Health system governance changes to Health New Zealand, and other news

In this post, a longer form news piece, we explore different views on the restructure of the governance bodies for the New Zealand health system. NZ’s 20 district health boards have been disestablished and replaced by Health New Zealand – Te Whatu Ora and the Māori Health Authority - Te Aka Whai Ora.

Health New Zealand will be in charge of day-to-day running of the health system in NZ, with functions delivered at local, district, regional and national levels. There will be about 80 locality networks, and iwi-partnership boards to guide decision-making. Primary health, wellbeing and community-based services will be planned and then purchased through the four regional divisions of Te Whatu Ora.

Te Aka Whai Ora will work with Iwi-Māori Partnership Boards, Māori health providers and professionals, iwi, hapū and Māori communities to understand Māori health needs and aspirations across New Zealand, and then ensure these are reflected in the priorities and plans of the health system, and how services are designed and delivered to meet those needs, including through the use of kaupapa Māori models and the application of mātauranga Māori in the system.

Health Minister Andrew Little said of the reform

Having 20 different DHBs created a “postcode lottery”, where the healthcare a person could access depended on where a person lived.

….centralising the health system was about improving access to healthcare on the basis of need, regardless of ethnicity, location or gender.

Little also talked about the inefficiencies of DHBs operating in their own manner.

"A population of five million, it does not make sense broken into 20 different parts plus a ministry plus a few add-ons as well.”

"I took the view we could get a lot more out of a single, unified structure that could streamline decision-making, get greater consistency and offer better career structures for the workforce."

Little discussed how there won’t be immediate changes for those using the health system.

They'll still go to their nearest hospital, still go to their same GP, although in a few years Little said there could be more "health hubs" across the country, centralising different services.

National's health spokesman Dr Shane Reti has three main concerns with the health reforms.

the scale of centralisation; the timing, in the middle of a pandemic; and what he says are a "lack of measurable outcomes".

An opinion piece by John Roughan questions the lack of information on the strategy behind the public health system changes.

This is merely a restructure, not a reform. There is a big difference. As the chairman of Southern Cross Health, Greg Gent, put it this week, "Structure follows strategy and I can't clearly see yet what the strategy is."

Nor can professionals in the public sector, from what I hear. They are going to work for a nominally different organisation on Monday but they don't know the point of it all. They don't know what, if anything, they are supposed to do differently.

The Nurses Organisation has concerns about how a struggling health system can undergo major reform.

“If they [Health New Zealand leadership] have allowed a culture to exist and perpetuate, the risk is they know nothing different and we might still be creating those problems,” Kerri Nuku, Kaiwhakahaere at the Nurses Organisation, said.

The problems have been seen around the country: dangerously under-staffed maternity wards, overcrowded emergency departments, a nation-wide shortage of GPs, and inequitable care where those who can afford private treatment are seen much faster than those in the public system.

Nuku fears the new system could just be more of the same.

Other members of the medical community have also voiced concerns.

Christchurch GP Dermot Coffey, who sits on the New Zealand Medical Association board, which will be liquidated, said primary care had also been left out in the changes despite being the bedrock of the health system, where 90% of health interactions take place.

“The success and failure of the reforms is down to the people working in the health system,” he said.

“There is an absolute lack of communication with people on the front line - particularly people working in primary care. It’s been really, really disappointing.”

Sarah Dalton, executive director of the Association of Salaried Medical Specialists speaks about how little funding has been promised to the specialist medical workforce.

“….the promised workforce taskforce being set up under Health NZ has yet to announce its scope, timeframe, or budget.”

“Covid has exposed years of underinvestment in our medical workforce, both at hospital and community level.”

“But the problems run deeper. Already, we have regions without any specialist cover for rheumatology, dermatology, haematology, radiation oncology, child and adolescent mental health…”

“And there are parts of the country where you cannot see a GP or dentist because there simply aren’t any.”

Health NZ - Te Whatu Ora chair Rob Campbell said that staffing was a priority.

"That is not just the numbers, it's the way the staff are organised, it's the way the staff are rewarded and valued, it's the way the staff are involved in making decisions about how their area of work is done.”

"Restoring confidence of staff is not going to happen in a week or a month, it will take time. We have to make the practical steps that people can see are going to make a difference."

Dalton also spoke about the need for more public discussion about the affordability of the health system.

“If we are going to share in a public health system that provides decent, timely, equitable, preventive, community-based, early-intervention, acute and planned hospital care, we have to share the real cost. This is more than a few one-off Budget bounces. It means taxes.”

More daily news:

RBNZ welcomes commencement of RBNZ Act 2021

Flu and RSV cases are increasing across the country

Government announces new measures to help manage COVID-19

Evan Cavanaugh to join Wealthpoint as Head of Insurance and Lending

Louise Nicholson leaves role at FMA

Graeme Edwards takes on new leadership roles at Resolution Life Australasia

Cigna New Zealand appoints Stephen Moir to board

Hospitals and urgent care facilities under pressure, and other news

Hospitals and urgent care facilities are under pressure, from influenza, Covid-19 and other respiratory illnesses. As of today, there are 383 cases of Covid-19 in hospitals across NZ. Hospitalisation rates for severe acute respiratory infections are exceeding rates for this time of year over the previous seven years. A Waikato DHB staffer spoke to Stuff, under conditions of anonymity, saying hospitals are not coping.

