Address to Ministry of Health/NGO forum

E aku rangtira, tēnā koutou katoa. Ka nui te honore ki te mihi ki a koutou.

Good morning and thank you for giving me the opportunity to speak at your national forum this morning.

I would like to acknowledge Jackie Edmond, Chair of the NGO Working Group and Jill Lane, General Manager, National Services Purchasing at the Ministry of Health.

I was brought up on a farm in rural Canterbury and was a registered nurse and a member of a number of NGOs, some of them health based. So I have a real interest in health care and how access to services throughout New Zealand can be improved for people in small towns and communities as well as in cities.

The high level of interest in this forum from across the health and disability sector highlights the value placed on the opportunity to get together and share our knowledge and experiences.

I am impressed to see such broad representation from the health and disability sector, including NGOs that deliver mental health, personal and public health and disability support services. I have been told a much larger venue could have been filled today had the NGO Working Group known over 400 people would like to attend.

These gatherings have been happening for over ten years. This shows the level of commitment to partnership of those in the NGO sector as well as the Ministry of Health and demonstrates a solid base that you can continue working from into the future.

Events like this are an opportunity for engagement between the Ministry of Health and the NGO sector and also within the NGO sector. It enables people to share their experiences and to network. This can only lead to better communication and relationships – and in the long term contribute to the provision of quality accessible health and disability services to New Zealanders. So I'm delighted that the theme of this forum focuses on connections and collaboration, as well as challenges.

Your agenda today will give a range of people opportunities to speak and share their views in a variety of formats. I’m sure the roundtable panel discussion and debate will be lively with such different perspectives representing the broad spectrum of the health and disability sector.

As you well know, non-government organisations make a huge contribution to New Zealand society. Your recent report ‘How NGOs make a difference to health care in the community’ illustrates the key role that NGOs play and the need for better-connected community health care. The different case studies discussed in the report highlight the ways in which NGOs can and do achieve amazing things for people in communities across the country. 

NGOs deliver many services on behalf of government, and this is a real strength of the New Zealand health and disability sector. However, to achieve good services for our communities, government agencies and NGOs have to work well together. It's great to see how the NGO Working group helps build stronger relationships between Health and Disability NGOs and the Ministry of Health. 

Across New Zealand there are vulnerable populations, those with poor health outcomes and high mortality rates and this is where many NGOs emerge. There are strong connections between these individuals and their health workers. The experience and networks of the people working in these NGOs help them deliver high-quality services.

While there is a lot to celebrate, we also need to reflect that at times the community-based NGO sector is left out of planning and development discussions. A key platform of the government’s Better Public Service reforms is about government agencies actively engaging with the full range of organisations working on the ground rather than simply approaching a few key contacts the officials may have worked with before.

You are probably aware that I am also Minister for Senior Citizens, Minister for the Community and Voluntary Sector and Minister of Women’s Affairs. A particular interest for me is how my various portfolios intersect and this forum is a perfect example of that. So I’ll just put my community and voluntary sector hat on here for a moment. Last year the government signed the Kia Tūtahi Relationship Accord with representatives of the community sector. 

The Accord is an aspirational document and the name Kia Tūtahi Standing Together symbolises the intent that communities and government should work jointly to build and strengthen relationships. It provides principles to enhance existing relationships and to inform future action. It's very appropriate that a representative of the NGO Working Group and the Ministry of Health NGO desk are involved in the work the Office for the Community and Voluntary Sector is leading to implement the Accord.

I see Kia Tūtahi as a lever for positive change where some government organisations may be lagging behind others to engage and work with the non-government sector. Many agencies will find, as some have already found, that the Accord is easily embraced into the way they do things from developing policies right through to the delivery of services to people around New Zealand. 

Kia Tūtahi has some long-term goals that include replicating across government the good work being done in champion agencies and communities, as well as three-yearly reviews of progress of implementation.

The Ministry of Health’s long-term commitment to the NGO Working Group is a powerful example to other government departments. I am sure that officials in the Ministry do not always agree with what the NGO Working Group might have to say, but the ongoing discussion and way in which the two groups have worked together for over ten years has added value to both the government and the NGOs.

Another focus of my community and voluntary sector portfolio is volunteering. I would like to take this opportunity to acknowledge the work of volunteers in the health and disability sector.

A particular concern of mine that relates to all of my portfolios is older people's health and how volunteering can contribute to reducing social isolation and improve wellbeing of older people. I look forward to hearing more about the NGO Working group project on Older People's Health and Aged Care.

