Agency overview | |
---|---|
Formed | 1 July 2022 |
Preceding agency |
|
Jurisdiction | New Zealand |
Headquarters | 133 Molesworth Street, Thorndon Wellington 6011 |
Employees | ~80,000 [1] |
Agency executive |
|
Website | tewhatuora.govt.nz |
Health New Zealand - Te Whatu Ora is the primary publicly funded healthcare system of New Zealand. It was established by the New Zealand Government to replace the country's 20 district health boards (DHBs) on 1 July 2022. Health New Zealand is charged with working alongside the Public Health Agency to manage the provision of healthcare services in New Zealand. [2] [3]
Health New Zealand is responsible for the planning and commissioning of health services as well as the functions of the 20 former district health boards. The Ministry of Health remains responsible for setting health policy, strategy and regulation.
As of 2022, the agency is New Zealand's largest employer, consolidating the DHBs' combined work force of 80,000, with an estimated annual operating budget of NZ$20 billion and an asset base of about NZ$24 billion. [4]
As of July 2024, Health New Zealand - Te Whatu Ora is headed by Commissioner Professor Lester Levy, who is serving for 12 months. While the organisation's board normally has seven members, it had fallen down to two members by late July 2024 after three members opted not to renew their terms and two resigned early. [5] Its Chief Executive is Margie Apa. [6]
Health New Zealand consists of four regional divisions, with regional commissioning boards overseeing the provisioning of primary and community health services. [7] These four regional divisions consist of:
As the successor to the district health boards, Health New Zealand is responsible for running all hospitals and health services including the DHB's 12 public health units and the former Health Promotion Agency. These public health units dealt with areas such as drinking water, infectious disease control, tobacco, and alcohol control. [9] [7]
On 21 April 2021, Minister of Health Andrew Little announced plans to replace the country's 20 district health boards with a new public health agency called "Health New Zealand", which would be modelled after the United Kingdom's National Health Service. Health New Zealand would work alongside a new Māori Health Authority, which was to be responsible for setting Māori health policies and overseeing the provision of Māori health services. In addition, a Public Health Authority was established to centralise public health work. [2] [3]
The National Party's health spokesperson Shane Reti criticised the government's plan to replace the district health boards with a new centralised agency. He claimed that centralisation took away autonomy from local regions and suggested that the government instead explore the consolidation of some functions such as asset management across the DHBs rather than abolishing them entirely. Reti claimed that the public was unaware of the cost of the government's planned restructuring and the potential disruption it would cause. [10]
In mid-September 2021, the government announced the interim board members of Health New Zealand. The agency was be chaired by the economist Rob Campbell. Other board members include Sharon Shea (co-chair of the interim Māori Health Authority and current chair of the Bay of Plenty District Health Board), former National MP Amy Adams, chartered accountant and lawyer Cassandra Crowley, former Labour Member of Parliament Mark Gosche, former Director General of Health Karen Poutasi, senior executive Vanessa Stoddart, and general practitioner, kidney specialist and Medical Council of New Zealand Chair Curtis Walker. [4] [11] [12] In December 2021, Margie Apa was appointed chief executive of Te Whatu Ora in December 2021. [13]
In October 2021, the government introduced the Pae Ora (Healthy Futures) Bill which formally entrenched various health reforms including the replacement of the district health board system with Health New Zealand. The bill passed its third reading on 7 June 2022. [14]
On 19 May 2022, the government allocated NZ$13.2 billion from the 2022 New Zealand budget to facilitate the establishment of the Health New Zealand and the Māori Health Authority over the next four years. This amount included $11.1 billion to address the cost pressures of the previous district health board system and $2.1 billion to set up the two new health entities. [15] [16]
On 1 July 2022, Health New Zealand formally launched as Te Whatu Ora, with the new entity assuming responsibility for all hospitals and health services formerly run by the district health boards. In addition, the 12 public health units, which operated within the DHBs, and the former Health Promotion Agency were transferred into Te Whatu Ora. The new entity also assumed the commissioning functions of the Health Ministry and the commissioning and delivery functions of the DHBs. [9] [7]
