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Waitakere Health Plan Launch

Annette King
9 November 2000 Speech Notes

Waitakere Health Plan Launch

It is an honour for me to be here today to celebrate the launch of the Waitakere Health Plan.

I am delighted with the initiative shown by the Waitakere Health Planning Group in preparing this plan. Its broad scope is to be commended, and so are the sheer hard work and dedication it represents.

Congratulations to everyone involved – the local providers, government agencies, and the community.

The health plan largely fits with this Government's objectives for the new health service. It is especially pleasing to see the range of health issues you have considered in the plan. As you will be aware, the Government has committed itself to improving mental health services, disability services, reducing health disparities and cutting waiting times for elective surgery.

The work of communities like Waitakere is crucial to the Government achieving its health goals. Those goals were an integral part of the New Zealand Health Strategy discussion document I released in June. More than 600 oral and written submissions were received in response to the document, and the amended NZHS will be released next month.

While the NZHS is the overarching document for the new public health service, the New Zealand Public Health and Disability Bill, to be passed this year, will put in place most of the structural changes under which the rebuilt service will operate. Those changes will include, of course, the establishment of District Health Boards, and those organisations highlight the importance this Government places on community involvement.
These boards, with their elected community representatives, will be responsible for identifying the unique health needs of their communities and meeting them. The Waitakere Health Plan convinces me this community is well placed to play its part in a health service that people can trust, and that relates to the community's actual population needs.

The Labour-Alliance Government believes it is essential that the health needs of local populations are recognised, particularly in terms of primary care. There can be a considerable difference in the level of need from community to community, and from region to region.

That is why we need a system of weighted funding, based on population needs, in respect of primary health care. Weighted funding should go a long way to helping ensure that people living in communities like Waitakere receive a level of primary health care as fair as the level of care available in areas of less need.

When I read the Waitakere Health Plan – Towards 2010 for the first time, I felt a strong sense of agreement with the plan's vision and strategic objectives. The plan aims for Waitakere to have a health status equal to the best in New Zealand. I cannot conceive a better vision for your community.

I have no doubt your plan will be of great assistance, particularly in terms of resource allocation, to your District Health Board when it gets fully underway. The work undertaken by the experienced group of local people who have developed this plan will mean your community gets off to a strong start under the District Health Board structure.

District Health Boards have a requirement to consult with their communities. The Waitakere Health Link, a joint sector and community group, will offer one excellent forum for such consultation.

I believe the Waitakere Health Plan provides a good positive role model to other communities who care about the health of their people. Each community is different, and the plan for one community's health cannot become a blueprint for other communities, but you have provided a positive example for action.

I would also like to say that your attitude is encouraging from a government point of view in the sense of your readiness to face the tough issues, and to take responsibility for some of them yourselves instead of laying all the responsibility at the door of the Government.

We are committed to improving the health of all New Zealanders, and reducing health disparities between different groups in society, but we can't do it by ourselves. We need a collaborative and cooperative approach in the community and from health professionals, and that is what seems to be on offer in Waitakere. Everyone here today will be aware of the health disparities in Waitakere. The closer everyone can work together to get rid of those disparities, the better.

Dealing to the health disparities in New Zealand is a huge challenge, and partnerships between the Government, District Health Boards and community groups offer the best opportunity to achieve maximum improvements.

I would like to talk now in some more detail about the new public health service, or the bigger picture to which you will be contributing. My hope is that the new service we develop will in turn help you achieve your aims of lifting the health status of people in your area.

As I mentioned before, the Government's health goals are set out in the NZHS discussion document. I was delighted with the response to the consultation. It is critical that all views from the health sector are encompassed in the final strategy – no easy task as I'm sure you'll understand – but even when the revised document is released next month, it will not be a static document. The NZHS must become a living and flexible document, evolving to meet the changing health needs of New Zealand's population.

Sitting alongside the NZHS will be its companion strategy, the New Zealand Disability Strategy. This strategy's discussion document, Making a World of Difference: Whakanui Oranga, was launched in August, and the strategy itself is expected to be finalised in early 2001. Like the NZHS, it is a high level intersectoral strategy that will become the blueprint for future disability policy and services. It aims to make the lives of people with disabilities better and remove barriers which stop people with disabilities from participating in society.

These two ‘umbrella’ strategies provide a broad framework under which all other existing and impending strategies are to be developed and implemented.

I have also talked briefly today already about the New Zealand Public Health and Disability Bill. This bill will allow the structural changes to take place that are necessary for us to achieve our health goals. The Bill will disestablish the Health Funding Authority and the Hospital and Health Services. The DHBs created under the Bill will replace the Hospital and Health Services, and in time will carry out many of the functions currently performed by the Health Funding Authority.

The boards will be established as Crown entities, statutory corporations which are not companies. Each DHB, in consultation with the community it serves, will be responsible for developing plans to meet the health and disability needs of that community. This will not be limited to arranging hospital treatment services. It will include arranging services with local health providers including GPs, Mäori and Pacific Health providers, Wellchild providers, disability support service providers and so on.

The plans of each District Health Board must be consistent with the NZHS and the Disability Strategy. They will be subject to scrutiny by me as Minister of Health, and will thus be accountable to both the community and the Government.

