# Ministry of Health (New Zealand)

The Ministry of Health (Māori: Manatū Hauora) is the public service department of New Zealand responsible for healthcare in New Zealand. It came into existence in its current form in 1993. The organisation was founded in 1901 as the Department of Public Health in 1901, and was renamed to Department of Health in 1922.

## History
### Origins

The Ministry of Health's origins can be traced back to the Department of Public Health, which was first established in 1901 at the advice of the Central Board of Health. The Department of Public Health assumed responsibility for the provision of Māori health services between 1906 and 1909, when Māori medical health services were returned to the-then Department of Native Affairs. In 1910, the Public Health Department resumed responsibility for the control of Māori health. In 1911, a Māori Nursing Service was established as part of the Department of Public Health.

### Growing strains

Under the Health Act 1920, major organisational changes were mandated. Seven separate divisions were created within the department, each headed by its own director. The department was renamed the Department of Health in 1922, dropping the word public. The structure remained relatively static even when the Social Security Act 1938 was passed where the New Zealand government took a larger role in health purchasing. The department remained actively involved in policy (as opposed to purchasing).
In 1947 the department assumed responsibility for the administration and operation of psychiatric hospitals after the Mental Hospitals Department was abolished and became the division of mental hygiene at the department.
By the 1970s problems had appeared in the health system. The high growth rate in hospital expenditure was occurring at a time when the economy was slowing down. Thus, the government was unable to sustain funding this growth. This led the health system to undergo a series of changes over a 20-year period from the 1980s.

### Fourth National Government, 1990–1999

During the 1990s the Fourth National Government attempted to stream-line the system in a series of reforms such as separating the government purchasing and provision of health care services. Four regional health authorities (RHAs) were created to oversee the purchasing of health services while general practitioners, specialists, and hospitals were tasked with delivering health services. Public services were also turned into quasi-commercial Crown health enterprises (CHEs). In 1993, the Department was renamed as the Ministry of Health.

### Fifth Labour Government, 1999–2008

The Labour–Alliance coalition government redefined the role of the Ministry of Health as part of Labour's election promises in the 1999 election.
In December 1999, the separate government health service purchasing entity, the Health Funding Authority, was merged with the Ministry of Health. Critics were anxious as to how the Ministry would perform as a funder, as they commented that the Ministry had in the past only performed as a policy organisation. However, supporters of this move stated that they believed this would make these agencies more accountable.
In February 2001, the Fifth Labour Government also launched the "New Zealand Primary Health Care Strategy" (PHCS) with the goal of improving public access to primary health care and reducing health inequalities. By 2008, the Primary Health Care Strategy had succeeded in reducing fees for doctors' and nurses' visits in "higher need areas" and for patients aged over 65 years. In addition, consultation rates increased across all age, socio-economic, and ethnic groups in New Zealand.
As part of the PHCS programme, the government encouraged the development of Primary Health Organisations (PHOs) to provide some primary health care services at the local level and to transition health care services from fee-for-service arrangements to capitation funding for health professionals who are members of these organisations. By early April 2003, 34 PHOs had been established throughout New Zealand.
In addition, the Fifth Labour Government established District health board (DHBs) in 2001 as subsidiary organisations of the Health Ministry. They were responsible for providing and funding health services within a defined geographical area. At the time of their dissolution in July 2022, there were twenty DHBs. They were also responsible for running hospitals and funding some health provisions in their respective areas. Funding for these DHBs was allocated according to the Ministry's population-based funding formula.

