How our health system is changing / E panoni ana tō tātou hātepe hauora

Health reform transformation

We are transforming the way we support New Zealanders to get well, stay well, live well and have healthcare choices that meet their needs. To do that, we are building the foundations to better support longer-term health transformation to really make a difference.

Transformation means making big changes while continuing to improve those parts of the health system that are working well.

The focus is on making sure everyone gets the right healthcare, where and when they need it. Right now, that doesn’t happen for a lot of people, such as people who live in struggling rural communities, Māori, Pasifika or people with disabilities. So, things are starting to change.

Health system entities

From 1 July 2022 two new health organisations assumed some of the responsibilities for our health system – Te Whatu Ora - Health New Zealand and Te Aka Whai Ora - Māori health Authority. These two organisations will work with Manatū Hauora / Ministry of Health and a new Public Health Agency within Manatū Hauora as the new health system.

Whaikaha - Ministry of Disabled People was also established on 1 July 2022.

Changes to the structures of the system will not have an immediate impact on how, where and when New Zealanders receive care, or where and how you work, if you're a member of the health workforce. However, having a national health system means that changes can be made to achieve better outcomes for our health. Some changes will take a few years to put in place.

Te Whatu Ora - Health New Zealand

The new national entity, Health New Zealand - Te Whatu Ora, is now responsible for the planning and commissioning of hospital, primary and community health services. The 20 DHBs have been disestablished and no longer exist.

Te Whatu Ora - Health New Zealand is managing health care services by planning nationally, delivering regionally, while tailoring health care services locally with increased opportunities for community input. It operates four regional offices and each region works with their districts, located closer to local communities, to develop and implement plans based on local needs to improve the health and wellbeing of communities.

Te Aka Whai Ora - Māori Health Authority

Te Aka Whai Ora - Māori Health Authority, was established alongside Te Whatu Ora - Health New Zealand, and has shared responsibility for decision-making, planning and delivery.

Local iwi-Māori partnership boards help shape appropriate health and wellbeing services to meet the needs of local communities through being an influencing and decision-making voice for iwi and Māori at a local level, supporting Te Tiriti partnerships throughout the system.

Manatū Hauora (Ministry of Health)

Manatū Hauora's (Ministry of Health) role as chief strategic advisor and kaitiaki (steward) of Aotearoa New Zealand's health and disability system has been strengthened and some of the things it does have changed.

Statutory roles such as the Director of Public Health and Director of Mental Health remain within the Ministry.

Public Health Agency

A new Public Health Agency within the Ministry now leads population and public health policy, strategy, regulatory, intelligence, surveillance and monitoring functions across the system. This:

places more emphasis on the determinants of health such as employment and housing which will mean working more closely with relevant government agencies and community partners
uses intelligence and monitoring to strengthen the system to enable New Zealanders to live longer, healthier lives.

Public Health Units were brought together into a national public health service that is now part of Te Whatu Ora – Health New Zealand. This ensures our Public Health Units are well equipped to respond as one to threats like COVID-19.

To ensure focus on keeping people well for longer is embedded in the heart of our health system, the Health Promotion Agency has also merged into Te Whatu Ora - Health New Zealand.

Whaikaha / Ministry of Disabled People

Whaikaha - Ministry of Disabled People is a new ministry set up in July 2022 to give a voice to the disabled community. Their work, done in partnership with the community and Māori, will transform the lives of many New Zealanders.

Whaikaha’s role is to lead and coordinate cross-government strategic policy. This will mean that whenever a government agency is writing policy which will impact all New Zealanders, that the rights and needs of our community are taken into account.

Collectively, the whole health system will deliver a greater focus on Māori health and addressing longstanding inequities. This will be achieved through reinforcing Te Tiriti o Waitangi principles and obligations and ensuring partnership with Māori in the design and delivery of services at every level. Supporting Māori to progress mana motuhake and rangatiratanga in this way is a key feature of the new system.

Our health system will support all New Zealanders to live longer and have the best possible quality of life.

How the system works together

Te Whatu Ora - Health New Zealand co-ordinates health services across New Zealand, from healthcare delivery in your community, through to national healthcare services.

Te Aka Whai Ora – Māori Health Authority and Te Whatu Ora - Health New Zealand work in partnership to enrich the health system, making it work better for Māori.

Te Aka Whai Ora - Māori Health Authority will work with the Manatū Hauora (MoH) on strategy and policy issues of particular relevance to Māori, providing direction for the health system, ensuring that our commitment to Te Tiriti o Waitangi continues to underpin approaches to hauora.

Alongside advising on, and commissioning, some health services, Te Aka Whai Ora - Māori Health Authority will design health care policy and approaches that:

improve outcomes for Māori and achieve health equity;
have a stronger focus on equity and evidence-based action; and
embed the improvement of Māori health across the health system (Te Whatu Ora – Health New Zealand)

This will be better for everyone, because a health system that does better for Māori, does better for all.

And this is just the start. Over time, the way people are supported to stay healthy will improve.

How did the system come together?

The 20 District Health Boards were formally disestablished on 30 June 2022 and were replaced by Te Whatu Ora – Health New Zealand.

Some tasks and services that had previously been provided by external agencies or Manatū Hauora (MoH) transferred to Te Whatu Ora – Health New Zealand and Te Aka Whai Ora - Māori Health Authority.

The ‘shared service agencies’ incorporated into Te Whatu Ora – Health New Zealand:

NZ Health Partnerships Limited
Central Region’s Technical Advisory Services Limited (TAS)
Health Alliance NZ Limited
Health Source
Northern Regional Alliance
HealthShare Limited
South Island Shared Service Agency Limited

Under the legislation Te Hiringa Hauora (HPA) was also assumed by Te Whatu Ora - Health New Zealand. Some roles from Te Hiringa Hauora transfered to the Public Health Agency (i.e. those working on the alcohol and advice functions).

Many individual DHBs also owned or had joint ventures in organisations specific to their local needs. Ownership of these entities transferred to Te Whatu Ora – Health New Zealand as part of the transfers of DHB assets.

Some functions or parts of functions transferred from Manatū Hauora (MoH) to Te Whatu Ora – Health New Zealand or Te Aka Whai Ora - Māori Health Authority.

Shared services organisations

Some tasks and services that had previously been provided by external agencies or Manatū Hauora (MoH) transferred to Health New Zealand - Te Whatu Ora, and Te Aka Whai Ora - Māori Health Authority.