Our priorities

Improving the quality of health care, especially delivering on health targets

The Government’s health targets are a set of national performance measures that provide a clear and specific focus for improving health and the quality of health care at local and national levels. They provide a way of measuring whether or not the health and disability system is delivering improvements in the health of New Zealanders and in their access to the services they need.

The Ministry of Health works collaboratively with district health boards (DHBs) towards health target achievement. Each DHB has its own local targets, which take into account the particular health needs of its community. Collectively these targets contribute to national improvement. DHBs’ achievement against these targets is publicly reported throughout the year. ‘Target champions’, who are experts in their clinical area, are supported by the Ministry to work with and provide support to the health sector.

The current health targets represent a balance between public access to hospital care when it is needed – for the important areas of elective surgery, cancer treatment and emergency medicine – and preventative action to limit the damage from smoking, communicable diseases and chronic disease.

A review of the health targets will be undertaken in 2012/13 to ensure the mix of targets reflects the areas of greatest priority for driving improvements.

Government priorities

In addition to the health targets discussed above, the Minister of Health has identified the following four priority areas for the Ministry’s short- and medium-term work programme:

• bringing health services closer to home
• improving the health and independence of older people
• strengthening the health workforce
• improving value for money.

These four Government priorities are described below, and are dealt with at a greater level of detail in the ‘Operation Intentions’ section of the Ministry's Statement of Intent 2011–14.

Bringing health services closer to home

We need to keep New Zealanders healthy and out of hospital. This means the health and disability system needs to be configured so that New Zealanders can get faster, more convenient health care closer to home.

As part of this, the Government is driving the development and implementation of proposals for reconfiguring primary health services and models of care. This will lead to people getting better access to a wider range of health services closer to home, including services previously only available in a secondary care setting.

The Ministry will lead work in this area with DHBs and primary health care, including overseeing the progress of Integrated Family Care Centres and developing integrated approaches to acute care.

Improving the health and independence of older people

The greatest area of projected growth in health spending relates to the health and independence of older people. This reflects both the ageing of the population and the expectation that services will improve in quality over time. The Government is committed to providing effective health care, improved frontline services, affordable and quality support services, and greater dignity for older New Zealanders.

Additional funding was provided in 2009/10 to support and retain nursing staff in residential care, which increased the subsidies for older people’s residential care. Looking forward, more and better services supporting older people to remain in their homes and a wider and more integrated continuum of care are the two broad directions for improving services.

The Ministry will lead work in this area, including policy advice centred on older people and their families, the quality of home support services and aged residential care, along with stronger monitoring of the aged residential care sector.

Strengthening the health workforce

The Government wants to strengthen the health and disability workforce, because unless New Zealand has the health professionals it needs, we will never be able to deliver the services New Zealanders expect.

The Government has already made significant progress in addressing shortages in key areas and has established the basis for improved planning for the future. The recently established voluntary bonding scheme now has over a thousand graduate doctors, nurses and midwives enrolled. Extra medical student places and general practitioner training places have been funded in the last two years.

In partnership with Health Workforce New Zealand, the Ministry will continue to lead work in this area, including carrying out workforce service reviews, establishing new regional training hubs, developing training and workforce roles, and continued administration of training and the voluntary bonding scheme.

Improving value for money

Current and projected constraints on government funds mean the health and disability system will need – more than ever – to ensure a strong and ongoing focus on maximising value from a constrained set of resources. This means that financial results for the health and disability sector need to be well managed and cost growth controlled. It requires a focus on doing more with the resources available through productivity improvements.

It also requires the sector to plan and work more collaboratively (eg, through sharing back-office functions) in order to deliver both financial and clinical sustainability across the country. Collaboration needs to encompass not only work across DHBs and other bodies, but also greater collaboration between managers and clinicians, with increased clinician involvement in decision-making resulting in positive impacts on the quality and affordability of services.

The Ministry will be working with and monitoring the sector in order to ensure effective financial management, foster improvements in productivity, put in place regional and national planning, and ensure that the development of workforce and IT infrastructure is coordinated and rationalised across the country. The Ministry has also instituted a Health Sector Forum, which provides an opportunity for sector organisations to discuss and align their work programmes.

Ministry policy advice will inform the annual budget process, including prioritising areas of best value expenditure.

Working across government

As well as fostering collaboration across the health sector, as discussed above, the Ministry is working collaboratively with other government agencies on the wider government agenda. This involves finding better ways to organise integrated and streamlined public services in order to deliver more effective, accessible and convenient services for New Zealanders.

As a member of the Social Sector Forum the Ministry shares leadership of the Forum’s work programme, which includes Whanau Ora, Drivers of Crime, and pilots of new approaches to social service delivery for young people. Improvements in primary health care are essential to many of these initiatives. Other work across government includes improving regulation to reduce barriers to exports, and improving medium- to long-term policy and forecasting.

One notable and emerging whole-of-government priority, to which the Ministry will make a significant contribution, is the Christchurch earthquake response.

Implementing Whanau Ora

The Government has made clear its intention to support new ways of delivering social services. Whanau Ora is a key cross-government work programme that aims to integrate the provision of health, education and social services. Whanau Ora is informed by an approach that places families at the centre and in control of achieving their own outcomes.

Although whanau will be self-managing, there will also be expectations on government services to deliver better results for New Zealand families. Supporting activity that is driven and shaped by whanau needs and aspirations will require the health sector to work in a more seamless way with other parts of the social sector.

The Ministry will work with Te Puni Kokiri (the lead government agency) and the Ministry of Social Development to implement government decisions on Whanau Ora over the coming years. This includes working with DHBs to improve contracting practices and the integration of contracts for providers, along with supporting providers to focus on improving whanau outcomes.

Responding to the Christchurch earthquake

Following the earthquake in Christchurch on 22 February 2011, the Government has made a clear commitment to rebuilding the city and to providing all necessary resources to deal with this natural disaster. Ensuring the health needs of Cantabrians are met is a key element of the Government’s response. Challenges to health extend beyond the immediate and obvious trauma and injury, and include the risks posed by untreated water supplies, waterways contaminated with sewage, and ongoing mental illness and disability stemming from stress and anxiety.

Medium-term planning will need to take account of the impact of the earthquake on Christchurch health services when considering how best to configure health service delivery and associated activities such as workforce training for the South Island and New Zealand.

The Ministry’s full earthquake response work programme will take time to emerge, but the Ministry will have a role to play through coordinating the activities of DHBs and other care providers, international liaison, studying and reporting on the health situation, and planning for the provision of services such as psychosocial support (in partnership with the Ministry of Social Development) and aged care facilities.

The emergent and contingent nature of this priority means that the full impact of the earthquake on our other priorities, and on the distribution of resources across the Ministry’s activities, is not fully understood at the time of writing. There are likely to be some adjustments as resources are moved to the earthquake response.

Strategic direction

For more information about the Ministry's priorities and strategic direction, go to our Statement of Intent 2011–14.