BACKGROUND INFORMATION

About the New Zealand Health Strategy and
New Zealand Disability Strategy

The accompanying policy statement sets out the new structural arrangements for the health and disability sector that will be created by the New Zealand Public Health and Disability Bill.

Beneath this structure, the Government is developing, or has developed a number of strategies which provide more detail about the context of what District Health Boards, DHBs and other agencies in the sector will be expected to do in funding and/or providing services.

In particular, the New Zealand Health Strategy and the New Zealand Disability Strategy will be key documents which will guide the delivery of services. These strategies are discussed in detail below.

What is the New Zealand Health Strategy?

The New Zealand Health Strategy will provide a set of clearly defined goals that the sector can work toward as a whole. It will provide the context within which the newly developing District Health Boards will be established.

Over time the DHBs will develop specific goals relating to the health needs of their individual communities. The New Zealand Health Strategy will also provide the Ministry of Health with a framework within which to operate in the new health environment.

The New Zealand Health Strategy will set the framework for protecting and promoting health and for delivering good health services to all New Zealanders regardless of where they live and their ability to pay.

The Strategy will play a key role in outlining priorities and performance standards for the health sector and ensure that health agencies meet their obligations under the Treaty of Waitangi.

How will the New Zealand Health Strategy achieve these aims?

A key step in developing the New Zealand Health Strategy was the publication, by the Minister of Health, of a discussion document.

The New Zealand Health Strategy Discussion Document sets out some goals and objectives for the health sector to work toward as a whole. These focus on:

 Addressing health differences between Maori, Pacific people and other New Zealanders;
 Addressing major risks to health such as smoking, violence in the community, alcohol and drug abuse;
 Addressing the causes and effects of major diseases such as cancer, heart disease and diabetes;
 Addressing social issues such as youth suicide;
 Promoting action to improve the health of individuals and communities through immunisation, exercise and good oral health.

Why do we need goals and objectives?

Goals and objectives translate the Government's vision for the health sector into the focused actions required to make a difference in improving health. Developing a nation-wide set of goals and objectives will assist the whole sector to direct its actions in a more co-ordinated and effective way.

What other countries have national health strategies?

The United Kingdom developed a national health strategy in 1997, which established a new structure for the National Health Service (NHS), and built on existing health gain targets. During the 1980s Wales developed a 'national' health strategy built on key goals and objectives specifically relevant to the country.

Australia developed a set of national goals and targets during the 1990s, but has still to put in place a comprehensive national health strategy. In Canada, Ontario developed a provincial health strategy, which established key goals and objectives and advocated 'healthy public policy' across a range of sectors. In developing the New Zealand Health Strategy these models have been studied and learned from.

What factors determine the health of individuals and communities?

The New Zealand Health Strategy Discussion Document recognises the impact that other sectors such as housing and education have on the health of individuals and communities. Accordingly representatives from a range of Government agencies across a wide variety of sectors contributed to the development of the New Zealand Health Strategy Discussion Document.

How will the New Zealand Health Strategy meet the health needs of Maori and Pacific people?

As a group, Maori have on average the poorest health of any group in New Zealand. The New Zealand Health Strategy Discussion document identifies some specific objectives that will contribute to the Government's aims of closing the gaps between Maori and non-Maori.

The Government will build on the gains of the past by continuing the momentum that has developed in meeting Maori health needs. In particular the Government will focus on increasing the ability of Maori health providers to meet the health needs of Maori communities; increasing the participation by Maori at all levels of the public health sector and supporting the development of the Maori health workforce. A Maori health strategy will be available by the end of the year, which will build on the direction set by the New Zealand Health Strategy.

Pacific people also have poor health when compared to other groups in society. The New Zealand Health Strategy identifies specific objectives for improving Pacific Health. A Pacific Health Strategy will also be developed which will focus on improving access to primary care programmes for Pacific people, improving specialist community-based services and making public health programmes - which focus on illnesses such as diabetes and heart disease - more appropriate to Pacific people.

When will we see the benefits of the New Zealand Health Strategy?

The New Zealand Health Strategy is a long-term project. The first benefits of the Strategy will be seen as the District Health Boards become operational over the next 12-24 months. However international evidence indicates it will take between five and ten years for the Strategy to have a real effect on the health of individuals and communities. In recognition of the need for this longer term focus, the Government will require DHBs to have both annual and long term strategic planning.

How will the New Zealand Health Strategy develop to meet the needs of future generations?

The New Zealand Health Strategy will be a 'living document' which will evolve over time as populations, technology and other factors change. Future developments of the Strategy will include guidelines for District Health Boards to use when planning to meet local needs within their communities.
How does the New Zealand Health Strategy fit with other strategies?

The New Zealand Health Strategy will provide a structure within which existing strategies or health-related goals, objectives and targets can be placed.

Existing strategies and programmes that will fit into the framework of the strategy include the Youth Suicide Strategy, National Drug Policy and the Child Health Strategy.

The Primary Care Strategy, which is currently under development, will encourage primary care organisations to take responsibility for keeping people healthy as well as providing treatment services. It also comes under the umbrella of the New Zealand Health Strategy.

How has the health sector participated in the development of the New Zealand Health Strategy Discussion Document?

The skills and knowledge of those working in the health sector are vital to the Strategy's development. A Sector Reference Group (SRG) chaired by the Director-General of Health contributed to the development of the Discussion Document. The SRG comprised a range of health professionals and health advocates from across the sector. An Expert Advisory Group (EAG) comprising health experts provided technical advice on the formation of health goals and objectives.

The discussion document has been widely distributed among health services providers, health consumer groups and health professionals for direct input. A series of public meetings, hui and fono have been held throughout the country and submissions closed on Friday 28 July. Those submissions will help shape the strategy.

How does the NZ Health Strategy fit with the Primary Health Care strategy?

Many of the Government's goal are ones that need to be addressed through primary health care. The Government is currently undertaking consultation on a Primary Health Care Strategy which sits under the umbrella of the New Zealand Health Strategy and aims to implement a population focused health and disability sector at the primary health care level.

A population health focus at the primary health care level means more preventative care to avoid unnecessary hospitalisations, better access to services, comprehensive care and more co-ordination between primary health care providers and secondary providers of services. It also means good quality care which meets agreed national standards.

About 300 submissions were received on the primary health care discussion paper. These submissions, along with advice from a sector reference group, are being used to finalise a more detailed strategy for release later this year.

What is the New Zealand Disability Strategy?

The New Zealand Disability Strategy aims to identify how to remove the barriers faced by people with disabilities to enable full participation in society. The strategy will identify barriers, goals, action areas and targets across all relevant sectors in order to guide policy and service development. It will provide a framework for development of future disability policy and service development in New Zealand.

It will be developed in collaboration with people with disabilities and the wider disability sector.

A reference group has been set up to work in an advisory position alongside the project team, providing advice on the content of the strategy and consultation process, as well as feed information and views of the sector to the project.

The reference group will be seeking the help of people with disabilities and the disability sector during preparation of the strategy to ensure all issues are considered.

How can the public participate in developing the disability strategy?

They can participate through the reference group and by writing to the project team at the Ministry of Health, or by making a submission on the strategy discussion document which is expected to be released for comment in late August.

What involvement will DHBs have with Disability Support Services?

The extent of the responsibility DHBs will have for Disability Support Services has yet to be determined. The work currently underway on the NZ Disability Strategy and the Positive Ageing Strategy will help set the direction for the provision of disability services in the future.

Consequently, until these strategies are finalised the administration of funding for disability support services will be undertaken by the Ministry of Health and decisions on the role of DHBs in disability support will be taken in early 2001.

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