In late February 2023, Te Whatu Ora's chair Rob Campbell criticised the National Party's proposal to scrap the Labour Government's Three Waters reform programme in a LinkedIn post and accused its leader Christopher Luxon of "dog whistling" on the issue of co-governance. Campbell's remarks were criticised by National MP Simeon Brown and ACT Party leader David Seymour, who accused him of breaching the Public Service Commission's policy requiring the directors of Crown entities to remain politically neutral. Campbell defended his remarks, stating that they were made in his capacity as a private citizen and denied violating the Commission's political impartiality policy. [17] [18]
On 27 February, Prime Minister Chris Hipkins criticised Campbell's Three Waters remarks as "inappropriate." On 28 February, Health Minister Ayesha Verrall used her discretionary powers under section 36 of the Crown Entities Act 2004 to relieve Campbell of his position as head of Te Whatu Ora. Though Campbell had apologised to Luxon and Verrall, the latter had demanded that he resign by 10:30 am on 28 February. Campbell had refused to resign and defended his right to criticise National's Three Waters policy. [19] [20]
On 4 May 2023, Verrall announced that Te Whatu Ora would play a leading role in the Government's 2023 Winter Health Plan that would include 24 initiatives to support community care and reduce hospital demand. These initiatives include using telehealth services to support primary care, ambulances and paramedics, remote patient monitoring, equipping pharmacies to treat minor ailments, community radiology services, increasing primary options for acute care, incentives to support aged residential care, improving access to allied health and community response services, investing in mental health services, bivalent COVID-19 boosters, and influenza vaccination campaigns, recruiting international nurses and health professionals, and continuing to invest in COVID-19 monitoring, response, and services. [21] [22]
In mid December 2023, Health Minister Shane Reti appointed Ken Whelan as a Crown observer to Health New Zealand, citing ongoing challenges that the agency was facing following the previous Labour Government's 2022 health reforms. [23]
On 12 April 2024, Health NZ chair Dame Karen Poutasi resigned as chair and board member prior to the end of her 18-month term, effective immediately. Health Minister Shane Reti said that Poutasi had been asked to remain in the role until a successor could be appointed in May 2024. [24]
By 17 July 2024, three of Health NZ's board members Amy Adams, Vanessa Stoddart and Dr Curtis Walker had decided not to renew their terms while two others Naomi Ferguson and Jeff Lowe had resigned prior to the end of their terms. This left Lester Levy and Roger Jarrold as the two remaining board members. [25] On 23 July, Health Minister Shane Reti and Prime Minister Christopher Luxon installed the last remaining board member Lester Levy as commissioner and chair of the organisation. According to Reti, these changes came amidst report that Health NZ was heading towards a NZ$1.4 billion deficit by the end of the financial year, with the agency spending $130 million a month. Luxon also criticised the organisation's lack of performance management, centralised and bloated bureaucracy, and financially mismanagement. The Sixth National Government also confirmed plans to split Health NZ into four regions, with each headed by a deputy chief executive. [5]
In mid August 2022, Radio New Zealand reported that Health New Zealand lacked Asian members on the organisation's 51 leadership roles despite Asians making up 15% of New Zealand's population according to the 2018 New Zealand census. Population and migration researcher Dr Francis Collins advocated legislation ensuring greater minority representation in leadership and decision-making. Asian medical professionals Doctor Carlos Lam and Vishal Niwi of the Asian Network criticised the lack of Asian representation and input within Health New Zealand's leadership. In response, Health NZ's chief executive Margie Apa claimed that the organisation was committed to diversity in its workforce but admitted they had not set targets for representation on the grounds that its employees and management were required to serve all communities equitably. [26]
In March 2024, The New Zealand Herald reported that a Health NZ manager had instructed a staff member to stop using the Māori language greetings in emails after two patients objected. The staff member disagreed and shared her story in a Reddit post. In response, Health NZ's chief people officer, Andrew Slater, described the manager's response as an overreaction. Former Health NZ chair Rob Campbell criticised the agency for its lack of "cultural leadership" and for failing to address racism. [27]
