The Ministry of Health (Māori: Manatū Hauora) is the public service department of New Zealand responsible for healthcare in New Zealand. It came into existence in its current form in 1993.
History
Origins
The Ministry of Health's origins can be traced back to the Department of Public Health, which was first established in 1901 at the advice of the Central Board of Health. The Department of Public Health assumed responsibility for the provision of Māori health services between 1906 and 1909, when Māori medical health services were returned to the-then Department of Native Affairs. In 1910, the Public Health Department resumed responsibility for the control of Māori health. In 1911, a Māori Nursing Service was established as part of the Department of Public Health.[3]
Growing strains
Its structure remained relatively static even when the Social Security Act 1938 was passed where the New Zealand government took a larger role in health purchasing. The department remained actively involved in policy (as opposed to purchasing).[citation needed]
By the 1970s problems had appeared in the health system. The high growth rate in hospital expenditure was occurring at a time when the economy was slowing down. Thus, the government was unable to sustain funding this growth. This led the health system to undergo a series of changes over a 20-year period from the 1980s.[citation needed]
Fourth National Government, 1990–1999
During the 1990s the Fourth National Government attempted to stream-line the system in a series of reforms such as separating the government purchasing and provision of health care services. Four regional health authorities (RHAs) were created to oversee the purchasing of health services while general practitioners, specialists, and hospitals were tasked with delivering health services. Public services were also turned into quasi-commercial Crown health enterprises (CHEs).[4] In 1993, the Department was renamed as the Ministry of Health.[3]
A poster produced by the Ministry of Health for 1962 World Health Day
In December 1999, the separate government health service purchasing entity, the Health Funding Authority, was merged with the Ministry of Health.[6] Critics were anxious as to how the Ministry would perform as a funder, as they commented that the Ministry had in the past only performed as a policy organisation. However, supporters of this move stated that they believed this would make these agencies more accountable.[citation needed]
In February 2001, the Fifth Labour Government also launched the "New Zealand Primary Health Care Strategy" (PHCS) with the goal of improving public access to primary health care and reducing health inequalities.[7] By 2008, the Primary Health Care Strategy had succeeded in reducing fees for doctors' and nurses' visits in "higher need areas" and for patients aged over 65 years. In addition, consultation rates increased across all age, socio-economic, and ethnic groups in New Zealand.[8]
As part of the PHCS programme, the Government encouraged the development of Primary Health Organisations (PHOs) to provide some primary health care services at the local level and to transition health care services from fee-for-service arrangements to capitation funding for health professionals who are members of these organisations.[8] By early April 2003, 34 PHOs had been established throughout New Zealand.[9]
In addition, the Fifth Labour Government established District health board (DHBs) in 2001 as subsidiary organisations of the Health Ministry. They were responsible for providing and funding health services within a defined geographical area. At the time of their dissolution in July 2022, there were twenty DHBs.[10] They were also responsible for running hospitals and funding some health provisions in their respective areas. Funding for these DHBs was allocated according to the Ministry's population-based funding formula.[11]
In October 2021, the Government introduced a parliamentary bill called the Pae Ora (Healthy Futures) Bill, which created the new public health entities and strengthened the Health Ministry's stewardship role.[14] This bill passed into law on 7 June 2022.[15] On 1 July, the Pae Ora (Health Futures) Act came into effect; with Health New Zealand, the MHA, and the Health Ministry's Public Health Agency assuming the district health boards' former provision of healthcare services.[16][17]
The former National Health Board (NHB), which was set up in November 2009, dealt with issues such as rising costs, increased demand, an ageing population and shortages of staff with a view to improving the quality, safety and sustainability of health care.[19]
^"Ministry business units". Ministry of Health – Manatū Hauora. 1 July 2022. Archived from the original on 10 July 2022. Retrieved 11 July 2022. The Ministry is made up of directorates and business units, each with its own functions and areas of responsibility.
^"National Health Board: About us". Ministry of Health. 2012. Archived from the original on 25 February 2013. Retrieved 6 March 2013. The public health and disability system faces serious challenges which range from rapidly rising costs to increased demand for services, an aging population and international shortages of skilled clinical specialists.[...] The National Health Board (NHB) was established by the Government in November 2009, to address these issues and improve the quality, safety and sustainability of health care, for New Zealanders. [...] The NHB is made up of a Ministerial appointed Board and a branded business unit within the Ministry of Health.
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