Find out what’s being done to improve the health of New Zealanders in the areas covered by the key results of the New Zealand Health Survey.
On this page:
- Smoking – what’s being done to reduce smoking rates
- Hazardous drinking – what’s being done to reduce hazardous drinking
- Obesity – what’s being done to prevent and manage obesity
- Mental health and addiction – what’s being done to improve mental health and addiction
- Access to health care – what’s being done to improve access to primary health care
- Oral health – what’s being done to improve New Zealanders’ oral health
- Māori health – what’s being done to improve Māori health
- Pacific health – what’s being done to improve Pacific health
- Disabled people’s health – what’s being done to improve the health of disabled people
- Rainbow community health – what’s being done to improve the health of the Rainbow community.
The Government has set a goal of making New Zealand an essentially smokefree nation by 2025. New Zealand’s progress in reducing smoking rates is the result of a range of initiatives over many years. In the past five years, these have included the following:
- a tobacco tax increase of 10% each year from 2010 to 2020
- standardised tobacco packaging and refreshed health warnings
- a reduction in duty-free tobacco allowances
- improved stop smoking services with a stronger focus on priority groups, particularly young Māori women
- health promotion campaigns through the Health Promotion Agency, including the Vaping Facts website and #Quitstrong
- Amending the Smoke-free Environments Act 1990 to:
- prohibit people from smoking (and vaping) in cars if they are carrying children under the age of 18
- regulate the sale and supply of vaping products.
The Government is committed to reducing the overall negative impact that alcohol has on New Zealand individuals, whānau and communities. A range approaches are being taken to prevent and reduce hazardous drinking and alcohol-related harm, including:
- the Sale and Supply of Alcohol Act 2012, which introduced maximum trading hours, strengthened restrictions around irresponsible promotion of alcohol, and tightened the law around the supply of alcohol
- reducing the maximum driving blood alcohol limit through the Land Transport Amendment Act (no 2) 2014
- supporting community-led resilience-building through organisations like Community Action Youth and Drugs
- implementing the Fetal Alcohol Spectrum Disorder action plan (2016–2019)
- Food Standards Australia New Zealand are leading work on pregnancy warning labels on alcohol, energy labelling on alcoholic beverages and nutrition/health claims on alcoholic beverages
- providing school-based health services to secondary school students. These are aimed at linking young people with primary health care providers to improve access to youth-appropriate services for alcohol and drug use, as well as a range of other health services (mental health, sexual health, nutrition, weight management, exercise and positive youth development programmes)
- providing self-help tools such as the Alcohol Drug Helpline website
- participating in the Advertising Standards Authority’s (ASA) review of the voluntary industry code for alcohol advertising and promotion. There are also advertising and promotion restrictions placed on the sale and supply of alcohol under the Sale and Supply of Alcohol Act
- investing $1.9 billion into a mental wellbeing package as part of Budget 2019: The Wellbeing Budget. This will contribute towards addressing many of the recommendations in He Ara Oranga, and includes:
- a four-year funding boost to DHBs of $213 million for mental health and addiction treatment services
- investment of $200 million in new and existing mental health and addiction facilities
- $44 million to improve existing specialist drug addiction services
- $14 million in primary responses for alcohol and drug issues.
The Health Promotion Agency is funded from the levy on alcohol produced or imported for sale in New Zealand. It aims to make people more aware, motivated and able to drink at lower-risk levels or to choose not to drink. It also advises the government, works with the hospitality and alcohol industry, and provides information, research and resources to people to help them make better decisions around drinking alcohol.
The Government is taking a broad population approach to achieving healthy weight, with a focus on improved nutrition and increased physical activity. The approach is designed to help address the significant health losses associated with obesity-related non-communicable diseases in New Zealand.
