New Zealand Health Strategy update

The New Zealand Ministry of Health is leading an update of the New Zealand Health Strategy.

From 27 October to 4 December 2015, the Ministry of Health consulted on the draft update to the New Zealand Health Strategy and road-map of actions.  It conducted approximately 90 meetings; talked face-to-face to more than 2,000 people, more than 7,000 consultation documents were downloaded and more than 100 comments were posted on our discussion forum. It also recorded a number of comments during the consultation meetings and assembled many of them in this video.

Transcript

Title: New Zealand Health Strategy Consultation 2015

[Jill Bond, Executive Director, Ministry of Health] We’ve had a fantastic response from people to engage in the consultation process for our draft New Zealand Health Strategy. Consultation has now concluded and we’re really busy having a look at all the feedback and information that we’ve gathered through this important process.

On behalf of the Ministry I’d like to say a huge thank you to everybody who’s been involved in this important work.

As well as more than 400 written submissions received, we’ve heard first hand from more than 2,000 people who have taken part in 100 formal meetings around the country.

[Dr Michael Chen-Xu, New Zealand Medical Association] Wouldn’t it be great if MSD was looking a housing policy, looking at health literacy in education policy and looking at health policies in various other areas of government and their impact on health outcomes – it could be a really good way of ensuring that people not only get well in the health system but live well and stay well.

[Derek Milne, Chair, Wairarapa DHB] I’d like to think we see our over 65s fairly early on to see if they’re actually heading towards diabetes: what’s driving that, are they too obese, not taking enough exercise, heading towards diabetes and actually giving them an early warning about this and saying, hey, you’re going to have a pretty unpleasant end to your life but you can do something about it.

[Mark Peterson, CMO, Hawke’s Bay DHB] You need to do that at 45, not 65 I have to say.

[Derek Milne, Chair, Wairarapa DHB] Well, yeah, yeah.

[Jill Bond, Executive Director, Ministry of Health] The conversation has been mature and thoughtful and the interaction between people has been enthusiastic. This has generated a lot of very useful feedback and worthwhile suggestions, which we are considering as we finalise this Health Strategy.

[Chai Chuah, Director-General of Health] There’s a consistent theme for the Saturday meeting – I haven’t been to all of them, I’ve been to some of them. I think one is the willingness of people to come and contribute and they come and contribute with great passion. So this morning I’ve met someone from public health, I’ve met someone from smoking cessation, I’ve met some board members, I’ve met practice nurses, I’ve met people from other government departments. All these people come with the desire to actually want to contribute and make something different.

If you watch around the discussion in the room there’s no lack of energy and that’s a good indication to me that people actually want to make a difference here and that they want this Strategy to make a difference.

[Jill Bond, Executive Director, Ministry of Health] We’ve also had a big response on-line. More than 6,500 people have visited the consultation website and the consultation documents have been downloaded nearly 7,000 times. Around 2000 people have visited the online discussion and left more than 100 comments on it.

People are enthusiastic about the five themes – people-powered, closer to home, value and high performance, one team and smart system. Here’s some of the comments we’ve received during consultation.

[Dr Margaret Wilsher, CMO, Auckland DHB] So we want the focus to be on the person in the home. We want to focus on health before sickness. We want people to maintain their health for as long as they can but when they become sick we want them to be able to direct their own support and their own care.

[Karen Orsborn, General Manager, Health Quality & Safety Commission] I think we should have consumers involved at all levels of the health system. I think that’s the one thing that would make a difference because it would be a catalyst for driving change to make services be more responsive to consumers.

[Vivien Pole, Manager Service Development and Integration, Alliance Health Plus] I like the five areas of focus of the Health Strategy that they’re looking at and People Powered is exactly what I was referring to in touching peoples’ hearts, because when they own it they feel empowered and they make change because you can’t force somebody to make a change. The People Power will definitely be helpful but you have to deliver it in a way that people will embrace it and support it and take it on board. We need a system that responds to the needs of the community.

[Dr Kathleen Logan, Office of the Children’s Commissioner] I think children’s services should include parenting support information for parents so they can learn about nutrition and the other things that children need to grow up well – behaviour support so their mental health can be supported as well and their cognitive development can proceed well and all those things will make for better childhood.

[Tony Kake, CEO, Papakura Marae] It was really good to hear this morning the intent to drop down those silos, to break into an interactive model. So you know I am encouraged by that. I really want to support that happening. It’s kind of like the approach we have here on a marae anyway. We don’t just deal with the health issues in isolation. My doctors, my nurses up at the clinic interacting with my social services arm, nurses, our driver’s licence programme. Those are the things that our whānau really need. That’s just part of our approach to integration.

