Speech to Planned Care Workshop

  • Hon Dr David Clark


E ngā mana, e ngā reo, e ngā karanga maha o te wa, tēnā koutou, tēna koutou, tēna tātou katoa.

Ki ngā mana whenua, ko Te Atiawa, Ngāti Toa, anō nei aku mihi ki a kōrua.
Rau rangatira ma, tēnā koutou.

Ki tēnei whare, Te Wharewaka, tēnā koe.
Nōku te hōnore kia haere mai ki te whakanuia tēnei huihuinga whakahirahira.

Ko te kaupapa rangatira e tauhere ana i a tātou katoa, ko te whakapiki i te oranga ō ngā tāngata katoa o Aotearoa,

Ehara i te mahi māmā, engari mehemea ka mahi tahi tātou, ka taea e tātou

Ko te tūmanako kia angitū tēnei hui.

Tēna koutou, tēna koutou, huri noa i te whare, tēnā rā tātou katoa.        

Thank you, for that kind introduction.

It’s a pleasure to be here today at the first of four workshops on Planned Care being held this month, including here in Wellington, and in Auckland, Hamilton and Christchurch.

First, I’d like to acknowledge Ministry of Health staff for organising these workshops to support District Health Boards in implementing the Government’s new approach for non-acute health care.

I understand there’s a diverse range of people here today from across the region, including representatives from DHBs – executive and clinical, Primary Health Organisations, consumer councils and other key stakeholders.

I want to thank all of you who have taken time out from your busy jobs to attend today’s workshop. 

You play important roles in our health and disability system to ensure New Zealanders get the care they need and deserve on a day-to-day basis.

I hope today’s workshop will help you to identify opportunities offered by Planned Care and to share your ideas about ways to best implement this new approach.

Your support is vital for the Government to successfully achieve our goal of ensuring all New Zealanders have fair access to high-quality health care, no matter who they are or where they live.

I’d also like to acknowledge Director-General of Health, Dr Ashley Bloomfield, and members of the Planned Care Sector Advisory Group, who will talk with you today about Planned Care. They have been meeting since about May last year.

They include Dr Jeff Lowe, who chairs General Practice New Zealand (GPNZ) and Nelson Marlborough DHB Chief Executive Dr Peter Bramley.

Planned Care
I know the Ministry has sent out a lot of information about this change to your DHBs, but this is a good opportunity for me to explain why we’ve introduced this new approach.

As you’ll all know, well over $1 billion of DHB’s funding nationwide is for non-acute medical or surgical care, which is defined as health care that is provided more than 24 hours after a decision to proceed with treatment.

Previously, this non-acute care was named elective services. 

However, that approach was too narrowly focused on procedures performed in hospitals.

A broader approach is needed to improve people’s health and wellbeing, and to better meet our priorities of achieving equity and sustainability for the health and disability system.

Changes are also needed to enable DHBs to better respond to our growing and ageing population, who have increasingly complex needs.

That’s why we’ve introduced a new description for non-acute services called ‘Planned Care’. It has a broader focus across the continuum of care and its core principles are equity, access, quality, timeliness and experience of care.

The new approach has five strategic priorities:

1.    Understanding health need – both in terms of access to services and health preferences, with a focus on understanding inequities that we can change

2.    Balancing national consistency and local context – ensuring consistently excellent care, regardless of where you are or where you are treated

3.    Simplifying pathways for service users – providing a seamless health journey, with a focus on providing consumer-centred care in the most appropriate setting

4.    Optimising sector capacity and capability – optimising capacity, reducing demand on hospital services and intervening at the most appropriate time

5.    Fit for the future – planning and implementing system support for long term performance and improvement.

Planned Care will better enable DHBs to provide more timely care in the most appropriate settings with the right workforce, including services that can be delivered in primary care and community settings.

I want DHBs to be acknowledged for offering a range of interventions to best meet the needs of people in their communities.