Examples of actions underway include:
- Healthy Active Learning, a new Wellbeing Budget 2019 initiative that invests $8 million into promoting and improving healthy eating and physical activity in all schools, kura, early learning services and kohanga reo across Aotearoa. This initiative, jointly implemented by the Ministries of Health and Education and Sport New Zealand, provides schools and early learning services with new health and physical education curriculum resources, as well as health promotion staff to support healthy food and water-only policies. Physical activity advisors are also working with selected primary and intermediate schools to help develop environments that encourage play, sport and physical education
- New Zealand’s first Child and Youth Wellbeing Strategy, which was launched in August 2019 and aims at improving the wellbeing outcomes for all young New Zealanders aged under 25 years old
- extending the nurses in schools programme to cover all publicly-funded decile 5 secondary schools, and boosting funding for existing health services in decile 1–4 secondary schools. This will help an additional 5,600 students
- updating the Food and Nutrition Guidelines for pregnant women and children 0–2 years (last updated in 2008) and integrating them into the Eating and Activity Guidelines
- co-leading New Zealand’s response to the World Health Organization’s Global Action Plan on Physical Activity, with Sport New Zealand
- supporting the implementation of the Clinical Guidelines for Weight Management in New Zealand Children and Young People, initially through improving measurement and monitoring of growth and weight in primary care and through Well Child providers. This includes providing an online BMI calculator and sleep resources for different age groups.
Other resources or initiatives that encourage healthy eating, physical activity and adequate sleep include:
- Green Prescriptions (GRx), which are scripts from a doctor or practice nurse referring the patient to a green prescription support person, who provides support to enable the person to be more active
- Fruit in Schools, which provides a piece of fruit or a vegetable each day to children in decile 1 and 2 primary schools
- Active Families: community-based health initiatives designed to increase physical activity and improve nutrition in children and young people aged 5–18 years and their whānau/families
- Healthy Families NZ, an initiative that supports families to make changes to improve their health and wellbeing. This initiative has been rolled out in 10 locations across New Zealand
- Breastfeeding support: all DHB maternity facilities must ensure support for breastfeeding is available from birth. Other breastfeeding support activities include peer support networks, social media, free lactation consultation services and events such as the Big Latch On
- Eating and Activity Guidelines for New Zealand Adults
- Physical Activity Guidelines, including sleep and screen time, for children under 5 years and for children and young people aged 5–17 years
- Clinical Guidelines for Weight Management for Adults and for Children and Young People.
The Government formally responded to the recommendations in He Ara Oranga, the report of the Government Inquiry into Mental Health and Addiction. Learn more details about the Government’s response to He Ara Oranga.
Budget 2019 took a transformational approach to mental health, wellbeing and addiction, with major new investments that strongly align with He Ara Oranga. Learn more about the new mental health, wellbeing and addiction initiatives funded through the Budget.
There is a comprehensive work programme underway on these initiatives. Updates can be found in the Mental health and addiction section of this website or by subscribing to the regular Mental Health Addictions email update.
Subsidised general practice visits for enrolled patients
Primary health organisations (PHOs) are the means by which the Government ensures that everyone has access to a general practitioner (GP) and a primary care practice. The Government provides funding to PHOs to ensure that people who are enrolled with them can receive essential primary health care services.
Most people living in New Zealand are eligible to enrol with a PHO, and enrolment is free. As of January 2019, 94% of the population was enrolled with a primary health organisation (PHO), mostly through their general practice. Almost all general practices are now part of a PHO. You can check if this is the case for your general practice by asking your doctor, nurse or receptionist, or by checking on the practice website.
New lower-cost general practice visits
On 1 December 2018, new initiatives were introduced to support better access to primary health care for those on lower incomes. These were part of Budget 2018, and were as follows:
- low-cost general practice visits were extended to all Community Services Card (CSC) holders and their dependents aged 14–17 years, including for injury-related (ACC) visits
- CSC eligibility was granted to all people receiving the accommodation supplement, or who are tenants in social housing.
Zero-fees for under-14s
Also on 1 December 2018, more children became eligible for zero-fee health care and prescriptions:
- Zero-fee general practice visits and exemption from the standard prescription co-payment charge (usually $5 per item) on subsidised prescriptions were extended to children under 14 years. This includes after-hours services and injury-related (ACC) visits. The Zero-Fees initiative had previously applied to under-13s only.
Find out more at Lower cost general practice visits.
Very Low Cost Access (VLCA) general practices
The Very Low Cost Access (VLCA) scheme supports general practices with an enrolled population of 50 percent or more high-needs patients, where the practice agrees to maintain patient fees at a low level.