[Stephanie Erick, Director, Action on Smoking and Health] I was really excited to hear about the move towards health services in schools and bolstering that up a bit more. Perfect for Pacific communities. You know we come from homes where people are busy. A lot of parents are working. A lot of parents don’t have transport to get to the services they need to get to so if children are able to learn at a younger age to consider their health then perhaps when they turn into young adults they will use health services rather than figure it out from friends or Facebook and so forth. So I think that’s a really good opportunity.

[Boy] Doctors.

[Interviewer] What makes you healthy?

[Boy] Fruit.

[Maioha] Motivate them more, try and get more social sports out there and encourage the young ones to give it a go.

[Te Aho] Make it compulsory for Year 9s or whatever in high school to do sports. You’re able to do more things and play sports when you’re older as well.

[Dr Kathleen Logan, Office of the Children’s Commissioner] Well, the thing I put down was children’s access to Well Child Tamariki Ora services. I think it’s something if all children at access to them - and I mean all children, nobody missing out – it means that you’ve got a better start in life and if you start in life well it means all the other things you spend money on in terms of health care have a better outcome. So that more children can start off with more access to the health care they need because they don’t know when they need to go to the doctor. They always depend on other people to get them the health care they need. So the services need to be quite joined up, culturally competent and delivering to all children.

[James (Hemi) Hokianga, Consumer representative] It came to a point where I’m in a small community and they had all these other places, courses, group sessions I could attend to deal with certain parts of your life. One would be alcohol and other drugs, one was diabetes and by the way that’s awesome, really awesome. I did four. I was really hooked into it because the dietitians were able to explain how food works, and how the body reacts to food as well. So that was a real eye-opener.

[Matiu Rei, Executive Director, Ngāti Toa Rangitira] I think the closer to home services is about knowing who your people are and know your services and if you can get that understanding, know that we’re here to help and we will do it in ways that’s more accessible to them.

[Brendan Boyle, Chief Executive, Ministry of Social Development] So, how are we going to bring ourselves together in a way that we can make it easier for them and given the complexity of a lot of the issues it actually requires much more than one particular agency to solve these kind of problems?

It’s actually information sharing, data analytics, shared ways of describing and understanding our clients, where they cross over the multiple agencies. So structuring information and having that information readily available is very important.

The other component which is probably under-estimated but is probably the biggest issue is cultural. It’s actually people in government agencies being prepared to share, being prepared to work together and in some cases being prepared to let go and allow others to fill a gap where it might currently exist.

[Musa Memo Chief Executive, New Zealand Nurses Organisation] I don’t think it’s particularly one thing – I think there are multiple which would be connected but I think the biggest challenge I see now is actually rethinking the funding model. That in turn results in the way services are either commissioned, purchased and then the workforce to support them.

[Emma Hickson, Nurse Educator, Capital & Coast DHB] Working in the system I see there’s a huge duplication of assessment as an example, which is why it’s so important – there’d be great efficiencies if we could only stop the duplications and share information among clinicians from health to social sectors. You know it’s across the board and so instead of everybody going in and asking the same questions of the poor consumer we should actually share that information and collaborate and know each other’s roles better as a consequence of that.

[Ashley Bloomfield, Chief Executive, Hutt Valley DHB] Oh look, the one thing from where I’m sitting now in a DHB CE role would be for us to really think about the progress we’ve made over the last six years in moving services into primary and community and progress has been quite limited. What is it that we have to do from a policy, funding, a workforce and infrastructure perspective that means over the next 15 years we absolutely are able to make that shift, as we have to speed up that process.

[Dr Mark Peterson, CMO, Hawke’s Bay DHB] The biggest difference? I think it’s actually addressing the social determinants of health and that’s actually income and social welfare and the equity problems we have.

[Sally Faisandier, Principal Research Advisor, ACC] Sign up to this. Get serious about it. Build it into the Statement of Intent, then the targeting, then the KPIs and keep it going and have people who are really championing the approach. And this isn’t just about the Ministry of Health actually. It’s about all other agencies as well so it does need a community to support it.

[Kathryn Cook, CEO MidCentral DHB] One of the things I’m picking up here is the need to challenge some of the established norms, the way we do things, the values and behaviours of our system, leaving behind things that are not making a difference. I think talking about a different way of contributing, working and I think that’s really refreshing.

