Third reading, NZPHD Bill

  • Annette King

Mr Speaker, I move that the New Zealand Public Health and Disability Bill be now read for the third time.

Mr Speaker, I feel a genuine sense of warmth and satisfaction that this Bill should now have reached this stage. And I know that all around New Zealand people will feel reassured that we are reclaiming a genuine public health service putting people and services first.

There has been much debate in the past few days about details of the Bill. Today, however, I want to talk about its spirit and general principals, because that is where this Government's vision for the health service has particularly struck a chord around the country.

And the reason they like what this Government is doing is that we are putting the word public back into our health service. There is only one reason to have a public health service in New Zealand. It is an overwhelming reason. It is to improve the health of New Zealanders.

All the changes that will be introduced into the health sector, immediately or gradually, following the passage of this Bill have that one guiding principle driving them. This Labour-Alliance Government wants to improve the health statistics affecting all New Zealanders, regardless of where they live, regardless of their race, regardless of their socio-economic circumstances.

I should recap on the main structural changes occurring as a result of this legislation.
· The New Zealand Public Health and Disability Bill repeals and replaces the Health and Disability Services Act 1993.
· The Health Reforms (Transitional Provisions) Act 1993 is also amended and renamed.
· The Bill disestablishes the Health Funding Authority and the Hospital and Health Services (HHSs).
· Twenty one Districts Health Boards (DHBs) will be established replacing the HHSs. The Ministry of Health and the DHBs will carry out the functions presently carried out by the HFA.

Those changes will allow us to achieve what we want to achieve in terms of health, but what people will really notice eventually about the new health service is the new emphasis and priorities.

At the beginning of the year, one journalist wrote a cynical story saying that all that was going to change was the initials, the HHSs becoming DHBs and so on. That journalist was right only in the sense that initials do not matter, but completely failed to understand what the structures are set up to do.

This Government is committed to the need to reduce shameful health disparities between population groups. That requires a long-term, collaborative approach that involves empowering communities to make decisions about the health needs of their own people.

The new public health service will embrace a population health focus for providing health services. We want to provide more funding where the population needs are greatest. We want people to judge our health service by the number of people we succeed in keeping out of hospital, succeed in keeping well within their own communities.

We need to be able to deliver quality health care to remote parts of New Zealand, to prevent people, particularly children, becoming sick in the first place. That, most simply, is the radical difference between our vision and the reality we have had for the past few years.

The health changes are about taking a cooperative and collaborative approach to personal health, public health and disability support services. The DHBs will be charged with leading the population approach to health care, and will be required to establish three core advisory committees: the community and public health advisory committee, the disability support advisory committee, and the hospital advisory committee.

Mr Speaker, arguments and debate about this Bill have centred on the fine print. The big picture is still intact, and it is the first time for a decade that there has been a big picture in terms of the health of New Zealanders, That is something to celebrate.

This big picture recognises that there are significant health disparities in New Zealand. There is a need, as the previous Government recognised, for focussed health programmes to target specific population groups. There is, however, an essential difference between health programmes and health treatment services. No one will receive preferential health services solely on the basis of race.

Perhaps the key ingredient of the Bill is that it requires the Minister to determine a New Zealand health strategy to provide a framework for improving the health of people and communities. A similar strategy must be determined in relation to disability support services.

It is clear, however, and the Bill reinforces this, that the determinants of good health are also influenced by housing, employment, education and other social issues. This fact will be recognised in the health and disability strategies. Under the Bill DHBs will be required to take account of the New Zealand health and disability strategies when developing their strategic plans and their annual plans.

This Bill fits within this Government's overall social objectives for New Zealand. The social sector in New Zealand has been run down for the past decade. This Bill is one of the many stakes that are being put in the ground by this Labour-Alliance Government as it helps to make it possible to create once again a fairer society in New Zealand.

Mr Speaker, it is important to recognise that a country the size of New Zealand will always be limited in what it can provide in terms of health care by what it can afford to fund. That limitation makes it even more important that we spend those dollars wisely and fairly. That is what the objectives in the New Zealand Health Strategy are all about.

Mr Speaker, this Labour-Alliance Government came into office pledged to provide an open and accountable public health service people could trust. We are delighted to be providing the means to make this vision a reality just 12 months later.

This Bill is, in effect, an empowering Bill. It empowers health professionals, and it empowers New Zealand communities. Now we ask everyone in the health sector to work together cooperatively and collaboratively to make this new public health service work for us all.