New Zealand Health Strategy consultation

Published online: 
27 October 2015

The New Zealand Health Strategy has not been updated since 2000. 

The draft updated Strategy proposes a clear view of the future we want for the health system over the next 10 years, to ensure all New Zealanders live well, stay well, get well. A Roadmap of Actions proposes a direction of travel for the next 5 years.

Consultation has now closed

From 27 October to 4 December 2015, the Ministry of Health consulted on the draft update to the New Zealand Health Strategy and road-map of actions  We conducted approximately 90 meetings; talked face-to-face to more than 2,000 people, more than 7,000 consultation documents were downloaded and more than 100 comments were posted on our discussion forum.  

We appreciate the time people have put into this process and the thoughtfulness of feedback.  We want to make a difference to the way the New Zealand health system supports New Zealanders during the next 10 years and the way with which people have engaged with this process has helped enormously.

New Zealand Health Strategy released

The updated New Zealand Health Strategy 2016 has now been released.

The Ministry of Health considered all feedback it received on the draft strategy and a final version of the updated New Zealand Health Strategy was launched at the Powering Up Our Future Symposium on 18th April 2016.

Hear about the Strategy

Chai Chuah - Director-General of Health: The vision for the updated Health Strategy is that all New Zealanders live well, stay well and get well.

The reason for the change is that it’s been 15 years since the last Strategy was released and many things have changed during that time. The direction given in the Strategy will help all of us focus on the direction of travel so that we are unified when we look at how we respond to the challenges we face in the future.

The fundamental thing about the refreshed Strategy is that it not only articulates the five themes in there but the important thing is not just a theme but how we are all within the system changing our mind-set and behaviours in responding to the themes and that’s really important because the document can only become a reality if there’s a mind-set change and a behaviour change from all of us throughout the system.

One of the things around the mind-set change is how we work with other participants in the system and what I mean by that is colleagues from Education, colleagues from Ministry of Social Development, colleagues from Housing, colleagues from the Justice sector, as well as other colleagues working in the local government, NGOs and even the private sector. I know that this has already been done in the sector by some organisations but what this Strategy clearly states is that this Strategy needs to be the norm as opposed to the exception and I look forward to an acceleration of that right across the sector on this particular theme.

But in the end I think that what we really need to think about is in our actions we focus on the words “needing to care” in the first instance and not just focusing on the health part of the healthcare equation.

Ron Dunham, Chair of DHB CEOs: The Health Strategy is the whole team health approach to improving the status of the population in New Zealand. We need a pathway and a plan to go down that track and we’ve got to work together on it.

The Strategy gives us an understanding of the needs of the populations for a start and our communities. We need to understand our population. We need to understand their needs. We need to understand what it takes to make an improvement to the health of the people in our community and we can only do that together. District health boards are only one component of the New Zealand health sector but they are an important component and they need to work with other components of that sector to get that improvement.

What makes us healthy or unhealthy is not just the health system per se. It’s a whole lot of different things that can be influenced by the council, it can be influenced by education, it can be influenced by social development and it’s a matter of us all concentrating on finding solutions for children and for families and if we find a child that needs to be supported in having breakfast before school, special education needs, needs to be immunised, needs their teeth fixed, needs to have their accommodation or housing sorted for them, then we can work together on finding those solutions. So it’s a great opportunity.

Dr Margaret Wilsher, CMO, Auckland DHB: People-centred care means putting the patient right in the middle of the health equation and it means taking the focus off the hospitals and in to the home, which is where people live. It’s where they have their recreational activities; it’s where their family is around them. So we want the focus to be on the person in the home. We want to focus on health before sickness. We want people to maintain their health for as long as they can but when they become sick we want them to be able to direct their won support and their own care.

First of all we need to talk to them as equals – as partners in their own care. Not with the doctor/patient relationship where the doctor has all the power historically but we want to redress that and put patients and families back in charge. We want to know what matters to them, not what matters to us as a health system, and how we can wrap the services around them in the setting that is most appropriate for them.

We ask patients and families for their opinions about the services we offer. There are on-line surveys and paper surveys. We have focus groups where we interview patients and we bring patients and families with us now to co-design our services. So we’re thinking about service delivery from the patient’s perspective and then we can develop the service and test it with patients and families and then roll it out.

The hospital staff have embraced it because it’s so rewarding working with patients and families, seeing what really matters to them. When we start having conversations with patients and their families, those conversations count.

