In July 2022, the most significant and complex reform of New Zealand’s health system began. The reforms brought together all the district health boards and supporting organisations into one entity (Te Whatu Ora – Health New Zealand), created Te Aka Whai Ora – the Māori Health Authority and Whaikaha – Ministry of Disabled People, and have been driving changes within Manatū Hauora as we focus on our role as chief steward of our health system and lead advisor to the government on health.
Change of this scale takes time. The health reforms introduced new entities in the health system and refocused the role of Manatū Hauora. Manatū Hauora is now focused on leading the health system and is not a significant commissioner of health services or involved in day-to-day operations.
We are regularly assessing progress and the documents below reflect point-in-time analyses of the reforms programme.
The following documents are being proactively released, with some information withheld pursuant to the following sections of the Official Information Act 1982:
- section 9(2)(a) – to protect personal privacy
- section 9(2)(f)(iv) – to maintain the constitutional conventions that protect the confidentiality of advice tendered by Ministers and officials.
Documents released
Briefing: Response to the Ministerial Advisory Committee on Health Reform Implementation report
The high-level assessment to support future focused health reform implementation was produced for the Minister of Health by the Ministerial Advisory Committee for Health Reform Implementation. The Ministry of Health, Health New Zealand and Te Aka Whai Ora accept the findings of the assessment and have provided a joint response to the key points in this briefing. Released 14 March 2024.
Ministerial Advisory Committee for Health Reform Implementation: High-level assessment to support future focused health reform implementation
The high-level assessment to support future focused health reform implementation was produced for the Minister of Health by the Ministerial Advisory Committee for Health Reform Implementation.
The report was informed by interviews conducted in September – October 2023 with 47 tier one, two and three leadership as well as clinical leaders and some external stakeholders. Approximately 150 documents were received from the organisations for review with additional desktop research undertaken where required. Released 28 February 2024.
Q1 health system reform progress report
The report outlines progress, risks and issues relating to the implementation of health reform for the period from July to September and is the second report on reform progress. The first report was released mid-year as a report-back to Cabinet: Update on progress on the health system reforms.
The Q1 report shows that as expected at this early stage, there are challenges and issues to work through, but overall, the report notes we are making steady progress. There is confidence that the reforms are progressing in line with intent, but the identified risks and issues will need to be managed to ensure progress remains on track.
EY Future Focused Ministry Report
The Director-General of Health, Dr Diana Sarfati, commissioned independent advice to inform the role and shape of the Ministry in the new system. The independent advice from Ernst & Young (EY) titled Manatū Hauora Future Focused Ministry provided advice on the current state and made some recommendations for Manatū Hauora to consider. This advice sits alongside the collected staff surveys and workshops over a 12-month period, which pointed to what was working well and what staff thought needed to change.
Note: this report contains point-in-time information about Manatū Hauora that is now almost a year old and does not reflect its current state or the changes underway as we work towards implementing most of the recommendations from the report.
- EY Report: Manatū Hauora Future Focused Ministry (April 2023) (PDF, 14.1 MB)
- EY Report: Manatū Hauora Future Focused Ministry, Appendices (April 2023) (PDF, 7.7 MB)
Sapere reports: Public health accountability framework review (Current state analysis: document review) and Intelligence, Surveillance and Knowledge Group capacity and capability review (A high-level review for the Public Health Agency)
The Public Health Agency, the National Public Health Service and Te Aka Whai Ora jointly commissioned the Sapere Research Group to review how the three public health entities were working together in the first year of the health reforms. The report was also an opportunity to update agreed ways of working and refine roles and responsibilities across the three public health entities.
The reports’ findings reflect the scale of the health reform, their impact on the public health system, and the dedication of public health staff to establish new ways of working during the transition. Since this report was written, cooperation has been strengthened across the three public health entities.
Separately, the Public Health Agency also commissioned Sapere to do a capability and capacity review of Intelligence. Surveillance and Knowledge (ISK) Group. ISK coordinates expertise and knowledge from across, and outside, the health sector, to ensure the Ministry, the Public Health Agency and our partners are connected to the latest relevant public health insights and evidence to inform public health activity.
The purpose of the review was to make some recommendations that would help to ensure the ISK had the right skills, structure and focus to support the Agency. Since the review was completed in November 2022, ISK has undergone a significant redesign to support this shift in focus. including many changes recommended by this report.
- Sapere report: Public health accountability framework review (Current state analysis: document review) (June 2023) (PDF, 1.83 MB)
- Working together to realise our shared vision for public and population health (August 2023) (PDF, 703 KB)
- Sapere report: Intelligence, Surveillance and Knowledge Group capacity and capability review (A high-level review for the Public Health Agency) (November 2022) (PDF, 1.83 MB)
- Public Health Accountability Review - Road Map for Change (PDF, 1.13 MB)
Ministerial Advisory Committee for Health Reform Implementation Report: Assessment of Te Whatu Ora Data and Digital Service
This report provides an assessment of the Te Whatu Ora Data and Digital Service’s progress towards, and consistency with, health reform objectives. The report highlights findings and provides recommendations. This assessment was tasked with identifying progress on implementation of the reform agenda regarding data and digital, with specific emphasis on the enablement of reform outcomes and the achievement of system efficiencies.
It is important to note this report reflects the status at a point in time. Please refer to the supplementary document titled, MAC Assessment of Te Whatu Ora Data and Digital Service – Preliminary Response for additional context from Te Whatu Ora Data and Digital.
- Ministerial Advisory Committee for Health Reform Implementation (Report: Assessment of Te Whatu Ora Data and Digital Service) (August 2023) (PDF, 1.13 MB)
- Preliminary Response from Te Whatu Ora regarding the Ministerial Advisory Committee for Health Reform Implementation (MAC) assessment of Te Whatu Ora’s Data and Digital Service (November 2023) (PDF, 1.13 MB)