VLCA funding recognises the extra effort involved in providing services to high-need populations. It ensures that fees are kept low for those least likely to be able to afford primary health care, and aims to improve health outcomes for those most likely to have the worst health.
Adults and their dependents aged 14–17 years who are enrolled at VLCA clinics will pay less than $20 for a standard daytime visit. There is no charge for children under 14 years. Patients wanting to know if their general practice is a VLCA practice should check with their doctor, nurse or receptionist.
Subsidised prescription co-payments
The prescription charge (co-payment) is a small contribution people pay towards the cost of the medicines they receive. For most people, this charge is $5 for each new prescription item.
New Zealanders can reduce their medicine costs through the Prescription Subsidy scheme. The subsidy is aimed at reducing costs for families and people who are prescribed a lot of medicines. People become eligible for the subsidy once they have paid for 20 new prescriptions from 1 February each year. After this, they do not have to pay any more prescription charges for the rest of that year (to 31 January). People can reach the 20-item threshold by combining prescription items for their partner and dependent children aged from 14 up to 18 years.
Improved access to health information
Patients enrolled with a PHO are being given greater access to and management of their own health information with the introduction of patient portals, an online service that allows people to access information about their health held by their general practice. People can also use patient portals to check laboratory test results, order repeat prescriptions or send messages to their GP. This service is being rolled out across New Zealand; check with your general practice team for more information.
Good oral health matters to everyone’s wellbeing, including basics such as being able to eat, speak, smile and socialise. Poor oral health is largely preventable, yet it is also one of the most common chronic health problems experienced by New Zealanders of all ages.
In 2019/20, the Government spent around $205 million on oral health services provided or funded by DHBs.
Publicly funded oral health services for children
Public funding for oral health care in New Zealand focuses on universal oral health services for children and adolescents (up to their 18th birthday). This is supported by evidence indicating that oral health status at age five determines oral health status at age 26. Child and adolescent oral health services aim to contribute to a good start in life for all New Zealand children. Facilitating and supporting good oral health from an early age helps set people up for life and reduces the likelihood of needing costly dental care in later years.
The past decade has seen significant reinvestment into the infrastructure, model of care and capacity of child and adolescent oral health services. The reinvestment was initiated in Budget 2007. The purpose was to move from a ‘drill and fill’ approach towards a preventive model of care. New fixed and mobile clinics are now in place, and there are signs of improvements in oral health outcomes for children.
Publicly funded oral health services for adults
Some publicly funded oral health services are available for adults when treatment is required for accident or injury, for people with medical conditions or disabilities whose conditions prevent them from accessing community-based dental care, and for low-income adults who need emergency dental treatment for pain relief or treatment of infection.
Community water fluoridation
The Ministry of Health supports water fluoridation as an effective, safe and affordable public health measure to improve oral health. Community water fluoridation has been endorsed by the World Health Organization (WHO) and other international health authorities as the most effective public health measure for the prevention of dental decay.
Legislation was introduced in Parliament in 2016 to transfer decision-making responsibilities for water fluoridation from territorial local authorities to DHBs. Changing the decision-making process would recognise that water fluoridation is a health-related issue. The Bill is currently awaiting its second reading in the House.
With this legislative change, there is potential for community water fluoridation coverage to be increased from 54 percent to 85 percent of the population.
Child oral health promotion initiative
The Ministry of Health has been delivering a phased oral health promotion initiative to promote regular tooth brushing with fluoride toothpaste, aimed at family and whānau of preschool children. The initiative involved a social marketing campaign that was rolled out in 2016/17 and continued in 2017/18 and 2018/19.
The campaign centres on a reimagined Tooth Fairy, who is a stern yet loveable ‘aunty’ figure with a big heart who doesn't sugar-coat her words. A post-campaign survey carried out by UMR Research showed that 35% of the target audience surveyed said they had made a change to their child's tooth-brushing as a result of seeing the campaign.
The Ministry plans to implement the next phase of the oral health promotion initiative consisting of social marketing and the provision of toothbrushes and fluoride toothpaste to pre-school age children from 2021 onwards.