The Health Strategy signals a new direction for us and it needs to be a document that appeals to our communities and our patients and families, and also the well communities as well as the clinicians and providers of health care. So it has to embrace the direction of travel we think will make the biggest difference to the health of New Zealanders as a whole.

This is not a document merely for economic purposes. It’s actually about getting wellness in to our communities and maintaining it.

Matiu Rei, Executive Director, Ngati Toa Rangatira: Our population is basically 36% Maori, 34% Pacific and 17% European and a we have a number of Asian and migrant groups.

So it’s different. Probably unique in the country. We have 70% of our population either have a chronic condition or are heading toward a chronic condition. Diabetes, obesity are two in particular. And of course they're linked as well, with CVD issues, respiratory issues. And so we have to do things differently. And we have to be close.

Well I think the closer to home is really about knowing who your people are and know your services and if you can get that understanding, know that we’re here to help and we will do it in ways that’s more accessible to them. That’s best for the provider and the community as well. That’s why right from the beginning we’ve had a programme of trying to create opportunities for our patients so that they come here to any one of our medical centres and we will provide workshops to address issues and give them a better understanding.

We’ve done a lot of value-added stuff like we have a free gymnasium for example. We run daily programmes in which people can come along and improve their mobility. If you’re an elderly person do muscle-strengthening to prevent falls, for young people we run cross-fit programmes and that attracts them into the service. They get the opportunity to use our gym and we get the opportunity to use our services and we can tell them more about how they can engage better with our health and the service.

Man on exer-cycle: I come down every morning for a half hour workout. Just to get the bones and the body going.

Matiu Rei: I like to think we’re making a difference to our population group. Our most important thing is getting people to understand that if they do have a health issue, than they and us, we need to work together to address that issue to make their lives better.

Robyn Scott, CEO, Age Concern NZ: When I think about one team approach I think about the care that my mother received through a hospital in New Zealand and the complete seamless integration from her referral to a specialist through to very complex surgery in hospital, through to a long stay in hospital, through to the hospital liaising with other services that she was going to need once she left hospital, right through to being back at home and a large NGO in New Zealand having to provide seamless transport services to transport her regularly back into hospital.

So volunteers transported her back to hospital. They made sure she got to the right place in the hospital. If she was in the wrong place somebody in the hospital took her to the right place and she was delivered back. And the seamless execution and the provision of home and community services to support her to be well, get well, stay well and recover at home worked very nicely and neatly.

I think that is an example of something that is very desirable in the health care system and if we could provide that really seamless integration that made it easy for an older person to navigate the health system with a minimum of effort, I think that’s really desirable.

I do believe that it’s not only systems that prevent things from happening like that; it’s actually people’s attitudes. Anything can happen if people have got a will to make it happen. So people-centred care is going to be really important for the future, with a growing number of baby boomers who have high expectations of the world as they grow older and live for longer.

Dr Richard Medlicott, GP, Island Bay Medical Centre: Well, information needs to follow patients. We often have situations where a patient is going off to see a specialist or through to the hospital or coming through to see us and to manage them you really need to have information and having connected systems lets you treat the patient appropriately with those tools.

Well I think the main thing that we’re doing here which we’re certainly promoting more widely is the use of patient portals. So that’s where people can log on, see their own health information, see their results, order prescriptions, message their GP or nurse. It’s a nice way of fostering the relationship between the doctor and the patient.

I think the reality is that any change can make people nervous but we don’t get a lot of emails coming in compared with say the number of requests to phone someone, or little notes that are left through the receptionist. So it’s another way of doing what you’re already doing and when you look at how often patients log in to see their results there’s a ratio of about 10 to 1 so they’re using it a lot. They’ve been universally very positive about the portal.

A new innovation we’ve got with that is the app for mobile devices and they really enjoy having that accessibility and I think looking forward to the future more and more stuff is going to be on mobile platforms.

We’re up to about 30, 35% of adult patients using the portal of the ones who have email addresses. There’s a certain population who are not particularly interested in it and it’s not the elderly. It tends to be the younger, healthier people who don’t have a need for it. You tend to find that it follows people’s needs. If they think they’ve got health conditions that need monitoring they’ll sign up for it.

We know that computer algorithms can often come up with better decisions around relatively simple stuff for example warfarin dosing to thin your blood, or managing your diabetes with insulin dosing. So that gives us more time to talk with the patient about what diabetes means to them or why are they on that agent that thins their blood. So it gives us more time to communicating the meaning of it with the patient.

I’m looking forward to the Health Strategy and what’s coming next.

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