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The Coalition Government’s Vision for the Health Sector
The overriding goal of the Coalition Government’s health policy is to ensure that principles of public service replace commercial profit objectives for all publicly provided health and disability services.
The principles of public service in the health sector are including the Crown having an interest in providing core health services for all New Zealanders.
The Coalition Government will change the structure and philosophy of Crown Health Enterprises (CHEs) so there is no longer a focus on profit. Further, the health policy sets out strict guidelines for the contracting out of services.
The guidelines state that private sector involvement in the health sector must:
- result in improvement as defined in health outcomes
- pose no financial risk to the Crown assessed over the next 10 year period
- be approved by the Minister of Health after consultation with coalition partners.
This new approach follows the recognition that the privatisation of services provided by CHEs has caused fragmentation in the health sector. The philosophy of the new health policy is to reduce competition and increase communication and commitment towards the integration of clinical practice through greater information sharing and co-operation.
Integration of clinical practices between hospital and general practitioner (GP) services is to be encouraged but there is no need for them to have financial relationships.
Details for Developing the New Structure
Details of the new structure of the health sector structure are being finalised.
The four Regional Health Authorities (RHAs) will be replaced by one funding body which is also responsible for ensuring providers are held accountable for the services they provide. It is, however, intended that this funding and accountability agency has a regional presence to ensure working relationships continue with local communities and providers.
CHEs will become Regional Health and Community Services. They will provide publicly funded health services but will still be required to operate efficiently showing the Government they are getting the best value for the tax payer dollar.
The Regional Health and Community Services will provide a range of core services such as health prevention, health promotion, community based assessment, treatment and rehabilitation, mental health, Maori health, dental health, disability support services, well child services and medical and surgical services.
Community based family health teams will be piloted to see core services as mentioned get the same status as inpatient medical and surgical services. The team will also act as a link between the hospital and community.
The Coalition Government also expects to review Accident Rehabilitation and Compensation Insurance Corporation’s (ACC’s) role as an independent purchaser of health services, given the policy to remove the focus of purchasing in the health sector.
It will also review GP budget-holding to ensure the model does result in improvements in health outcomes.
Plans for these structural changes are currently being developed. The Government’s main aim is to ensure that the good work achieved in the past is not lost, and experienced and valuable people remain in the health sector during the transition process.
For this reason the Government will communicate its objectives, and the process for change, as details are finalised.
It does not, however, intend further health dollars be diverted into restructuring and setting up new office facilities, so it is expected that existing RHA premises will be used as regional offices. Further, staff who currently work in CHEs and RHAs are likely to have the skills and knowledge required by the new entities so it is expected many will transfer to the new organisations.
The priority is not to compromise the level and quality of health services being delivered.
For this reason, under the coalition agreement health is expected to get a $378 million funding boost. More than $156 million is intended to be spent on general health services and the remainder on new initiatives such as:
- free doctor visits and prescriptions for children five years and under
- new Maori health plans
- child health teams.
Announcements on funding and implementation of the initiatives will be made when the budget round is completed.