The government has made a number of commitments to older people and services providers. They are about moving support and services for older people forward, by working together to find new, smarter and more integrated ways of doing things. 

I am very pleased that the Ministry is working with DHBs, the Accident Compensation Corporation and Home and Community Support Services to ensure the services for older people are safe and are of a high quality.

You will know better than most that demands on health services are increasing. Patients living with long term conditions, an ageing population and the complex needs of vulnerable populations are placing greater and unaffordable pressures on services in an environment of tight fiscal constraint. 

The government is committed to ensuring that we have comprehensive, affordable health services, focussed on patient needs and providing more convenient patient experiences, better population health outcomes and more cost-effective delivery of care that reduces duplication and makes better use of available resources.

We want to see integrated health services which do not just focus on hospitals and GPs. The whole health and disability sector has a part to play. We want to see patients going to hospital as a last resort. One way that NGOs do this is by reducing acute demand pressures on hospitals by supporting people to better self-manage chronic conditions. 

Integrating health services enables clinical leadership, better coordination, better productivity and better willingness to work together to reduce fragmentation or duplication of care. And importantly it puts patients in the centre of health planning by ensuring that community, primary and secondary health services work together for them. Putting the patient at the centre of health planning should enable a smooth pathway for patients as they move from primary to secondary services and back to the care of their primary health provider.

As well as better integration, shifting services to primary care where appropriate and feasible makes sense. It more fully recognises the wealth of skill in primary care. It brings services closer to where people live in the community. And it builds on the already strong relationship between patients and their General Practice, the single most important relationship most people have with the health system. 

Fiscal constraint will be the hallmark of all government services as we move towards balancing the books in 2014/15. Internationally, health budgets are being cut dramatically. However, this government is following a prudent strategy future-proofing our health service to better deal with increasing demographic and financial pressures.

But it is not just the financial strain on health services that is the driver for looking at how we manage services differently. We need to improve the experiences of patients to ensure that they receive the quality of care they need, when they need it and how they need it. 

To continue improving integration and to get it to work even better, we need changes in ways of thinking and working, and organisations like yours, who are already focussed on the needs of the people you serve are able to lead the way.

Two weeks ago the Prime Minister announced ten targets for the public sector. As health-focused organisations some of the work you do will go towards achieving these targets. An increase in the number of immunised children across New Zealand has had and will continue to have long-term health benefits for people throughout the country. Many NGOs are perfectly placed to support and encourage people to get their children immunised.

Another target, improving interactions with government in an increasingly digital environment, will make things better for you all as end users of government services.

As part of the government's plan to ensure public services meet the needs of 21st century New Zealand, the Crown Entities Reform Bill, currently at Select Committee, proposes to disestablish the Health Sponsorship Council and Alcohol Advisory Council and establish a new entity called the Health Promotion Agency. 

The Health Promotion Agency will retain all of the functions of the Health Sponsorship Council and Alcohol Advisory Council and provide exciting opportunities to better integrate promotional activities and build strong expertise in this area. 

The Chair of the HPA Establishment Board, Dr Lee Mathias, informs me that the focus at the moment is on maintaining business as usual. This applies also to any programmes that will transfer from the Ministry of Health to the new agency. The Board wants to take some time to consider how best to integrate the Health Promotion Agency's work programme and ensure it has the resources it needs. 

Please continue to work with the existing entities up to, and beyond, 1 July when the Bill will take effect to ensure progress on these important issues is maintained.

The last thing I would like to mention today is a project underway at the moment that aims to reduce the duplication of audits of Disability Support Services-funded home and community support services. Those of you who provide services in the residential disability area may already be aware of this project. A team of people from the Ministry of Health, District Health Boards, ACC, the New Zealand Home Health Association and auditing agencies are working together to reduce the number of monitoring events related to certification audits and developmental evaluations.

As part of this project, 15 providers are trialling an organisational self-assessment tool that focuses on the service's contribution to quality of life outcomes for people with disabilities. These 15 providers are working closely with people who use services and their families and whanau for their perspectives in this self-assessment.

The finer details of the new approach to integrate audit and developmental evaluation activities are currently being worked through with the help of a reference group including provider and consumer representatives.

Thank you for the time to speak with you today. As a Minister, I welcome every opportunity to meet with as many groups as possible and I have enjoyed the chance to speak with such a wide range of representatives from across the health and disability sector. 

No reira, tēnā koutou, tēnā koutou, tēnā koutou katoa.