[Dr Ros Gellatly, Chief Medical Advisor – Primary, Nelson Marlborough DHB] To teach everyone to use the Model for Improvement so that everybody – consumers, providers right across the whole system – are looking at testing and improving things all the time, measuring what we are doing, knowing if we’re making an improvement. It just empowers people to say we’ve got a good idea, let’s test this out, let’s do it.

[Kate Wang, Wellington Free Ambulance] If we can break the boundaries and make some flexible. Of course you measure the outcome of what we’re trying to achieve but I think that’s the most important thing to me.

[Te Puea Winiata, CEO, Turuki Health Centre] I also want to mention that with the Health Strategy, workforce development is of ongoing importance for bringing services to be more culturally competent and more responsive, more whānau-centric.

[Forum attendee] I think a nationalised health IT system. I think everybody would agree on this as being a good idea but I think it has some massive practical challenges.

[James (Hemi) Hokianga, Consumer representative] The main thing is the system. I feel there’s not enough connections to different departments where they can gather this information. A patient comes in and they can only gather information from certain departments.

[Erin Reeves-McMillan, Consumer representative] There’s not enough connection I think across the whole country and between DHBs in terms of medical records and what happens to people and when people move and things. It’s quite hard to access all of that. And I also think that the investment in the information technology is the key thing as well.

[Dr Richard Medlicott, Island Bay Medical Centre] We know that computer algorithms can often come up with better decisions around relatively simple stuff for example warfarin dosing to thin your blood, or managing your diabetes with insulin dosing. So that gives us more time to talk with the patient about what diabetes means to them or why are they on that agent that thins their blood. So it gives us more time to communicating the meaning of it with the patient.

[Jill Bond, Executive Director, Ministry of Health] These are just a few of the many comments that we’ve heard during the course of consultation on the Strategy. We also heard a lot over the consultation period about the need to focus on a better end of life. Shortly we will be releasing new principles and guidelines called Last Days of Life. This is a great example of the sector, the Ministry and consumers working together to produce something that is tangible and clearly needed. This is an example that we expect to see more of in the future and we’ll be able to have these discussions in future forums when we come together to discuss really important things that matter not only to the system but to the people of New Zealand.

[Te Puea Winiata, CEO, Turiki Health Centre] I’m very excited about the Health Strategy and the direction we’re travelling on. I think it is important that the Strategy framework will encourage innovative spaces for whanau and providers and the sector to work in, ensure we understand what success looks like to them, what wellbeing looks like to them. It’s important that the Strategy supports collaborative working together, using resources, wisdom, collective support to encourage better outcomes.

[Jill Bond, Executive Director, Ministry of Health] We’re hearing people want change and they want that change happen with pace. So here at the Ministry we’re making changes so we are better able to lead that Strategy and to work alongside the sector and our colleagues across government to make a difference. Achieving outcomes for all New Zealanders will require us to work really smartly with DHBs, with consumer groups, with PHOs and NGOs and this will require us to build to our strengths, know our roles, responsibilities and accountabilities and make a real difference together.

[Chai Chuah, Director-General of Health] I think one of the things we’ll be looking at is keeping the momentum up so this is not a process that we run just during consultation. Each year we’ll be looking at holding at least one of these so we use the opportunity for people to hear our feedback about what’s gone well, what we’re thinking about for the following year and actually get their feedback as well. I think this is a great success.

We appreciate the time people have put into this process and the thoughtfulness of feedback. We want to make a difference to the way the New Zealand health system supports New Zealanders during the next 10 years and the way with which people have engaged with this process has helped enormously.

During the coming months the Ministry of Health will analyse the feedback to the draft strategy and a final strategy will be produced by the middle of 2016.

Background to the strategy update

The New Zealand Health Strategy has not been updated since 2000.

The draft updated Strategy proposes a clear view of the future we want for the health system over the next 10 years, to ensure all New Zealanders live well, stay well, get well. A Roadmap of Actions proposes a direction of travel for the next 5 years.

The draft updated Strategy covers challenges and opportunities for the health system, the future we want, including principles and behaviour that will enable it, and 5 strategic themes:

  1. people-powered
  2. closer to home
  3. value and high performance
  4. one team
  5. smart systems.

The 7 original guiding principles remain, with a new principle added: thinking beyond narrow definitions of health and collaborating with others to achieve wellbeing. Including this principle signals the need for new ways of working and challenges us to evolve from a good health system to a great one.