### Sixth Labour Government, 2017–2023

In 2018, the government launched the He Ara Oranga inquiry into mental health and addiction. In 2021, this resulted in the creation of Te Hiringa Mahara, an independent Crown entity that promotes mental health and wellbeing.
On 10 September 2019, Prime Minister Jacinda Ardern and Health Minister David Clark announced the establishment of a Suicide Prevention Office within the Health Ministry to address the country's suicide rate. Key changes include shifting from a mental health service model to a community-based one and supporting people bereaved by suicide. There were also plans to later establish the Suicide Prevention Office as a separate standalone government service.
The Ministry of Health was the agency responsible for the New Zealand government response to the COVID-19 pandemic.
In April 2021, the Sixth Labour Government announced that DHB system would be abolished and replaced by three new entities: a centralised agency called Health New Zealand, a Māori Health Authority (MHA) to fund Māori health services, and a Public Health Agency to centralise public health work.
In October 2021, the government introduced a parliamentary bill called the Pae Ora (Healthy Futures) Bill, which created the new public health entities and strengthened the Health Ministry's stewardship role. This bill passed into law on 7 June 2022. On 1 July, the Pae Ora (Health Futures) Act came into effect; with Health New Zealand, the MHA, and the Health Ministry's Public Health Agency assuming the district health boards' former provision of healthcare services.

### Sixth National Government, 2023–present

In March 2024, the Health Ministry proposed slashing 180 jobs following a cost-saving directive from the National-led coalition government. In early April 2024, the Public Service Association expressed concerns that proposed job cuts at the Health Ministry would lead to the closure of the Suicide Prevention Office and other specialist roles. The PSA's statement was disputed by the Minister for Mental Health Matt Doocey, who said he had not been briefed about the closure of the Suicide Prevention Office. Doocey said he had spoken with the Director-General of Health to ensure the Office would remain open. Doocey reiterated that mental health and suicide prefention remained a priority for the New Zealand Government.

## Organisational structure

The directorates and business units of the Ministry include:
* Evidence Research and Innovation directorate
* Strategy Policy and Legislation directorate
* Māori Health directorate
* Public Health Agency
* Regulatory Services directorate
* System Performance & Monitoring directorate
* Government & Executive Services directorate
* Corporate Services directorate
* Chief Clinical Officers
** Chief Nurse
** Chief Medical Officer
** Chief Allied Health Professions Officer

### Others

Medsafe carries out medical regulatory functions within the Ministry.
The former National Health Board (NHB), which was set up in November 2009, dealt with issues such as rising costs, increased demand, an ageing population and shortages of staff with a view to improving the quality, safety and sustainability of health care.
Health New Zealand exists as a separate Crown agent while the Māori Health Authority exists as an independent statutory entity.

### List of directors-general

Directors-General of Health (Chief Executive) are:
| No. | Name | Term of office | Term of office |
| 1 | James Mason | December 1900 | June 1909 |
| 2 | Thomas Valintine | June 1909 | December 1930 |
| 3 | Michael Watt | December 1930 | March 1947 |
| 4 | Thomas Ritchie | March 1947 | February 1950 |
| 5 | John Cairney | February 1950 | October 1959 |
| 6 | Harold Turbott | October 1959 | December 1964 |
| 7 | Doug Kennedy | January 1965 | December 1972 |
| 8 | John Hiddlestone | January 1973 | March 1983 |
| 9 | Ron Baker | April 1983 | March 1986 |
| 10 | George Salmond | March 1986 | May 1991 |
| - | Ian Miller (acting) | May 1991 | January 1992 |
| 11 | Chris Lovelace | January 1992 | June 1995 |
| 12 | Karen Poutasi | June 1995 | July 2006 |
| 13 | Stephen McKernan | July 2006 | July 2010 |
| - | Andrew Bridgman (acting) | July 2010 | January 2011 |
| 14 | Kevin Woods | January 2011 | January 2013 |
| 15 | Chai Chuah | March 2015 | February 2018 |
| (13) | Stephen McKernan (acting) | February 2018 | June 2018 |
| 16 | Ashley Bloomfield | June 2018 | July 2022 |
| 17 | Diana Sarfati | July 2022 | February 2025 |
| - | Audrey Sonerson (acting) | February 2025 | present |

## Ministers

The Ministry serves 2 portfolio and 4 ministers.
| Officeholder | Portfolios | Other responsibilities |
| Hon Simeon Brown | Lead Minister (Ministry of Health) Minister of Health | |
| Hon Matt Doocey | Minister for Mental Health | Associate Minister of Health |
| Hon David Seymour | | Associate Minister of Health (Pharmac) |
| Hon Casey Costello | | Associate Minister of Health |