They said the key issues causing stress to the health system were inadequate staffing numbers and underfunding from successive governments.

They also said staff were not immune to Covid and the flu, which was exacerbating the staffing shortages.

Yesterday the government announced expansion of funded access to the flu vaccine, to cover people with specific mental health conditions and/or additions issues as well as children ages 3 – 12. Epidemiologist and University of Otago (Wellington) Professor Michael Baker praises the government’s move to expand free flu vaccine access but is asking ‘why not make it free for everyone?

Workplace flu vaccination programs are one of the most common forms of employee wellbeing assistance. It is often covered by health insurance or is an action that is rewarded by systems such as AIA Vitality. Employers running wellbeing programs for staff report to us that it is one of the best value interventions. Estimates at effectiveness range from 30% to 60% in terms of preventing infection.

More daily news:

Study finds more than 19 million lives saved in first year of rollout of COVID-19 vaccines

Ministers to review whether orange traffic light setting should be changed

US FDA approves Covid-19 vaccinations for children over 6 months old

BNZ gives tips on how relationships can be financially healthy #ItStartsWithAction

ACC updates client payment rates

Economists say NZ recession almost certain, could trigger brain drain

Cigna responds to $180,000 FMA fine, and other news

The FMA has announced OnePath Life and Cigna Life will jointly pay $180,000 to the FMA after admitting liability for breaching the fair dealing provisions of the FMCA. While OnePath Life and Cigna Life did not directly make any misleading representations, their agent, ANZ was found to have. Tamsyn Parker writes in NZ Herald:

The breaches relate to misleading representations ANZ made when issuing monthly credit card statements to certain ANZ customers who held credit card-repayment insurance (CCRI) policies with Cigna and OnePath.

The bank was found to have charged customers for credit card-repayment insurance (CCRI) which offered no cover or benefit and issued duplicate policies between April 2014 and November 2019.

Cigna says impacted customers were contacted and issues put right in early 2020, before it offered an enforceable undertaking to the FMA re the discontinued CCRI proposition.

Cigna also records its commitment to developing and maintaining effective policies, systems, and processes to support good customer outcomes and to prevent issues of the kind referred to in these undertakings from occurring in the future.

More daily news:

AIA launches 'AIA MyCare' portal for advisers and corporate partners

Jo Mason of NZbrokers shares opinion on the challenges and opportunities in the insurance market

Zurich Australia and New Zealand announces new sustainability targets and initiatives

Kath Johnson leaves Fidelity Life for GM Channel Strategy & Delivery role at AA

ANZ appoints Amanda Owen Chief Financial Officer

Fidelity Life appoints new Head of Strategic Alliances, and more daily news

Melanie Beattie leaves her current role as Head of Strategic Alliances to take on the newly created role of Head of Distribution. Bronwyn Kirwan has said that Melanie will be responsible for ensuring the distribution mix continues to provide customers with choices and aligning with Fidelity Life’s end-to-end customer focus.

“Fidelity Life has created a new Head of Distribution role, and its current Head of Strategic Alliances, Melanie Beattie, has been appointed to the position.

Chief Sales and Service Officer Bronwyn Kirwan says the new role brings together accountability for all of Fidelity Life’s distribution relationships.

“Our advisers and strategic alliance partners are critical components of our customer-led transformation and work with us to protect New Zealanders’ way of life. As Head of Distribution, Mel will be responsible for ensuring our entire distribution mix – including new and emerging channels - continues to provide customers with choice, and aligns with our end-to-end customer focus.”

Bronwyn says Mel brings a strong strategic focus to Fidelity Life.

“Since Mel joined us in October 2021 she’s successfully helped us shift gears in our approach to our strategic alliance partnerships, and is poised to apply the same rigour and strategic thought to elevating our support and partnerships in the adviser community.

“The decision of our Head of Adviser Distribution Todd Allan to embark on a new career as a financial adviser, as well as our proposed acquisition of Westpac Life and strategic alliance with Westpac NZ, also played a part in our re-evaluation of our distribution leadership structure.”

Mel Beattie joined Fidelity Life as Head of Strategic Alliances in October 2021. She spent the formative years of her career in the UK starting and selling a business in the energy sector before making a switch to corporate – initially with EY as Executive Director Business Development, then IBM Associate Partner, Global Business Services. She became Head of Strategic Partnerships at ASB and led their partnership practice across corporate, commercial, SME, and rural/primary sectors. In 2020 she took a up new role at tech start up Trade Window as Head of Global Ecosystems.”

In other news

Fidelity Life: Todd Allan to leave Fidelity Life 18 February to become an adviser

Cigna: Claire Terblanche will replace Toni McAlpine as Product Manager for all in Market products after Toni leaves Cigna

FMA: The target date for Class 1 and Class 2 licence applications is 30 September 2022 and the target date for Class 3 licence applications is 30 June 2022

From NZ Herald: Regulators will show more muscle this year, directors warned