Our role in the health system

Te Whatu Ora leads the day-to-day running of the health system across New Zealand, with functions delivered at local, district, regional and national levels.

It weaves the functions of the 20 former District Health Boards (DHBs) into its regional divisions and district offices, ensuring continuity of services in the health system.

Te Whatu Ora manages all health services, including hospital and specialist services, and primary and community care. Hospital and specialist services are planned nationally so they can be delivered more consistently across the country. It also manages national contracts. 

Primary health, wellbeing and community-based services are planned and then purchased through the four regional divisions of Te Whatu Ora.

Each region works with their district offices, located closer to local communities, to develop and implement plans based on local needs to improve the health and wellbeing of communities.

Te Whatu Ora is also responsible for improving services and outcomes across the health system. We do this in partnership with the Māori Health Authority.

2022 health system reforms

In 2018, the Government commissioned an independent review into our health system: the Health and Disability System Review/Hauora Manaaki Ki Aotearoa Whānui (the Review).

The Review was based on widespread consultation with the health and disability sectors and interested parties over an 18-month period.

It found a fragmented health system that did not serve everyone well and produced unequal outcomes, particularly for vulnerable populations.

In September 2020, the Health Reform Transition Unit was established within the Department of the Prime Minister and Cabinet in response to the Review.

Led by former Director-General of Health Stephen McKernan, the Transition Unit provided the Government with advice on the response to the Review and the future of our health system, including:

  • developing the policy response and design of the system operating model
  • providing advice on the establishment of new entities and legislative change
  • working on an overall implementation plan and work programme for the transition.


Details of the reforms

In April 2021, the Government announced details of the reforms that culminated in the passing of the Pae Ora (Healthy Futures) Act 2022 which, among other changes, established Te Whatu Ora - Health New Zealand.

Our new health system is a single health service providing consistent, high-quality health services for all people.

The Ministry of Health is focused on policy, strategy and regulation while Te Whatu Ora has taken over the planning and commissioning of services and the functions of the 20 former District Health Boards to remove duplication and provide true national planning.

Te Aka Whai Ora - Māori Health Authority works alongside Te Whatu Ora to improve services and achieve equitable health outcomes for Māori.

Pātiki and Waharua Kōpito patterns

Background resources

A lot of consideration went into making these big changes to the New Zealand health system. We have many detailed documents you can read to better understand the reforms.