The Government is currently asking for public input into some of the biggest changes to our health system in a generation. The outcome will shape our healthcare system for at least the next couple of decades. 

The Bill replaces District Health Boards (DHBs) and the Health Promotion agency with new structures, such as Health New Zealand, and the Māori Health Authority, the latter intended to drive improvement in hauora Māori.

Have your say by 9 December

Use this guide to put your own submission together. Pick out what is important to you. It can be as long as you want but a minimum of four sentences.

Please DO NOT cut and paste everything here. If you do that, your submission will not be considered unique and it is unlikely you could make an oral submission.

We suggest you put in your submission:

  • Your name and any relevant background – why do you care about the new health system personally?

  • Do you support the Bill or not? We recommend support.

  • Say whether you want to make an oral submission. The Government receives thousands of submissions on many bills – the oral submissions make the biggest impact. You can always change your mind later.

  • The things you care about in relation to this bill. Below are some of the issues the Greens speak out about and you may have your own issues as well. Start with what you support and then add what you would like to change.

Te Tiriti o Waitangi and Tino Rangatiratanga

This bill should properly give effect to Te Tiriti o Waitangi. This would mean recognising that it is a different document to the Treaty of Waitangi, and that it is the constitutionally preferred document.

  • We support the establishment of the Māori Health Authority to be independent, and properly resourced.
  • Te Tiriti should be implemented across all aspects of the bill, not just the Māori specific parts. The bill itself should clearly outline how it will uphold the principles and articles of Te Tiriti o Waitangi.
  • This includes consultation with whānau, hapū, iwi, and Māori communities, cultural safety, expertise and responsiveness, as these areas are not the responsibility of the Māori Health Authority alone.                     

This bill should give proper effect to tino rangatiratanga for Māori over hauora, as is afforded to them in Article Two. This would mean ensuring that joint decision-making with tangata whenua occurs through proper co-governance.

  • This includes access to health services, whether they are kaupapa Māori or otherwise. Māori tino rangatiratanga rights are afforded to tangata whenua in both situations, and the bill should reflect this.
  • The Māori Health Authority needs to be controlled by Māori, including the appointment of board members. 
  • The Māori Health Authority does have joint decision-making authority with Health New Zealand for health services, but it also needs to have joint decision-making authority with the Ministry of Health in policies.
  • There should be a commitment in the law to progressively increase the Māori Health Authority budget, so that by 2030 it has an equitable share of public funding for the health system.
  • The bill should ensure that the Māori Health Authority will be provided with enough resources to ensure that it does not fail. If Māori controlled bodies are to be tasked with the enormous task of fixing a broken system, they need proper resources to effectively do this, and to ensure the rollout of services happens in a manner that benefits whānau, hapū, and iwi Māori.
  • Eliminating health inequities should be written into the purpose of all the new agencies. 

Community and marginalised voices

All service users, including vulnerable communities, must have a right to participate in planning health service delivery. Given that elected District Health Boards will be disestablished under the Bill, it is crucial that the new system is set up to prioritise meaningful engagement and accountability to the public. The health system should be set up to provide for:

  • Healthcare professionals, service users and communities to be involved in planning and decision-making, with decisions based on the best available evidence.  In the initial stages of the new health system, this foundational planning and decision making includes the defined localities and locality plans, health and disability strategies and the Code of Consumer Participation.
  • The consumer health forum and other engagement mechanisms to be developed must be robust and comprehensive and enable community voice and accountability as the new health entities take up their roles and responsibilities. This engagement must also include those population groups with the lowest health status, such as the elderly, women, children, Māori, Pasifika, refugee and migrant, Rainbow communities, people with low socioeconomic status and people with disabilities, as part of ensuring equal health outcomes for all.

Rainbow Health

Develop specific health programmes, including professional education, in partnership with Rainbow communities.  This includes to prevent marginalisation and medicalisation of intersex, trans and non-binary people to ensure that their wellbeing, ability and participation in planning service delivery is not compromised and that their needs are being met.

  • The Greens have recommended a Rainbow locality. Even though it would be nationally based, it would enable a consistent approach to gender-affirming healthcare and ensure that gender normalising surgery never happens in this country again.

Health Promotion

We know that social, cultural and environmental factors outside the traditional health system have a great impact on our health. Therefore, a key part is health promotion through supportive physical and social environments, and empowering communities to identify their own priorities and implement their own solutions.  The Bill, and the health system needs to:

  • Emphasise that keeping people well is not something that the health system can do alone, so it is important that Government agencies and local government are required and empowered to collaborate to reduce health inequalities and achieve social and environmental goals relevant to health; and
  • Provide more clarity about how this collaborative approach will be enacted in practice through clear responsibilities across the relevant agencies.

People with Disabilities

Health services must meet the diverse needs of people of different ages, cultures, access to financial and social resources, and physical and mental health status. People with disabilities are significantly disadvantaged by the health system. Therefore, the health system set up under the Bill should integrate well with the reform underway in the disability system.  It is fundamentally important that disabled people have access to responsive, flexible, and culturally appropriate health services that are focussed on inclusion and empowerment so that they are able to meet their individual needs and those of their families.

Other areas you might like to address:

  • COVID-19 and the ability of the health system to cope with the demands of the pandemic
  • Focus on and investment in prevention
  • Resources for rare disorders
  • Health workforce to ensure we have enough to staff the system we hope for
    • Better immigration policies to bring in health and disability workers
    • Better training opportunities for Māori, Pasifika and migrant people to reflect the health needs of those communities.