Purpose and role

The Ministry of Health seeks to improve, promote and protect the health and wellbeing of New Zealanders through:

·        its leadership of New Zealand’s health and disability system

·        advising the Minister of Health, and government, on health and disability issues

·        directly purchasing a range of national health and disability support services

·        providing health sector information and payment services for the benefit of all New Zealanders.

The Ministry works in partnership with other public service agencies and by engaging with people and their communities in carrying out these roles.

Leadership

The Ministry leads the health and disability system and has overall responsibility for the management and development of that system. It steers improvements that help New Zealanders live longer, healthier and more independent lives.

The Ministry ensures that the health and disability system is delivering on the Government’s priorities, and that health sector organisations are well governed and soundly managed from a financial perspective. To do this, the Ministry:

·        advises the government

·        funds, monitors and drives the performance improvements of health sector Crown entities, including district health boards (DHBs)

·        supports the planning and accountability functions of health sector Crown entities, including DHBs

·        regulates the sector and ensures legislative requirements are being met.

Funding for these functions is provided through the appropriations ‘Sector Planning and Performance’ and ‘Regulatory and Enforcement Services’.

Advising government

Health and disability policy choices are complex and challenging, and the Ministry has a responsibility to provide clear and practical advice to the Minister of Health and Associate Health Ministers, supported by strong, evidence-informed analysis.

The Ministry also provides expert clinical and technical advice to Ministers and the health and disability sector. Some Ministry functions (such as those that rest with the Director of Public Health) include clinical decision-making or statutory responsibilities.

The main appropriation relating to this function is Policy Advice and Ministerial Services. Some decision-making roles and the advice provided by statutory committees come under the Regulatory and Enforcement Services appropriation.

Buying health and disability services

The Ministry is a funder, purchaser and regulator of national health and disability services, on behalf of the Crown. These services include:

·        public health interventions (such as immunisation or dealing with outbreaks of disease)

·        disability support services

·        screening services (such as cervical screening)

·        maternity services

·        child health

·        ambulance services.

Funding for these functions is provided through the appropriation ‘Managing the Purchase of Services’.

Information and payments

The Ministry provides key infrastructure support to the health and disability system, especially through:

·        the provision of national information systems

·        a payments service to the health and disability sector.

Funding for these functions is provided through the appropriations ‘Health Sector Information Systems’ and ‘Payment Services’.

The health and disability system and its funding

The health system’s funding comes mainly from Vote Health, which is administered by the Ministry of Health. In 2018/19 this will total $18.225 billion. Other significant funding sources include other government agencies (most notably the Accident Compensation Corporation – ACC), local government, and private sources such as insurance and out-of-pocket payments.

The Ministry allocates the majority of the public funds it manages through Vote Health to DHBs ($13,236 million or 73 percent of the Vote), who use this funding to plan, purchase and provide health services for the population of their district, to ensure effective and efficient services for all of New Zealand. DHBs oversee funding for all levels of care, including primary care such as general practitioners (GPs), nurses, pharmacists and community health services. They also oversee funding for hospital services, aged care services and services provided by non-government health providers, including Māori and Pacific providers.

New Zealand’s health and disability system also includes private non-governmental providers, and professional and regulatory bodies for all health professionals, including medical and surgical specialties, nurses and allied health groups. In recent years the Ministry has been working increasingly with other government social sector agencies to improve health and social sector outcomes.

The Ministry spends approximately 19 percent of Vote Health to directly purchase a range of services such as disability support services, public health services, specific screening programmes, mental health services, elective services, Well Child and primary maternity services, Māori health services, and postgraduate clinical education and training, as well as Māori and Pacific provider development and supporting equitable pay. In 2018/19 the Ministry will directly manage funding for about $3.529 billion worth of health and disability services and supports.

Vote Health also funds various capital requirements for the health sector, including investing in infrastructure (like new hospitals and wards) and providing equity support when DHBs have deficits. The allocation for these purposes in 2018/19 is $1,244 million (or 7 percent of the Vote).

About $216 million of Vote Health (1 percent in 2018/19) in operating and capital funding is spent on running the Ministry to support the wider health sector.​