As kaitiaki of the system, the Ministry of Health has an important leadership role to play in creating an environment that enables Maori to live healthier, happier lives. The Ministry is charged with setting the direction for Māori health and guiding the sector as we work to increase access, achieve equity and improve outcomes for Māori.
Whakamaua: Māori Health Action Plan 2020-2025
The Ministry of Health released Whakamaua: Māori Health Action Plan 2020-2025 in July 2020. Whakamaua guides the Ministry, the wider health sectors and the whole health and disability system to give practical effect to He Korowai Oranga: Māori Health Strategy – it will help us achieve better health outcomes for Maori by setting the government’s direction for Maori health advancement over the next five years.
Whakamaua means, ‘to secure, to grasp, to take hold of, and to wear’. Its use for this plan conveys a sense of acting to take hold of the pae tata, those goals within our reach, as well as working to secure pae ora, healthy futures for Māori, which is the vision of He Korowai Oranga. Whakamaua outlines a suite of actions that will help to achieve four high-level outcomes that will contribute to the achievement of pae ora.
- iwi, hapū, whānau and Māori communities exercising their authority to improve their health and wellbeing
- ensuring the health and disability system is fair and sustainable and delivers more equitable outcomes for Māori
- addressing racism and discrimination in all its forms.
- protecting mātauranga Māori throughout the health and disability system.
Whakamaua presents new opportunities for the Ministry, the health and disability system, and the wider government to make considerable progress in achieving Māori health equity. This direction is supported by the final report of the Health and Disability System Review.
He Korowai Oranga
New Zealand’s Māori Health Strategy, He Korowai Oranga, sets the overarching framework that guides the Government and the health and disability sector to achieve the best health outcomes for Māori. Pae Ora (healthy futures) sits within this framework and describes the Government’s vision for Māori health, which is composed of three interconnected elements: mauri ora (healthy individuals), whānau ora (healthy families) and wai ora (healthy environments).
He Korowai Oranga also sets expectations that the health system will work with Māori to improve health outcomes and achieve health equity. Implementing He Korowai Oranga is the responsibility of the whole health and disability sector. This includes all 20 DHBs, which are responsible for providing health services to address the needs of the local population.
One aspect of He Korowai Oranga is whānau ora, which focuses on increasing the wellbeing of individuals in the context of their whānau. It aims to empower whānau by placing them at the centre of services to make decisions and opportunities about what they need and how they access them, and achieve better outcomes in areas such as health, education, housing, employment and income levels.
The whānau ora approach has increasingly become a feature of work across government. The work of the Whānau Ora Taskforce informs a programme of work led by Te Puni Kōkiri that supports whānau to build their capacity and capability, and empowers whānau to determine their own aspirations and take control of their own futures. This work has evolved to include the establishment of three whānau ora commissioning agencies to purchase a range of whānau-centred initiatives at a local level.
Each year DHBs are required to develop an Annual Plan and a Regional Service Plan. These annual planning documents outline each DHB’s effort to reduce disparities and achieve health equity for all New Zealanders.
Pacific Health Action Plan
Ola Manuia: The Pacific Health and Wellbeing Action Plan 2020–2025 is the government’s new national plan and commitment to improving the health and wellbeing of our vibrant and growing Pacific population living in Aotearoa New Zealand. This plan was informed by the previous Pacific health action plan, ‘Ala Mo’ui: Pathways to Pacific Health and Wellbeing 2014–2018’ (Ministry of Health 2014).
Ola Manuia sets out the priority outcomes and accompanying actions for the health and disability system for our Pacific peoples over the next five years.
The Ministry of Health developed Ola Manuia with the guidance and input of Pacific communities, the health sector, and relevant government agencies with a vision that all ‘Pacific families are thriving in Aotearoa New Zealand.’
The Ola Manuia framework sets out three high-level outcomes that reflect the strength of their impact on equity. These are evidence of Pacific people’s health needs, and the insights of Pacific communities and the health and disability sector. These outcomes are:
- Pacific people lead independent and resilient lives
- Pacific people live longer in good health
- Pacific people have equitable health outcomes.