Priorities include prevention and wellbeing, more integrated services, support for innovation, better collaboration, new ways of working to reach our most vulnerable, giving every child a healthy start, and ensuring information and services are more accessible.

You can read the draft Future Direction and Roadmap of Actions at New Zealand Health Strategy consultation.

Engagement to date

The Ministry has developed the draft update of the Health Strategy with input from clinicians, leaders and organisations in the health, disability and social sectors. This included a series of meetings and workshops. Find out more at Sector feedback on the New Zealand Health Strategy update.

In addition to wide engagement, inputs to the draft update include other government programmes and initiatives, for instance, Better Public Services targets; independent reviews on sector funding and sector capability and capacity; and the Productivity Commission's recent report on social services.

Next steps

All feedback will be carefully considered and common themes reflected in any changes to the updated New Zealand Health Strategy. A final updated Health Strategy is expected to be released in the first half of 2016.

Hear about the strategy update

Transcript

Chai Chuah - Director-General of Health: The vision for the updated Health Strategy is that all New Zealanders live well, stay well and get well.

The reason for the change is that it’s been 15 years since the last Strategy was released and many things have changed during that time. The direction given in the Strategy will help all of us focus on the direction of travel so that we are unified when we look at how we respond to the challenges we face in the future.

The fundamental thing about the refreshed Strategy is that it not only articulates the five themes in there but the important thing is not just a theme but how we are all within the system changing our mind-set and behaviours in responding to the themes and that’s really important because the document can only become a reality if there’s a mind-set change and a behaviour change from all of us throughout the system.

One of the things around the mind-set change is how we work with other participants in the system and what I mean by that is colleagues from Education, colleagues from Ministry of Social Development, colleagues from Housing, colleagues from the Justice sector, as well as other colleagues working in the local government, NGOs and even the private sector. I know that this has already been done in the sector by some organisations but what this Strategy clearly states is that this Strategy needs to be the norm as opposed to the exception and I look forward to an acceleration of that right across the sector on this particular theme.

But in the end I think that what we really need to think about is in our actions we focus on the words “needing to care” in the first instance and not just focusing on the health part of the healthcare equation.

Ron Dunham, Chair of DHB CEOs: The Health Strategy is the whole team health approach to improving the status of the population in New Zealand. We need a pathway and a plan to go down that track and we’ve got to work together on it.

The Strategy gives us an understanding of the needs of the populations for a start and our communities. We need to understand our population. We need to understand their needs. We need to understand what it takes to make an improvement to the health of the people in our community and we can only do that together. District health boards are only one component of the New Zealand health sector but they are an important component and they need to work with other components of that sector to get that improvement.

What makes us healthy or unhealthy is not just the health system per se. It’s a whole lot of different things that can be influenced by the council, it can be influenced by education, it can be influenced by social development and it’s a matter of us all concentrating on finding solutions for children and for families and if we find a child that needs to be supported in having breakfast before school, special education needs, needs to be immunised, needs their teeth fixed, needs to have their accommodation or housing sorted for them, then we can work together on finding those solutions. So it’s a great opportunity.

Dr Margaret Wilsher, CMO, Auckland DHB: People-centred care means putting the patient right in the middle of the health equation and it means taking the focus off the hospitals and in to the home, which is where people live. It’s where they have their recreational activities; it’s where their family is around them. So we want the focus to be on the person in the home. We want to focus on health before sickness. We want people to maintain their health for as long as they can but when they become sick we want them to be able to direct their won support and their own care.

First of all we need to talk to them as equals – as partners in their own care. Not with the doctor/patient relationship where the doctor has all the power historically but we want to redress that and put patients and families back in charge. We want to know what matters to them, not what matters to us as a health system, and how we can wrap the services around them in the setting that is most appropriate for them.

We ask patients and families for their opinions about the services we offer. There are on-line surveys and paper surveys. We have focus groups where we interview patients and we bring patients and families with us now to co-design our services. So we’re thinking about service delivery from the patient’s perspective and then we can develop the service and test it with patients and families and then roll it out.

The hospital staff have embraced it because it’s so rewarding working with patients and families, seeing what really matters to them. When we start having conversations with patients and their families, those conversations count.

The Health Strategy signals a new direction for us and it needs to be a document that appeals to our communities and our patients and families, and also the well communities as well as the clinicians and providers of health care. So it has to embrace the direction of travel we think will make the biggest difference to the health of New Zealanders as a whole.