It will give DHBs more flexibility to better meet the health needs of your local communities.

I acknowledge this new approach means changes to how you work, and how your DHBs are funded and monitored, including accountability for performance.

As you’ll know, the Ministry has asked all DHBs to develop a three-year plan for implementing Planned Care through the annual plan process. These plans are due with the Ministry by the end of March next year.

I’m aware that the Ministry has been working with the Sector Advisory Group to update policies, monitoring and funding frameworks to remove inconsistencies in how Planned Care is counted and to remove barriers to shifting care into less intensive settings.

This year, we’ll start funding non-surgical interventions, which will delay or avoid the need for people to have complex hospital interventions.

For example, we’ll fund early intervention programmes for musculoskeletal conditions that have been successfully trialled in the past three years. It will include education, physiotherapy, exercise programmes and multi-disciplinary support that haven’t previously been able to be funded from Planned Care funding allocations.

Last year, I learned about South Canterbury DHB’s mobility action programme, which has proved very successful in supporting people who were waiting for hip or knee replacements. 

Some of those people found they no longer needed these procedures after joining these early intervention programmes, which is an excellent outcome for their health and wellbeing. 

The Government has invested an additional $115 million over four years into Planned Care as part of this year’s Wellbeing Budget to support this new approach.

This will help DHBs to design and deliver services differently to meet increasing demands from a growing and ageing population with more complex needs, workforce and facility constraints, and competing budget demands.

Cancer Action Plan
For many of the approximately 23,000 people diagnosed with cancer each year, their cancer treatment will fall under Planned Care.

Three weeks ago, it was my privilege to stand alongside our Prime Minister, the Rt Hon. Jacinda Ardern, to release our Cancer Action Plan.

It will steer New Zealand’s cancer action for the next decade.

Our Cancer Action Plan’s priorities closely align with our priorities for Planned Care, such as achieving equity for all New Zealanders, particularly Maori, and an increased focus on prevention and early intervention for better outcomes.

We’re introducing stronger national governance for cancer control with a new Cancer Control Agency to be established by the start of December this year. 

The Cancer Action Plan also includes increased funding for pharmaceuticals, which will allow access to new cancer treatments.

Earlier last month, the Prime Minister and I announced our first steps for our Cancer Action Plan – funding 12 new linear accelerators to replace ageing machines around New Zealand in the next three years. 

This initiative will place new linear accelerators in three regional centres for the first time – Hawke’s Bay, Northland and Taranaki. That will make radiation treatment for cancer more accessible to people living in our regions.

We know there are regional disparities for people needing cancer care and our Cancer Action Plan aims at ending this postcode lottery. 

This will better support DHBs to deliver Planned Care for people fighting cancer.

And we know there are similar disparities in non-acute care, which our Planned Care approach aims to address.

Health and Disability System Review

Before I conclude, I want to say a few words about our Health and Disability System Review.

As you’ll know, the Review panel’s interim report was made public at the start of this month.

Its main themes also align with our goals for Planned Care - and with the Government’s priorities.

For example, it calls for a greater role for primary and community care, the need to deliver better outcomes for Māori and improve equity, and more focus on prevention and early detection.

This interim report is built on significant engagement with the sector and service users by the review panel, which is chaired by Heather Simpson.

I’m sure many of you here today have contributed your wisdom to this review – and I want to thank you for that.

The review panel is seeking further feedback about its interim report and I encourage you all to take that opportunity. 

We need your expertise to help to shape what I believe is a once-in-a-generation reset of our health and disability system so that it is better balanced towards wellness, access, equity and sustainability.

The panel’s final report and recommendations will be delivered to the Government in March next year.
I’d like to thank you all again for gathering here today to share your ideas about Planned Care.

I look forward to hearing the outcomes of these workshops and wish you all the best for your discussions. 

No reira, tēnā koutou, tēnā koutou, tēnā ra tātou katoa.