This plan identifies key areas of Pacific health we need to focus on, and the specific actions we need to take to improve Pacific health. Ola Manuia is a tool for DHBs and the health sector to use to inform the development of their strategic documents, work programmes, key actions, and community initiatives.
Faiva Ora 2016–2021 National Pasifika Disability Plan
The Faiva Ora 2016–2021 National Pasifika Disability Plan focuses on:
- improving outcomes for Pacific disabled children, youth and their families
- encouraging Pacific communities to better engage with and support individuals with disabilities and their families to participate in their communities
- ensuring disability services and supports meet the needs of Pacific disabled people and their families
- encouraging stakeholders to work in partnerships to address challenges experienced by Pacific disabled people and their families.
Pacific health scholarships
The Pacific Health Scholarships contribute to improving access to health services for Pacific peoples by assisting the development of the Pacific health and disability workforce.
The Scholarships provide financial assistance to Pacific students who are undertaking a course in health or disability-related studies accredited by the New Zealand Qualifications Authority (NZQA) or the New Zealand Vice Chancellors Committee.
Last year over 150 Scholarships were offered to Pacific students undertaking a course in health and disability-related studies.
The priority workforce areas of this year’s cohort are medicine, dentistry, nursing, midwifery and allied health.
Improving access to primary health care
The Government announced its commitment to improving access to primary health care in 2018 with initiatives to lower GP fees for under-14s and Community Services Card (CSC) holders.
This initiative means approximately 15,500 more Pacific people with a CSC across the country will be eligible for very low-cost fees in primary health care, increasing the total number to 74,000.
Waka Hourua – FLO Talanoa
FLO Talanoa is the national Pacific suicide prevention education programme for Pacific communities, led by Le Va. It has been specifically tailored to meet the needs of Pacific families and communities in Aotearoa New Zealand. FLO Talanoa aims to empower and equip Pacific communities with culturally relevant knowledge and tools to prevent suicide and respond safely and effectively when suicide occurs.
Funded health services for low decile schools
The Ministry of Health currently funds school-based health services for students in low decile secondary schools, teen parent units and alternative education facilities. Budget 2018 expanded this service from decile 1–3 secondary schools to include decile 4 schools.
The expansion means approximately 24,000 more students will have access to an on-site nurse. Pacific learners will benefit from this expansion as they are predominantly in lower decide schools.
What’s being done to improve the health of disabled people
The Government’s vision is that disabled people will have high standards of health and wellbeing (outcome 3: health and wellbeing, New Zealand Disability Strategy 2016–2026). This means that:
- disabled people are consulted on and actively involved in the development and implementation of legislation and policies concerning health and wellbeing, including sport, recreation, arts and culture
- access to mainstream health services is barrier-free and inclusive
- services that are specific to disabled people, including mental health and aged care services, are high quality, available and accessible
- all health and well-being professionals treat disabled people with dignity and respect
- disabled people participate in community activities if they choose (for example, sport, recreation, arts and culture), or just being present and belonging to our community is supported and valued
- decision-making on issues regarding the health and well-being of disabled people is informed by robust data and evidence.
Whāia Te Ao Mārama
Whāia Te Ao Mārama is a culturally-anchored approach to supporting Māori with disabilities (tāngata whaikaha) and their whānau, with a vision of tāngata whaikaha pursuing a good life with support.
An action plan describes what the Ministry of Health is committing to do from 2018 to 2022, and provides examples of actions that disability providers, other organisations, whānau and tāngata whaikaha can take.
The 2018 to 2022 action plan:
- supports tāngata whaikaha to achieve their aspirations and to reduce the barriers they may face
- builds on the foundation, vision and outcomes of the Whāia Te Ao Mārama 2012 to 2017 plan
- outlines progress and changes since 2012
- documents goals and actions for 2018 to 2022
- is endorsed by Te Ao Mārama: The Māori Disability Advisory Group.
The six goals for this action plan are that by 2022 tāngata whaikaha will:
- participate in the development of health and disability services
- have control over their disability support
- participate in Te Ao Māori
- participate in their community
- receive disability support services that are responsive to Te Ao Māori
- have informed and responsive communities.
