Legislation to create a new public health system has passed its third reading in parliament, and the bill is now just one step from becoming law.
Labour’s Pae Ora (Healthy Futures) Bill sets out the Government’s vision for a health system restructure that is just weeks away from coming into force. It was first introduced in October last year and received more than 4500 submissions.
The legislation was the biggest building block in the government’s health reforms. Now it has passed three readings in parliament the bill would become law after receiving the royal assent from the governor-general – a ceremonial step.
Minister of Health Andrew Little said it was a new beginning and marked “a significant milestone” toward better health and well-being for all New Zealanders.
“This is a landmark reform for health in Aotearoa New Zealand, and is key to righting the wrongs of inequity and unacceptable health outcomes that have for too long been suffered by too many.
“Removing the postcode lottery to put patients and communities at the heart of our health system is what the reforms are about. We need a system that works for all New Zealanders, and that is what we are building.”
The Act comes into force on 1 July this year, to replace 20 District Health Boards with a crown agency called Health New Zealand and to establish a Māori Health Agency. The two agencies are required to work together to design and budget for a three-year health plan.
It would also establish a public health agency within the Ministry of Health, and “strengthen” the stewardship role of the Ministry of Health, Little said.
The bill was always going to pass the way the government wanted it to. The only major surprise was a u-turn on including a rural strategy.
Little said the lobbying came from Labour’s rural caucus.
ACT’s health spokesperson Brooke van Velden had also been pushing for one.
“We have changed this law to make sure that rural New Zealand is not being forgotten and that has made access – I hope – in the future, better for rural New Zealand,” she said in her speech to the House.
Other suggested amendments, such as a mental health strategy, a rainbow health strategy, and an older people’s health strategy were voted down.
Te Pāti Māori’s proposals to include tino rangatiratanga in the legislation and establish a Māori Director-General of Health were also not supported.
“The government must not see the passage of this bill as the end, but the start of the road to reforming our health system and restoring power to tāngata whenua to look after ourselves,” said Te Pāti Māori co-leader Debbie Ngarewa-Packer.
National’s Dr Shane Reti said the reform would not do anything for the 36,000 people waiting four months to see a specialist.
“They only see an ideological health reform in the middle of a pandemic, and at a time when New Zealanders are still dying from Covid every single day. The timing is terrible,” he said.
Despite the third reading being essentially the big rubber stamp that didn’t stop the opposition putting the boot in.
National’s mental health spokesman Matt Doocey called it a “vanity project,” while its rural communities spokesperson Nicola Grigg said: “It’s finishing up as nothing but the shifting of the deck chairs on the Titanic.”
But Labour’s Kieran McAnulty said the status quo wasn’t working – and accused National of playing politics.
“They can stand there and say that they wanted a strategy here; even if they got it, they weren’t going to vote for it. What a crock.”
ACT’s opposition was framed around concerns the bill was only around co-governance.
“We should acknowledge the needs of all of our diverse New Zealand populations, and I think it’s a shame the way that this bill has been written to divide New Zealanders based on their race,” said van Velden.
It drew a passionate response from Minister for Pacific Peoples Aupito William Sio.
“When she said about the need to address the health of all New Zealanders, I did not believe that I was part of the New Zealand she was describing.”
“The fact that she continues to ask “Why the Treaty?” indicates the ignorance of that party, ignorance of where her place is in Aotearoa New Zealand, ignorance of the value of the Treaty as a fundamental pillar of this nation.”
Associate Health Minister (Māori) Peeni Henare said the reform was a response to calls from Māori for the government to do better when it came to health equity and a system “that takes care of them”.
“For far too long the status quo has failed to deliver this. The Pae Ora (Healthy Futures) Bill enshrines the Māori Health Authority as an equal partner at the heart of the new health system, empowering it to co-commission and plan services across the system in conjunction with HNZ, commission its own kaupapa Māori services, and monitor the performance of the health system for Māori.
“In addition to the MHA, Iwi Māori Partnership Boards will ensure that the voice of whānau is heard and helps shape health services delivered locally, so that they better reflect those who need and use them.
“I am proud that Māori voices and hauora expertise will be reflected at every level of our new health system,” Henare said.
The shake-up reflected Labour’s 2020 manifesto promise of reform to build a stronger health system, Little said, and would lead to better health for New Zealanders.
“We have already backed the system with multi-year budgets and the funding needed to get on with the job.
“Now we’re removing the structural challenges so resources can be used more effectively, IT systems can be better connected to streamline care, and patients can get treatment sooner to prevent small issues becoming bigger problems.”