Each Board will be required to establish at least three committees. The Health Improvement Advisory Committee will advise the Board on the needs of the local population and the priorities for using the Board’s funding. The Hospital Governance Committee will advise on the performance of the District Health Board’s hospital or hospitals and on longer term, strategic issues affecting hospital-based services. The Disability Support Advisory Committee will advise on issues facing people with disabilities and how these can best be managed.

The funding allocations for the boards will be negotiated with me, as Minister of Health, through the District Health Board’s annual plan. I reiterate that these allocations will be based on the population of the area the board serves, rather than on the services the board delivers.
Funding will take into account particular local conditions and needs.

I also want to touch today on this Government's commitment to people with mental illness. I know this is an important subject to many of you here. The Government has signalled its commitment to the Mental Health Commission's blueprint by announcing an additional $257.4 million for mental health services to be spent progressively over the next four years.

Implementation of the blueprint will result in comprehensive services that should ensure that people with mental illnesses are treated fairly and with respect and dignity.It will also give people with mental illness the opportunity to participate fully in their communities free from negative discrimination.

It will result in more diverse services that are easier to access and better able to respond to a diverse range of needs more quickly.

The key to achieving these outcomes is collaboration between providers of mental health services. This is imperative. Hospital-based and community-based services must work with each other as well as with non-governmental providers and primary health care services. All are integral to improved provision of mental health services.

Developing better mental health services is not just a question of money. It is also a matter of working out the rate of progress the sector has the ability to sustain. A limited workforce still remains the most significant barrier for the sector to overcome. The New Zealand Public Health and Disability Bill will establish a Health Workforce Advisory Committee to advise me on long-term workforce issues, and solutions to them. The terms of reference for the committee have been settled, and nominations have closed for the committee's membership.

The Government is also particularly concerned about Mäori mental health services. Mäori must have the choice to access mental health services that are aligned with cultural expectations. To achieve this, there must be an increase in the number of trained Mäori mental health workers. Mäori are significantly under-represented in the professionally qualified mental health workforce. This has resulted in reduced opportunities for cultural difference to be appreciated in assessment, treatment, support, and education for recovery.

There has to be a short-term and long-term strategy to address this urgent issue. A substantial Mäori workforce must have some presence in all kaupapa Mäori and mainstream services. The establishment of Mäori provider skills in administration and management is also imperative. There is ample evidence to show the cultural background of providers influences the results they achieve.

Pacific Health also is another priority for this Government. A Pacific Health branch has been formed at the Ministry of Health, the first time in public sector history that a strategic policy unit focusing on Pacific health issues has been established.

A key aspect of ensuring that the Ministry’s policy advice is robust, as well as holding the Ministry accountable for improving Pacific health, has been the establishment of the Pacific Sector Reference Group. A number of you here today sit on this group.

I know a significant amount of work has been done on what is needed to improve the health of Pacific communities. It is now time to put these good plans into action. If issues affecting Pacific health are not addressed successfully, it is highly likely the health status and wealth gap between non-Pacific and Pacific people will continue to widen. I am determined that will not happen, and that the future health prospects of Pacific people will be bright. Improving the health of Pacific peoples is a key goal in the New Zealand Health Strategy.

The NZHS discussion document specified a number of goals and targets that could potentially improve the health status of Pacific peoples. In particular it outlined plans to:
 Strengthen primary health initiatives for Pacific peoples
 Improve the health of Pacific children
 Improve mental health services for Pacific peoples
 Enhance screening programmes
 Increase the number of Pacific peoples in the health workforce.

We must support services responsive to Pacific communities by building on community strengths, proven strategies for early engagement in health promotion, and Pacific health workforce development strategies. I am aware that for Pacific peoples conventional delivery of health services does not adequately meet their needs. This is very apparent in primary health care.

We need to make sure that Pacific modes of care are recognised and supported. As with Maori, the Government also recognises the need to train more Pacific peoples in the health workforce. We know service provision ‘by Pacific for Pacific’ works.

Pacific providers and communities should and will be consulted on aspects of care delivery which are important to Pacific peoples. They should be given the opportunity to develop, mange and provide health care for their communities.

I understand that the complexity of illness faced by many Pacific peoples needs to be recognised. It is also important that the funding of Pacific health services not only recognises the complexities of Pacific health, but that the funding allocation allows Pacific peoples to develop solutions to these problems creatively.

I am very aware that Pacific health services have grown and developed on their own, led by committed Pacific people. The Government would like to build on this development.

The Ministry is now beginning to facilitate the development a Pacific Health Strategy. This strategy will be part of the second phase in the development of the NZHS, and will reinforce the broader health sector action required for improving the health of Pacific peoples, including Pacific provider and workforce development, and the responsiveness of mainstream providers to the needs of Pacific peoples.

For the first time a costed implementation plan will be developed and endorsed by the cabinet. This implementation plan will become the guiding tool for DHBs in terms of Pacific health issues.

In conclusion I congratulate you again on all your hard work and commitment to developing such a comprehensive and wide-ranging health plan for Waitakere.

I note that you began from the standpoint that doing nothing was not an option. To quote from the plan: "We are intolerant of historical problems, and we act to solve them." That is exactly what I want to achieve too. It may take time, but the vision of a fair and accountable health service is worth taking time to achieve. I am sure we all agree on that. Thank you for inviting me to be part of this important day.


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