In late August 2022, Health NZ was criticised by the opposition National Party's health spokesperson Shane Reti for abandoning the previous district health boards' practice of holding public monthly meetings. Health NZ has closed its meetings to the public and media, releasing only brief summaries of its board meetings. The organisation's chair Rob Campbell defended the decision to exclude the public and media from its initial board meetings on the grounds that they dealt with sensitive issues such as staff appointments and Cabinet decisions. Campbell and chief executive Margie Apa held half-an-hour media briefings following board meetings to discuss the contents of their meetings with the media. [28]
In February 2023, Te Whatu Ora Te Toka Tumai Auckland introduced an Equity Adjustor Score, which seeks to reduce inequity in the New Zealand health system by using an algorithm to prioritise patients based on clinical priority, time spent on the waitlist, geographical location, ethnicity and deprivation level. In June 2023, the Equity Adjustor Score has sought to improve health outcomes for Māori and Pasifika New Zealanders, who have experienced higher levels of deprivation and health problems than other ethnic groups in New Zealand. Health Minister Verrall, Pasifika health expert Sir Collin Tukuitonga, Te Toka Tumai Auckland interim lead Dr Mike Shepherd, and University of Auckland medical education senior lecturer Dr Mataroria Lyndon defended the Adjustor Score's prioritisation of Māori and Pasifika, citing inequalities in the health system, higher obersity rates, and lower life expectancy within these communities. [29] [30] National Party health spokesperson Shane Reti and ACT Party leader David Seymour objected to the Adjustor Score's ethnic criterion, describing it as racial discrimination that did not properly address social and health inequalities. [31]
By 1 August 2024, Health NZ had dropped the Equity Adjustor Score after a review concluded it was "legally and ethically justifiable but didn't follow best practice." This review had been supported by Health Minister Shane Reti. Health NZ instructed hospitals to stop using the algorithm for prioritising non-urgent waitlists until the development of a new comprehensive strategy. [32]
In early December 2023, Te Whatu Ora investigated an administrator who was accused of spreading COVID-19 misinformation using COVID-19 vaccination data obtained from the organisation. The employee had allegedly developed a database for the vaccine rollout and had been interviewed on a conspiracy theory website. [33] On 3 December, Te Whatu Ora lodged a police complaint against him over the vaccine rollout data breach. [34] On 4 December, he was identified as Barry Young, who appeared at the Wellington District Court on the charge of accessing a computer system for dishonest purposes, which carries a maximum seven year prison sentence. [35] After being released on bail on 5 December, Young was interviewed by American conspiracy theorist Alex Jones on his website InfoWars. [36] On 8 December, Te Whatu Ora enlisted the services of international cybersecurity and forensic experts to investigate the COVID-19 vaccine data leak. [37]
On 19 December, after Te Whatu Ora previously said that the data was anonymised, the agency admitted that the data could make identifications of people, with considerable effort. [38] By 16 February 2024, Health NZ acknowledged that at least 12,000 people had their personal information compromised. Several of the affected individuals had their data leaked by a US blog. [39]
District health boards (DHBs) in New Zealand were organisations established by the New Zealand Public Health and Disability Act 2000 under the Fifth Labour Government, responsible for ensuring the provision of health and disability services to populations within a defined geographical area. They existed from 1 January 2001, when the act came into force, to 30 June 2022. Initially there were 21 DHBs, and this was reduced to 20 organisations in 2010: fifteen in the North Island and five in the South Island. DHBs received public funding from the Ministry of Health on behalf of the Crown, based on a formula that took into account the total number, gender, age, socio-economic status and ethnic mix of their population. DHBs were governed by boards, which were partially elected and partially appointed by the minister of Health.
Shane Raymond Reti is a New Zealand politician and a member of the New Zealand House of Representatives, and a Cabinet Minister with the roles of Minister of Health and Minister for Pacific Peoples, since 27 November 2023. He was first elected at the 2014 general election as the Member of Parliament (MP) for the Whangārei electorate. He is a member of the New Zealand National Party and served as its deputy leader from 10 November 2020 to 30 November 2021 including a period of five days as interim leader following the ousting of Judith Collins.
The Whanganui District Health Board was a district health board that provided healthcare to the Wanganui, Rangitikei, and parts of the Ruapehu districts of New Zealand. In July 2022, it was merged into the national health service Te Whatu Ora.
