Speech to NZ Health Symposium, Wellington

Opening

It’s great to be here with you all today. I’m pleased to see a diverse group of leaders from across the sector, as well as the social sector.

We have DHB Chairs, board members, CEs, clinicians and management. I also want to acknowledge our non-DHB Crown Entity leaders. Our NGO and PHO sector are also well represented.

It’s great to see other government agencies have taken this opportunity to participate in this Symposium. Improving the health and well-being of New Zealanders requires a combined effort.

Your Symposium theme of ‘Leading Our Future: Explore – Innovate – Transform’ is highly relevant.

Health Strategy

One of the first things I did as Minister of Health was to ask officials to work on a very clearly laid out direction for healthcare in New Zealand.

At the inaugural Health Symposium last April, I launched the New Zealand Health Strategy. The Strategy covers five themes - people-powered, closer to home, value and high performance, one team, and a smart system.

The five themes of the Health Strategy signal a focus on prevention and wellbeing, and more integrated services.

At the same time we want to see support for innovation, better collaboration, and new ways of working to reach our most vulnerable. We want to give every child a healthy start, and ensure information and services are more accessible.

Leadership

The Ministry plays an active role in facilitating and coordinating the implementation of the Strategy, and I expect the Ministry to take a strong strategic leadership role in driving progress.

I stressed the importance of the Strategy when I met with the new DHB boards recently. I encouraged the Boards to keep the Strategy in mind when making decisions, particularly when they consider the delivery of local services.

One of the Strategy’s themes - ‘one team’ - has a vision of a health system that operates as a team in a collaborative high-trust system. ‘One team’ encompasses the need for leaders to enable change.

I ask you all to take on the challenge of being leaders in a continuously adapting and improving system.

Ultimately, delivery of real transformation must take place through frontline services in homes, schools, pharmacies, general practices, hospitals, and other healthcare locations.

That means everyone involved in health and disability services has a contribution to make.

Progress made

Since the release of the Strategy last year, several programmes are underway which will help deliver against its five themes.

Some of these are in early stages of planning; others are already making a difference to New Zealanders. These are being guided by the Strategy Roadmap.

I’d like to pick out a few examples which show the progress being made.

National Telehealth Service

The National Telehealth Service has now been running for over a year. This flagship initiative links to the ‘smart system’ theme in the Strategy.

The service draws together seven previously separate help-lines. The integration means that New Zealanders receive the appropriate help they need, no matter what phoneline or channel they use.

Registered nurses, mental health and addiction specialists, and poisons specialists provide 24/7 advice, support, assessment of symptoms, triage and treatment advice.

In its first year of operation, the National Telehealth Service helped around 425,000 New Zealanders.

Patient portals

Through the uptake of patient portals we’re beginning to see how health IT can empower patients to be more involved in their care. This fits in well with the Strategy’s ‘people-powered’ theme.

Portal usage continues to grow with over 297,000 New Zealanders now registered to use a portal. 56,000 people signed up to use a portal system in the last quarter - that's more than 4,000 new users a week. To date, 445 practices have introduced a patient portal service.

There are many stories of people with diabetes and other long-term conditions who use a patient portal to help manage their own health. They send their blood glucose results to their GP via the portal, and their GP can make comments.

The move towards a single electronic health record - allowing individuals to communicate their health story, presenting health information in a single view that can be seen by patients and their care team – will also further empower patients to take a more active role in their care.

Closer to home

Telehealth services are a great example of care ‘closer to home’. Most DHBs now use telehealth to deliver services to patients in remote areas and also offer guidance and training to clinicians.

Part of care closer to home includes harnessing the full potential of our health workforce, growing the use of our pharmacists, and also the use of nurse specialists.

A greater focus on prevention is also a key area. There is considerable work underway to deliver better outcomes for children and their families.

Much has been achieved through the combined efforts of service providers, the Ministry and other social sector agencies – but there’s always more to do.

We continue to achieve increases in the enrolment of mothers with midwives and newborn babies with PHOs.

Nationally progress is being made on our Better Public Services targets aimed at improving immunisation rates and reducing rheumatic fever.

Budget 2016 saw an investment of $18 million over four years to extend the Healthy Homes Initiative and ensure more families have warm dry housing. Work is underway to implement this in 11 DHBs.

We’re also making progress through the Government’s Childhood Obesity Plan.

Central to the Plan is the new Raising Healthy Kids target. The latest target results released today show that since the target was introduced last July, the number of obese children referred for help has increased to 72 per cent, that’s a 23 per cent rise on the last quarter.

I’d also like to acknowledge DHBs which have shown leadership by collectively agreeing to stop selling sugar-sweetened drinks. Through their public health units, they’re also helping primary schools to adopt a water and milk only policy.

Value and high performance theme

We developed performance monitoring systems based increasingly on outcomes, with accountability for health and disability services. This is a good example of the Strategy’s ‘value and high performance’ theme.

Getting this right is a complex undertaking, but the system-level measures are a step in the right direction towards achieving important outcomes, such as keeping children out of hospital, and improving care from the perspective of patients.

I am also looking to implement a more streamlined planning process for DHBs. The 2017/18 DHB annual planning requirements will be kept to a minimum and focus more on statutory requirements along with my specific expectations as Minister which are tailored for each DHB.

I want to provide greater freedom for leaders to focus on longer-term planning within DHB localities, rather than putting energy into an intensive yearly planning cycle.

One team approach

Establishing an annual forum which allows the whole system to share best practice and help build a culture of trust and partnership supports the ‘one team’ approach.

So this Symposium is another good example of the Strategy’s implementation.

Innovation at a local level

There are an increasing number of examples of innovation at the local and regional level. I receive regular updates on some of the work being undertaken by DHBs and partner organisations to advance the Strategy.

For example, a number of DHBs are supporting the Health Navigator website where the public can access reliable health information.

Counties Manukau DHB has introduced a comprehensive health service into Papakura High school. It brings together general practice, mental health and a youth worker.

In MidCentral hospital specialists are working with general practice teams to deliver better specialist care closer to home for older people with complex needs.

In the Bay of Plenty, 98 per cent of community pharmacies are signed up with Medcheck which enables pharmacy dispensing information to be uploaded to hospital databases where clinicians can access it, improving the safety of patient care.

Changing the way we work

To support the delivery of the Strategy, there have been significant changes within the Ministry of Health. I would like to acknowledge everyone involved in this process.

I’m also aware the Ministry and DHBs are collaborating to a greater extent with the social sector. This is particularly important for supporting vulnerable families and progressing outcomes for children and young people.

Health overview

I’d like to finish with a short update on the sector.

Funding

Health has remained the Government’s number one funding priority. The Government’s investment in health will reach a record $16.1 billion in 2016/17.

Claims that health funding has been cut are incorrect. Over the last eight years, health funding has kept up with demographic pressure and inflation.

We’re also focused on delivering results, ensuring New Zealanders can access more services.

Priorities

In terms of the Government’s priorities for health, we want to see continued progress on non-communicable diseases. Implementing the Childhood Obesity Plan is a key focus.

Another area of focus continues to be lifting elective surgery rates. The answer to increased demand is to do more, whether it’s appointments or operations.

The health targets continue to be a priority. They are not just about numbers – they’re about delivering better and quicker access to important health services.

Mental health is also top of the list of priorities. Mental health and addiction services are responding to increased demand.

We’ve increased mental health and addiction services funding from $1.1 billion in 2008/09 to over $1.4 billion for 2015/16.

Closing

There’s always more to be done in health, and that’s what the Government is focused on delivering.

I hope you enjoy the rest of the conference, and use it as an opportunity to consider how you can drive future health solutions.