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
- 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
- a ban on displaying tobacco products in stores
- standardised tobacco packaging and refreshed health warnings
- a reduction in duty-free tobacco allowances
- implementation of the Better help for smokers to quit programme, which has the following targets:
- 90% of PHO-enrolled patients who smoke have been offered help to quit smoking by a health care practitioner in the last 15 months
- 90% of pregnant women who identify as smokers upon registration with a DHB-employed midwife or Lead Maternity Carer are offered brief advice and support to quit smoking
- improved stop smoking services with a stronger focus on priority groups
- health promotion campaigns through the Health Promotion Agency, including the Vaping Facts website
- proposed legislation to improve the regulation of vaping and smokeless tobacco products
- proposed legislation to amend the Smoke-free Environments Act 1990 to prohibit smoking in vehicles carrying children under the age of 18
- 24/7 Quitline telephone and texting service.
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 link 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 review of the voluntary industry code for alcohol advertising and promotion
- 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, will provide 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 will also work 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.
In May 2019, 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 this year’s Budget.
There is a comprehensive work programme underway on these initiatives. Updates can be found in the Mental health and addictions section of this website or by subscribing to the regular Mental Health and Addiction 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.
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 2018/19, the Government spent $212 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. Moving the decision-making process from local councils to DHBs recognises that water fluoridation is a health-related issue. The Bill is currently awaiting its second reading in the House.
Child oral health promotion initiative
The Ministry of Health recently delivered an 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.
As the Government’s advisor for health and disability, 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. Listed below are some of the, investments, strategies and initiatives across the health sector that are focused on achieving better health outcomes for Māori.
Investment in Māori health in Budget 2019
In Budget 2019, $455 million was allocated over four years to expand access to and choice of primary mental health and addiction support. Of this funding, $62 million will be allocated to Kaupapa Māori services.
Budget 2019 also included some significant investment to grow our Māori health workforce, including investing $10 million over four years for our Māori workforce development programmes to incentivise and support hundreds more Māori students into health professions. The Te Ao Auahatanga Hauora Māori: Māori Health Innovation Fund has been increased by $4 million over four years to support Māori health providers to develop and provide Māori-led health initiatives that improve equity.
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.
Māori Health Action Plan
The Ministry of Health is working with the health and disability sector to develop a Māori Health Action Plan to support and further embed He Korowai Oranga, with a five-year outlook. This will be an important tool ensuring the health and disability sector is working collaboratively to deliver high-quality and effective services that support Māori health and wellbeing.
The Māori Health Action Plan aims to improve health outcomes for Māori by:
- setting out priority areas for action, key progress measures, and milestones to meet Treaty of Waitangi obligations for improving Māori health and to achieve equitable health outcomes for Māori
- strengthening Māori-Crown relationships, ensuring a shared commitment to act, and to enable Māori whānau, hapū and iwi to exercise control over their pathway to health and wellbeing
- supporting the role of Mātauranga Māori in the development and delivery of health services to Māori, including the provision of Rongoā Māori
- promoting collective action by Government agencies, social sectors (including health), and communities in working towards pae ora
- enabling changes across the broader social, economic and behavioural determinants of health as key levers improving Māori health.
Improving access to lower-cost health care
On 1 December 2018, low-cost general practice visits were extended to all Community Services Card (CSC) holders. As at 1 January 2019, 97% of eligible Māori CSC holders are enrolled with a practice that offers lower fees.
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.
Investment in Pacific health in Budget 2019
Budget 2019 invested $10 million in the Pacific Provider Workforce Development Fund to help develop a strong and sustainable Pacific health workforce and leadership. It also included a $4.3 million initiative, which offers wraparound support for Pacific nursing and midwifery students.
Budget 2019 also invested almost $10 million in the Pacific Innovation Fund, which aims to better resource, drive and assess innovative community health projects that improve Pacific peoples’ health and wellbeing. It also included $12 million over four years for rheumatic fever programmes to reduce the incidence rate among Māori and Pacific peoples, and to support better management of the illness in the wider Auckland region.
Pacific Health Action Plan
A new Pacific Health Action Plan is currently being developed and will replace Mo’ui: Pathways to Pacific Health and Wellbeing, which ran from 2014–2018.
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
In 2018, the Government announced its commitment to improving access to primary health care along 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 the Rainbow community
The Government is committed to improving health care for our Rainbow communities. Rainbow is an inclusive term used to refer to anyone with a diverse sex, gender identity or sexual orientation. It is important that health services meet the needs of all New Zealanders, with inclusiveness and dignity for all.
Increased access to gender-affirming surgeries
There will be increased access to gender-affirming genital reconstruction surgeries to about 14 a year, up from a minimum of two a year, with an extra $800,000 funding for this purpose annually.
The Ministry is committed to continuing its support for the NZ AIDS Foundation and its Ending HIV campaign, which includes the aspirational goal of ending new HIV transmissions in New Zealand by 2025. In 2017, the rate of newly-diagnosed HIV cases decreased. Last year, it was announced that New Zealand was a front-runner in publicly funding the use of Pre-exposure Prophylaxis (PrEP) to prevent HIV infection for people who are at high risk. It is hoped that PrEP, with the support of regular and early screening, condom use and treatment of other STIs, will lead to a continued decline in rates of new HIV transmission in New Zealand.
He Ara Oranga
The Government is also dedicated to better meeting the mental health and addiction needs of the Rainbow community. He Ara Oranga, the Report of the Government Inquiry into Mental Health and Addiction, found that Rainbow communities had unmet mental wellbeing needs, felt unsafe accessing mainstream mental health services and suffered harm from discrimination. The Government is committed to providing services that are responsive to people from different cultural backgrounds, life experiences and perspectives by providing a greater variety of service options. The goal is to put people and their needs at the centre of service response, and not further stigmatise or marginalise them.
These work programmes supplement a range of initiatives occurring across government and the community sector to create a more inclusive society and promote the wellbeing of Rainbow New Zealanders.