Māori will be in control of their own health in a revamped system in which all 20 District Health Boards (DHBs) will be combined into a centralised model.
In a major shake-up of the health sector, the Government plans to create a new organisation, Health NZ, to replace the 20 DHBs, to enable simplicity and consistency of healthcare across New Zealand.
The Government will also create a Māori Health Authority, which will work in partnership with Health NZ to commission care across the country, ensuring the needs and expectations of Māori are met through design and delivery.
The Ministry of Health will still play a central role in providing advice to the Health Minister on health strategy and policy. It's hoped the Ministry of Health will have better visibility of health as a whole under the simplified system.
A new Public Health Agency will also be established in response to COVID-19, so New Zealand is better prepared for future outbreaks and pandemics. The centralised unit will provide technical expertise to the Ministry of Health.
The shake-up of the sector is a response to the Health and Disability System Review, led by Helen Clark's former chief of staff Heather Simpson, which found the public health system, was complex and not equitable for Kiwis.
The current system has been criticised as fragmented and convoluted. A 'postcode lottery' means the care Kiwis receive depends on where they live and what DHB covers them.
It's led to inequitable outcomes in health for Māori and Pacific communities, as well as disabled people, as highlighted in Heather Simpson's review.
The spread-out health system across 20 DHBs also means there is limited national planning, meaning decisions that could be made once for the whole population are often repeated multiple times, wasting time and money.
The old system
The new system
Health Minister Andrew Little says the reforms are not about cutting spending or reducing the health workforce.
"We need greater spending in health, not less, and more, not fewer, people working in the future health system," he said. "The reformed system will need to harness all the best skills and talent across the current organisations."
The interim Health and Disability System Review report in 2019 found Māori have "not been served well by the system", and the "system overall has not delivered Māori health and wellbeing outcomes that are fair".
The new Māori Health Authority will give Māori greater decision-making power in health, which is welcomed by National Urban Māori Authority chair Lady Tureiti Moxon.
"The Māori Health Authority was born out of our decades-long Waitangi Tribunal claim thanks to the kaha of those who chose to stand up for our people against the might of the DHBs and the Ministry of Health," she said.
"Māori finally get to hold the pen to determine health outcomes for our own people."
Māori Party co-leaders Rawiri Waititi is also delighted, describing the establishment of a Māori Health Authority as transformational.
"We applaud the admission that the current system no longer serves our needs and we also applaud the intention to address inequities and living up to the vision of Te Tiriti o Waitangi," he said.
National leader Judith Collins told The AM Show she is "absolutely" against the separate Māori Health Authority, describing it as "not acceptable".
"People need help through the public health system irrespective of their ethnicity, and they should get it," she said. "I don't accept it's all to do with race or anything like it, a lot of it is people's expectations and what they can do for themselves."
An interim Health NZ organisation and Māori Health Authority will be set up in late 2021, before legislation is passed to establish the formal organisation. The formal date to transfer to the new structure is likely to be July 2022.