Auckland District Health Board (ADHB) was a district health board that provided healthcare in the Auckland Region in New Zealand, mainly on the Auckland isthmus. This district health board existed between 2001 and 2022 and was governed by a part-elected, part-appointed board. In 2022, its functions and responsibilities were subsumed by Te Whatu Ora and Te Aka Whai Ora.
The South Canterbury District Health Board was a district health board with the focus on providing healthcare to the Timaru, Mackenzie, Waimate districts in New Zealand. In July 2022, it was merged into the national health service Te Whatu Ora.
MidCentral District Health Board was a district health board that provided healthcare in the Manawatū region of New Zealand. The DHB covers the Manawatū District, Palmerston North City, Tararua District, Horowhenua District, and the Ōtaki ward of the Kāpiti Coast District. In July 2022, the MidCentral DHB was merged into the national health service Te Whatu Ora.
The Bay of Plenty District Health Board was a district health board with the focus on providing healthcare to the Bay of Plenty area of New Zealand. In 2022, the Bay of Plenty DHB was dissolved as part of a national overhaul of the district health board system. Its former functions and responsibilities were assumed by Te Whatu Ora.
The Hawke's Bay District Health Board was a district health board with the focus on providing healthcare to Hawke's Bay, New Zealand. In July 2022, it was merged into the national health service Te Whatu Ora.
The Hutt Valley District Health Board was a district health board that provided healthcare to the cities of Lower Hutt and Upper Hutt in New Zealand. In July 2022, the Hutt Valley DHB was merged into the national health service Te Whatu Ora.
The Lakes District Health Board was a district health board that provided healthcare to the area covered by Taupō and Rotorua districts in New Zealand. In July 2022, the Lakes DHB was merged into the national health service Te Whatu Ora.
The Nelson Marlborough District Health Board was a district health board with the focus on providing healthcare to the Nelson, Tasman and Marlborough districts of New Zealand. In July 2022, it was merged into the national health service Te Whatu Ora.
The Northland District Health Board is a district health board with the focus on providing healthcare to the Northland Region of New Zealand. In July 2022, the Northland DHB was merged into the national health service Te Whatu Ora.
The Tairāwhiti District Health Board, branded as Hauora Tairāwhiti since 2015, was a district health board with the focus on providing healthcare to the Gisborne District of New Zealand. In July 2022, the Tairāwhiti DHB was merged into the national health service Te Whatu Ora.
The Taranaki District Health Board was a district health board which provided healthcare to the Taranaki region of New Zealand. In July 2022, the Taranaki DHB was merged into the national health service Te Whatu Ora.
The Wairarapa District Health Board was a district health board that provided healthcare to the Masterton, Carterton, and South Wairarapa districts of New Zealand. In July 2022, the Wairarapa DHB was merged into the national health service Te Whatu Ora.
The Waitemata District Health Board was a district health board that provided healthcare to people living in the area that used to be covered by North Shore city, Rodney District, and Waitakere City in New Zealand. It was abolished on 1 July 2022, and replaced with Te Whatu Ora.
The West Coast District Health Board was a district health board with the focus on providing healthcare to the West Coast region of New Zealand. In July 2022, the West Coast DHB's functions and responsibilities were taken over by the national health service Te Whatu Ora.
Te Aka Whai Ora was an independent New Zealand government statutory entity tasked with managing Māori health policies, services, and outcomes. The agency was one of four national bodies that oversaw New Zealand's health system since 2022, along with the Ministry of Health, the Public Health Agency, and Te Whatu Ora. They replaced a system in which a single Ministry funded services through 20 district health boards (DHBs).
Fepulea'i Margie Apa is a New Zealand healthcare manager and head of Te Whatu Ora, the health authority which came into operation in July 2022. Of Samoan descent she was the first Samoan to be head of a district health board.
Robert James Campbell, is a New Zealand socialist, economist, trade unionist, businessman and public servant. He has chaired several organisations and institutions including Resistance Bookshop, the Distribution Worker's Federation, Federation of Labour, Guinness Peat Group (GPG), SkyCity, Summerset Holdings, Tourism Holdings, Te Whatu Ora, and the Environmental Protection Authority (EPA). He has also served as Chancellor of Auckland University of Technology since 2019.