This is not a document merely for economic purposes. It’s actually about getting wellness in to our communities and maintaining it.

Matiu Rei, Executive Director, Ngati Toa Rangatira: Our population is basically 36% Maori, 34% Pacific and 17% European and a we have a number of Asian and migrant groups.

So it’s different. Probably unique in the country. We have 70% of our population either have a chronic condition or are heading toward a chronic condition. Diabetes, obesity are two in particular. And of course they're linked as well, with CVD issues, respiratory issues. And so we have to do things differently. And we have to be close.

Well I think the closer to home is really about knowing who your people are and know your services and if you can get that understanding, know that we’re here to help and we will do it in ways that’s more accessible to them. That’s best for the provider and the community as well. That’s why right from the beginning we’ve had a programme of trying to create opportunities for our patients so that they come here to any one of our medical centres and we will provide workshops to address issues and give them a better understanding.

We’ve done a lot of value-added stuff like we have a free gymnasium for example. We run daily programmes in which people can come along and improve their mobility. If you’re an elderly person do muscle-strengthening to prevent falls, for young people we run cross-fit programmes and that attracts them into the service. They get the opportunity to use our gym and we get the opportunity to use our services and we can tell them more about how they can engage better with our health and the service.

Man on exer-cycle: I come down every morning for a half hour workout. Just to get the bones and the body going.

Matiu Rei: I like to think we’re making a difference to our population group. Our most important thing is getting people to understand that if they do have a health issue, than they and us, we need to work together to address that issue to make their lives better.

Robyn Scott, CEO, Age Concern NZ: When I think about one team approach I think about the care that my mother received through a hospital in New Zealand and the complete seamless integration from her referral to a specialist through to very complex surgery in hospital, through to a long stay in hospital, through to the hospital liaising with other services that she was going to need once she left hospital, right through to being back at home and a large NGO in New Zealand having to provide seamless transport services to transport her regularly back into hospital.

So volunteers transported her back to hospital. They made sure she got to the right place in the hospital. If she was in the wrong place somebody in the hospital took her to the right place and she was delivered back. And the seamless execution and the provision of home and community services to support her to be well, get well, stay well and recover at home worked very nicely and neatly.

I think that is an example of something that is very desirable in the health care system and if we could provide that really seamless integration that made it easy for an older person to navigate the health system with a minimum of effort, I think that’s really desirable.

I do believe that it’s not only systems that prevent things from happening like that; it’s actually people’s attitudes. Anything can happen if people have got a will to make it happen. So people-centred care is going to be really important for the future, with a growing number of baby boomers who have high expectations of the world as they grow older and live for longer.

Dr Richard Medlicott, GP, Island Bay Medical Centre: Well, information needs to follow patients. We often have situations where a patient is going off to see a specialist or through to the hospital or coming through to see us and to manage them you really need to have information and having connected systems lets you treat the patient appropriately with those tools.

Well I think the main thing that we’re doing here which we’re certainly promoting more widely is the use of patient portals. So that’s where people can log on, see their own health information, see their results, order prescriptions, message their GP or nurse. It’s a nice way of fostering the relationship between the doctor and the patient.

I think the reality is that any change can make people nervous but we don’t get a lot of emails coming in compared with say the number of requests to phone someone, or little notes that are left through the receptionist. So it’s another way of doing what you’re already doing and when you look at how often patients log in to see their results there’s a ratio of about 10 to 1 so they’re using it a lot. They’ve been universally very positive about the portal.

A new innovation we’ve got with that is the app for mobile devices and they really enjoy having that accessibility and I think looking forward to the future more and more stuff is going to be on mobile platforms.

We’re up to about 30, 35% of adult patients using the portal of the ones who have email addresses. There’s a certain population who are not particularly interested in it and it’s not the elderly. It tends to be the younger, healthier people who don’t have a need for it. You tend to find that it follows people’s needs. If they think they’ve got health conditions that need monitoring they’ll sign up for it.

We know that computer algorithms can often come up with better decisions around relatively simple stuff for example warfarin dosing to thin your blood, or managing your diabetes with insulin dosing. So that gives us more time to talk with the patient about what diabetes means to them or why are they on that agent that thins their blood. So it gives us more time to communicating the meaning of it with the patient.

I’m looking forward to the Health Strategy and what’s coming next.

Stephanie Erick, Action on Smoking and Health: What I’ve learnt today is there is a movement towards more preventative health and that fits perfectly for me in what I envision for Pacific communities and Pacific families. I think that’s great that there’s that move there.

