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National's Ten Point Health Action Plan

18 OCTOBER 1999

National's Ten Point Health Action Plan

National will continue to:

· build stability, certainty and public confidence in the country's health and disability system so that all New Zealanders feel secure about their health services

· address long-standing health outcome disparities so that all New Zealanders have an equitable health status

· significantly increase the level of early intervention, integration of primary/community and secondary services, health promotion and population health improvements generally, and the involvement of local communities in developing their own solutions to their health issues

1. Stability

Our health system needs stability. National wants it and so do other New Zealanders. With the structural changes bedded in, now the sole focus is on getting on with the job of delivering health services.

The current health structures will remain as they are. We've improved them by cutting the bureaucracy ($40 million to be saved over the next three years by having a single Health Funding Authority) and two years ago removing the profit motive from hospitals (claims by opposition parties to the contrary are incorrect).
2. Public certainty about access, quality, and security of services

National wants New Zealanders to have certainty, security and confidence about their health services.

National is making a big commitment to new hospitals and health clinics - including new hospitals for Auckland and Wellington. The investment stacks up to $920 million over the last 5 years, and $1 billion more in the following three years.

National will :

· implement the Hospital Services Plan which broadly maintains the current configuration of services for three years

· implement the Rural Health Policy

· implement the Roadside to Bedside emergency strategy to ensure people get the right care at right time by right person

· support the use of modern technology to improve quality and effectiveness of the delivery of health services through initiatives as Healthline and telemedicine
· continue to pilot, trial, develop and/or advance new ways of delivering services, for example, mobile surgery and medical clinics, mobile dentistry clinics and similar initiatives
· ensure longer term contracts for hospitals and health services to ensure certainty and stability in health service provision

· continue with the sustainable funding path approach to funding health services, locking in certainty of funding in the future

3. Ensure people needing surgery get it in a timely, equitable and nationally consistent way by continuing to improve and implement Booking Systems.

Booking systems are a big advance on the old 'first come first served' waiting lists. Booking systems are continually being improved to ensure people get their elective surgery in the optimal time regardless of where they live.

People needing heart, hip and eye operations will benefit from a new catch up initiative for these operations.

We expect to deliver approximately an extra 32,000 operations in the orthopaedics, cardiac, ENT, ophthalmology and gynaecology. This will see the clearing of all people currently on waiting lists who meet the criteria for treatment.

$60 million out of $84 million dollars extra for operations this year for the 17,000 extra elective operations for the 'front five'.

4. Keeping children healthy and well by preventing illness and getting them care as early as possible

The Government's Child Health Strategy injects an extra $13.25 million a year into improving the health of children at high risk of poor health. Specifically we are improving children's access to health services through:
· ensuring all children are enrolled with a primary care/well child provider
· encouraging and supporting the co-ordination of well child providers at a local level
National is developing with community groups programmes to address child health issues. Specifically, more work will be done to reduce the rates of significant illnesses and injury, especially in populations of children at high risk of poor health. This includes:
· implementing, in co-operation with other agencies, funding and other policies to significantly increase immunisation coverage rates, with the aim of eliminating epidemics of vaccine-preventable diseases
· reducing repeat hospital admissions for respiratory disease in Mäori children and in Pacific children
· reducing rheumatic fever incidence and prevalence in Mäori children and in Pacific children
· reducing meningococcal disease incidence in Mäori children and in Pacific children
· reducing the rate of sudden infant death syndrome in Mäori infants
· reducing the rate of hearing loss at five years amongst Mäori children
· reducing intentional and unintentional injury rates for all children.

5. More health promotion and population health approaches to keep people well and out of hospital.

This is the key to keeping on top of health problems in the future. National is improving population health by making further progress on immunisation rates, healthier lifestyles, less smoking, better diets, and screening and health promotion programmes.

In particular:

· more funding will go to programmes that promote and deliver improved health status in the community generally
· ensure that all services, regardless of the ring fences for personal health, mental health services and public health services, contribute towards improving population health goals and objectives
· work will continue on developing, in association with the Ministry of Health, consumer groups and others, strategies to address major long-term health issues, including:
· coronary heart disease
· stroke
· cardio-pulmonary disease
· cancer, including lung and colorectal cancer
· dementia
· asthma
· arthritis
· diabetes
· parkinsons
and the risk and protective factors for:
· obesity
· motor vehicle crashes
· injuries
· gender specific health issues
· healthy lifestyles.
· further development and implementation of funding plans to give effect to the key priorities and desired outcomes set out in existing Government strategies for health improvement:
· Whaia te ora mo te iwi
· New Zealand Youth Suicide Prevention Strategy (including both In Our Hands and Kia Piki te Ora o te Taitamariki)
· National Drug Policy
· Strategies for the Control and Prevention of Diabetes in New Zealand
· Breast Cancer Control Strategy
· Child Health Strategy
· Sexual and Reproductive Health Strategy
· Moving Forward, the national mental health strategy
· Maternity Services Strategy
as well as those strategies currently under development:
· Oral Health Strategy
· Primary Health Strategy
· Pacific Health Strategy
6. Focus on primary care services - including enhancement of services from GPs, nurse led initiatives, community care services.

In particular:

· develop Health Action Zones along the lines of the new Porirua integrated care initiative
· develop and implement a Primary Care Strategy
· implement Nurse Prescribing
· funding and expansion of Family Start
· encourage community development of local solutions to local needs
· reduce compliance costs for primary care providers
· implement strategies to ensure rural primary health services, especially for rural GPs

7. Cut long-standing disparities in health status

Make marked progress in decreasing the long-standing disparities in health and disability status, in particular for the needs of Mäori and the needs of Pacific peoples, so that these groups can enjoy the same level of health status as other New Zealanders.

In particular:

· implement service delivery plans designed to reduce disparities in health and disability status for those groups experiencing historically poorer outcomes than the population in general, including Mäori, Pacific people and families of all ethnic groups experiencing multiple social and economic disadvantage

· funding will ensure the ongoing strength of current Mäori and Pacific providers of services, as well as providers of services to families of all ethnic groups experiencing multiple social and economic disadvantage, and also progress new developments in these areas

· develop additional gender and ethnic-group specific approaches that support improved health outcomes for groups experiencing historic disparities, including anti-smoking, healthier lifestyles and community development programmes

8. Improved Mental Health Services

In particular:

· increase access to specialist mental health services for the three percent of the population with the greatest needs, including Mäori, Pacific people, children and young people and those with the highest support needs
· funding decisions will focus on improving the appropriateness, safety, quality and effectiveness of services
· support the effective development of the mental health workforce, in co-operation with the Ministry of Health and other agencies, to meet the workforce needs of New Zealand throughout the continuing implementation of the National Mental Health Strategy

9. Well co-ordinated, integrated services that contribute to better health and disability outcomes

In particular:

· expand the use of innovative contracting focused on improving outcomes for individual patients and for the population health by bringing various parts of the sector together, especially the primary and the secondary sectors
· incentives to involve local communities to developing their own solutions to their health issues, and encouraging new ideas to improve health outcomes
· support pilot initiatives designed to better integrate primary and secondary health services.

10. Government agencies and providers working together

· continue to work with other Government agencies to implement the Strengthening Families strategy aimed at breaking the cycle of disadvantage. These programmes are to focus on local specific long-term initiatives that address the needs of children and families with high support needs


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