangi Tribunal report as “vindication”.

Fraser told RNZ Morning Report it was a strong ruling that showed the Crown had to uphold its Treaty obligations during a pandemic.

“We want to give credit to the tribunal, they took urgency.”

He said the “exceptional report” of more than 140 pages was put together in a couple of weeks before Christmas.

“It’s absolutely vindicated the Māori Council.”

He said he expected a difference in the paediatric vaccine rollout and booster programme.

Hopeful about new Māori Health Authority
“We are hopeful about the Māori Health Authority and we wish it was up and running now.”

Interim Māori Health Authority chief executive Riana Manuel said the report’s findings were not surprising.

She told Morning Report that she had been on the frontline during the pandemic, vaccinating and swabbing communities for nearly two years.

“We knew that if we didn’t prioritise Māori, we were going to be having to do what we’ve done for the last five months, which is try and get our people back online to getting them vaccinated.”

She said Māori were exposed to lots of misinformation while they waited for access to the vaccine, which had increased hesitancy.

“The problem is, though, like everybody else, we expend a lot of our time getting our people out of that misinformation mode and getting them back into those clinics.

“If we can learn to take the politics out of health and actually focus on what health requirements are … it’ll bring us back to what we need to do, what the right thing is to do.”

This article is republished under a community partnership agreement with RNZ.

New Zealand is scrapping district health boards and creating a new Māori health agency in a radical “fairer and smarter” shake-up of the medical system.

Health Minister Andrew Little announced details to health leaders at Parliament today.

The 20 district health boards which run services for individual areas around the country will be replaced by one new body, Health NZ, which will instead plan services for the whole population.

• READ MORE: ‘Clear’ inequity for Māori in health care – report

Health NZ will have four regional divisions but also district offices.

It will delegate authority to local levels so regional services have a say in what they need and how they work, Little said.

“The system must work in true partnership with Māori… Māori still suffer, on average, worse health than others.”

There will also be a new Māori Health Authority, sitting alongside that, to both set policies for Māori health and to decide and fund those who will deliver services.

Direct commission
The new authority will “have the power to directly commission health services for Māori”.

“There are other equity challenges as well … the system must listen to the voice of Pacific people, disable people, rainbow … and all other people,” Little said.

“We can and must do better.”

The country’s 30 primary health organisations – large regional networks of GPs and primary care – will also be ditched.

And, on the back of covid-19, there will be a new Public Health Agency which will target widespread health problems – like smoking – and try to prepare for pandemics and epidemics.

• WATCH:

RNZ News video of the national health shake-up announcement.

Little said today’s announcement was a plan to create a “truly national health service” that “draws on the best that we have now” but reduces pressure on healthcare workers and hospitals and specialist services.

“By making the changes I am announcing today, we will have the chance to put the focus on primary health care,” he said.

“We can start giving true effect to tino rangatiratanga and our obligations under Te Tiriti O Waitangi.

‘System under stress’
“It’s a system under stress. Our health and care workers strive every day … but demand is growing … and the job is getting harder.”

The changes being announced go further than the Health and Disability System Review, the basis for today’s plan.

That recommended halving the DHBs, and having a Māori health authority but with fewer powers and less autonomy that the one announced today.

The changes have been made to try to stop what is called the “post code lottery of care”, where people get different care – or have different changes of survival – depending on which DHB area they live in.

The report released today says a lot of those problems are caused by the fact that hospitals and specialist care are often managed in isolation from each other, not in a coherent network.

Instead of district health boards, the new Health NZ, will oversee the health needs of four regions.

And there is an increased focused on primary – or GP-level community care.

Primary care funding
The report says at the moment specialist or hospital care draws away a lot of primary care funding and it wants that to stop.

It also wants those community services – including GPs, midwives and pharmacists, to work more together

And the Māori Health Authority is aimed at overcoming the huge health disparities for Māori as a whole, with lower life expectancy and higher rates of disease in many areas.

Associate Health Minister (Māori Health) Peeni Henare said many Māori did not like going to the doctor because their experiences of the health system is negative.

“This authority will drive hauroa Māori and make real change,” he said.

It would represent Māori from all iwi.

“This is where we make a start,” Henare said.

Public health units
“Regional public health units, long underfunded, will stay but under the new Health NZ entity.

Little said he had heard calls for change, quickly.

“The current system no longer serves our needs well. Our goal is a health system that helps all New Zealanders to live longer in good health,” he said.

“We need a system that is not only fairer but also smarter.”

Smarter means making the most of the money and resources available, Little said.

He was not underestimating the challenges faced, he said.

“Our system has become overly complex. It is too complicated for a small nation.

‘Operate as one system’
“We need to operate as one system. Organisations working together should be the norm, not the exception.”

The Ministry of Health would be strengthened, Little said.

But it will no longer directly fund and commission health services.

Health New Zealand – a new Crown entity – will run hospitals and commission primary health care.

It will replace the existing 20 health boards, Little said.

“DHBs have served their communities well.”

But they have their failings, he said.

‘About doing better’
“I want to stress this reform is about doing better with what we have. It is not about cutting services,” Little said.

Little said the fourth element of the announcement was about public health, including “Pacific people, disabled people, rainbow … and all other people”.

“Disability issues span the full range of issues any community faces. That’s why I have more work being done in this area,” he said.

Little said technology would play a part in the new system.

That would include improving access to things like virtual diagnostic tools.

“Health NZ will work with communities … to develop the priorities for their areas, making sure people have a say in the services they get.”

“You should be able to turn up anywhere in the health service and know the health professional has access to information relevant to you.”

New health charter
There will also be a new health charter.

“We will start work on this soon.”

Some aspects of change would take years, not months, Little said.

He acknowledged the challenge of making change during a global pandemic.

He was confident they could safely take place at the same time.

“Covid-19 is not a reason to preserve a system that is not fit for purpose,” he said.

“I am mindful we need to proceed carefully and not disrupt day-to-day services.

“I expect the new system to come into effect in July 2022.”

Establishing interim versions
In coming weeks, work will begin on establishing interim versions of Health NZ and the Māori Health Authority.

New legislation for them will be worked on and Little expects that legislation to be passed by April 2022.

“Together we have an opportunity to make a once in a lifetime change, to put in a new system and improve the health of this, and future, generations.”

DHBs will continue in their roles for now.

“I want to reassure new Zealanders that the care they rely upon will still be available.”

The changes are overdue, and “this time, it must be different”, Little said.

During the process of the reform plan, Little said he had been thinking of those working in the system, and those who needed healthcare.

“We are a small nation, and we can make this change working together, and we can make this change in the spirit of Te Tiriti (O Waitangi).”

This article is republished under a community partnership agreement with RNZ.