Building a stronger health and disability system

  • Hon Dr David Clark

The Government is committing to a long-term programme of reform to build a stronger New Zealand Health and Disability System that delivers for all.

The Health Minister today released the final report of the Health and Disability System Review, which makes a series of far-reaching recommendations.

“The Review makes it clear we have a very good health and disability system – as has been shown by the outstanding performance of our health services in response to COVID-19,” Health Minister Dr David Clark said.

“But it also confirms that our health services and workforce are under considerable stress and our system is complex and fragmented.

“One of the key lessons of COVID-19 was the importance of a strong public health service. That is what this Review has been all about. 

“It sets out a path towards a better, more sustainable health system with clear lines of accountability. One that is more responsive to the needs of local communities and that better tailors services to the way that people live their lives.

“This is particularly important when it comes to improving health outcomes for those most in need including Māori, Pacific people, the disabled and rural communities. 

“We need our health and disability services to work well for everyone,” David Clark said.

The Review’s recommendations include:

  • Shifting to a greater focus on population health 
  • Creating a new Crown Entity, provisionally called Health NZ, focused on operational delivery of health and disability services and financial performance
  • Reducing the number of DHBs from the current 20 down to 8-12 within five years, and moving to fully appointed Boards
  • Creating a Māori Health Authority to advise on all aspects of Māori Health policy and to monitor and report on the performance of the system with respect to Māori
  • Greater integration between primary and community care and hospital/specialist services

“Cabinet has accepted the case for reform, and the direction of travel outlined in the Review, specifically changes that will reduce fragmentation, strengthen leadership and accountability and improve equity of access and outcomes for all New Zealanders.

“That means we are committing to an ongoing programme of reform to build a stronger health and disability system. Decisions on individual recommendations will be taken to Cabinet over coming months and into the next term of Parliament.

“The Prime Minister will lead a group of ministers that will drive the changes. The group will include the Finance Minister, Health Minister and Associate Health Minister Peeni Henare.

“One immediate priority will be to lock in many of the positive changes made in recent months in response to COVID-19, such as the greater use of virtual consultations and e-prescribing and the renewed national focus on Public Health.

“Make no mistake, reforming our health and disability system is a massive undertaking, and will not happen overnight. Meaningful change and improvement will take concerted effort over many years.

“With that in mind, I will be appointing a Ministerial Committee (under Section 11 of the Public Health and Disability Act) to provide ongoing expert advice.

“An implementation team will also be set up to lead the detailed policy and design work. It will be administered by the Department of Prime Minister and Cabinet.

“This is a once-in-a-generation opportunity to back our world-class doctors, nurses and other health staff and deliver a truly national health and disability system. That is nothing less than New Zealand deserves,” David Clark said.

The Health and Disability System Review is available at