I’m really excited about the space for more innovation and collaboration because I think that’s really important.

I think that our communities have a space in this Strategy and that’s important too. It will just have to be communicated well to them but overall I’m really excited about this Strategy. I think we need to view it as an opportunity for some excellent change.

I think what would make some of the biggest change is that the Ministry of Health are looking at everyone else to support health for all New Zealanders and that’s great. They would be the stewards of health which is fantastic and the enablers for it to happen but I think the change in leadership to looking at everyone being responsible is really good.

I was really excited to hear about the move towards health services within schools and bolstering that up a bit more. I think that’s perfect for Pacific communities. You know, we’re communities that come from homes that are busy. A lot of parents are working. Grandparents don’t have transport to get to the services they need to get to so if children are able to learn at a younger age to consider their health then perhaps when they turn into young adults it will be second nature for them to access health services rather than to go to friends or figure it out for themselves on Facebook and so forth. So I think it’s a really good opportunity.

Get to understand the Strategy. Turn up to a meeting or two. To pull the strategy offline. To start having a discussion about it and to see where they can fit.

Vivien Pole, Alliance Health Plus: We have the Healthy Village Action Zone which is a parish nurse service that we offer to 28 churches. We use another provider to help us – Tongan Health Society. So we work with them to encourage healthy living, self-management that was covered today. There was also a bit on nutrition and healthy living, fitness and training and so it’s empowering the community to take ownership of their own health.

So we thought for Pacific people to make a behaviour change you need to touch the heart.

Speaker 1: We need a system that responds to the need of the community.

Speaker 2: Making sure that we all own that Strategy.

Vivien Pole: And I like the five focuses of the Health Strategy that they’re looking at and ‘people power’ is exactly what I was referring to in touching peoples’ hearts, because when they own it they feel empowered and they can make the change.

So people power is definitely going to be helpful but you have to deliver it in a way that people will embrace and support that and take it on board.

Until you achieve that it will be very difficult for people to commit and take ownership and do it themselves. And there's so many literatures, there's so many health education ... There is free services available but our people don’t always access it and it’s good to be told what to do but it’s making the move – it’s making that first step to make the change that is the difficult part.

And so I believe that in a Pacific setting you’ve got to engage people. You’ve got to come down to their level instead of reading a script or reading it from resources. You have to understand them well in order to connect at a level that will initiate change.

Te Puea Winiata, Turuki Health Centre: Turuki was started in 1995 by a group of midwives who started the service in Mangere and as the organisation grew we began to understand that health outcomes were not going to be achieved in the health sector alone, that we really needed to include a range of other issues to be dealt with, such as housing, employment and education and also linking people with the services that they needed.

So over a period of time we looked at how we could actually deliver services closer to home and now 90 percent of our services are delivered in the community.

Our GP service has remained in Mangere but over the last couple of years we’ve looked at opportunities for us to deliver health services differently. So we’ve been involved in the rheumatic fever programme and that’s really allowed us to work in schools and for the first time we’ve really touched on being able to access whānau who are not accessing primary care.

So that’s been a very significant development for us and of course we’re swabbing the throats of about 8,000 to 10,000 children a month. And so working with their whānau in the community is really important.

Moving on from that we’ve developed a partnership with a tertiary institution. So now we’re running nurse-led clinics on campus for young and mature students – mainly Māori and Pacific – and we’ve also just received a contract this year to run GP services in the Auckland South Correctional Facility and take our pharmacy with us.

This has led us to thinking more about how we work collaboratively with other organisations already working in this space to deliver better health outcomes for those who have been incarcerated and for their loved ones who come into South Auckland.

So closer to home is about bringing services into the community, about being responsive to whānau needs and to really work with whānau to understand the issues that they’re grappling with and how to deliver them in a more responsive way.

I also want to mention with the Health Strategy that workforce development is of ongoing importance for bringing services to be more culturally competent and more responsive, more whānau-centric.

I’m very excited about the New Zealand Health Strategy and the direction of travel that we’re on. I think it’s important that the Strategy as a policy framework will encourage innovative spaces for whānau and providers and the sector to work in, to ensure that we understand what success looks like to them, what wellbeing looks like to them. It’s important that the Strategy supports collaborative working together, to using resources, wisdom, collective support to encourage better outcomes.

So through this Strategy – the new New Zealand Health Strategy – my hope is that whānau will be able to aspire, to dream, to fly, to thrive, to prosper, to live well and stay well in their community of choice. Mauri ora.

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