For more information see Whāia Te Ao Mārama 2018 to 2022: The Māori Disability Action Plan.
The Faiva Ora 2016–2021 National Pasifika Disability Plan aims to improve outcomes for Pacific disabled children, youth and their families. See the Pacific section for more detail.
Disability Action Plan 2019–2023
The Ministry has committed to progressing a work programme to ‘improve the health outcomes and access to health care for disabled people’ under the Disability Action Plan 2019–2023.
This work programme aims to:
- improve access to quality health care for disabled people, including:
- implementing disability actions in national health action plans
- supporting and monitoring district health board (DHB) disability action plans
- exploring options to improve access to health care for disabled people, with a focus on people with a learning/intellectual disability
- improve disability data and evidence
- improve disability awareness and capability of the health workforce.
The disability phase of the Health Services and Outcomes Kaupapa Inquiry (Wai 2575) will hear claims in relation to government provision of disability services and their effectiveness for Māori with lived experience of disability (tāngata whaikaha). The Waitangi Tribunal has yet to make final decisions on the claims and issues to be inquired into. Hearings are set down for 2021.
WAI 2575 is an opportunity for the Ministry of Health to review and improve its approach under Te Tiriti o Waitangi and the UN Convention on the Rights of Persons with Disabilities in protecting the health and wellbeing of tāngata whaikaha and their whānau.
Disability support system transformation
The government is working in partnership with the disability community to transform the existing disability support system. This transformation is based on the Enabling Good Lives (EGL) vision, principles and approach. The EGL vision is that “in the future, disabled people, their families and whānau will have greater choice and control over their lives and supports and make more use of natural and universally available supports”.
There are currently two EGL demonstration sites in Christchurch and Waikato and an EGL prototype in the MidCentral DHB region (named Mana Whaikaha). You can find out more about them on the Enabling Good Lives website.
The Ministry of Health is currently finalising an evidence brief that brings together evaluative information across the three EGL sites and will assist in informing the next steps for system transformation. Advice is currently being developed for Ministers on the next steps for system transformation.
What’s being done to improve the health of the Rainbow community
The government is committed to improving the health care for our Rainbow communities.
Rainbow is an umbrella term that encompasses a range of identities and experiences to describe people whose sexual orientation, gender identity, gender expression or sex characteristics do not match majority or binary norms. Indigenous and cross-cultural understandings of gender, sexuality and diverse sex characteristics may differ from a western perspective, for example the Māori concept takatāpui and Pacific acronym MVPFAFF.
There is a list of resources available at Resources for transgender New Zealanders that provide information on understanding diverse rainbow identities.
Rainbow communities need access to health care that is accessible, appropriate, and affirms their gender and sexual identity. Primary care is where much of this care can be delivered and should be supported by a confident and competent health workforce delivering rainbow-inclusive services. See Delivering health services to transgender people.
Expanding access and choice of primary mental health and addiction supports
The Ministry has a programme of work underway to increase access to, and choice of, mental health and addiction supports in primary and community settings. A key focus of these services is ensuring they meet people’s diverse needs, including the needs of rainbow communities.
Expanding primary and community mental health and addiction support available through general practices, kaupapa Māori, Pacific and youth health services, will provide people with greater choice to support their wellbeing. See Expanding primary mental health and addiction support for more information.
Some people may also wish to have gender affirming genital surgery, such as a phalloplasty or vaginoplasty, congruent with their gender identity. A hospital specialist or in some regions (ie, Wellington and Canterbury) a general practitioner may refer people onto the Gender Affirming Surgery wait list. More information on the Gender Affirming Surgery wait list can be found at Delivering health services to transgender people.
The Ministry of Health has also provided extra support for rainbow communities and other groups who were impacted strongly by COVID-19 and lock down measures. See the media release Mental health and addictions charities and community groups get share of $200K to support people through impacts of COVID-19.
Wider Ministry of Health work
Budget 2019 provided an additional $2.992 million over the next four years for gender-affirming genital surgery. The Ministry of Health continues to provide updates from the gender affirming (genital) surgery service which you can read at Updates from the Gender affirming (genital) surgery service.