Ryall Tony: New Zealand Public Health and Disability Amendment Bill — Second Reading 
Ryall Tony: New Zealand Public Health and Disability Amendment Bill — Second Reading 
[Volume:667;Page:14360] 
Hon TONY RYALL (Minister of Health) 
: 
 I move  
That the New Zealand Public Health and Disability Amendment Bill be now read a second time 
. This is the second reading and report back of the New Zealand Public Health and Disability Amendment Bill which has come back from the Health Committee and I acknowledge the contribution from members on all sides of the House towards the bill. The bill proposes legislative amendments necessary to support the improvements following the recommendations of the ministerial review group earlier last year. It would be fair to say that this is not a major restructuring of the health service; it is really about trying to get the health structure working more effectively. The proposed changes represent a major drive to better value for money in our public health service to enable greater national and regional cooperation in the sector and to reduce duplication and bureaucracy. The changes enable us to improve efficiency and move resources to improve front-line services. 
The main provisions of the bill are a new objective for district health boards to seek most effective and efficient delivery which is a way of ensuring that we move beyond the silo mentality that is such a fixture of so much of anything that central government does in order to ensure that we meet our local regional and national health needs. It has new functions for district health boards to collaborate to work together to ensure the most effective and efficient delivery of services to meet those different levels of community needs. 
As the House will be aware the Government has also established a shared service organisation Health Benefits Ltd to harness the power of bulk purchasing procurement and supply chain management in order to free up cash that could be used elsewhere in the public health service. Fundamental to that is the ability to ensure that the major participants in the public health service the district health boards assist in that cooperative approach and that where there are roadblocks to that happening there should be ministerial direction that is transparent to enhance the Government’s ability on behalf of taxpayers in order to ensure greater system collaboration and the use of shared services. 
It also provides for a new planning framework. The bill amends the current requirements that district health boards have a reporting structure that involves statements of intent annual plans district annual plans and so much that is duplicated and not really read by participants. We need to not only streamline that reporting process but also take into account the fact that we are moving towards a more regional cooperative approach in the way district health boards work and that needs to be facilitated in the whole reporting infrastructure. It needs to be slimmed down the duplication removed and made much clearer. 
There is very strong consensus across the health service for the establishment of a Health Quality and Safety Commission to advise the Government on health epidemiology and quality assurance matters to determine quality and safety indicators and to promote better support and better quality in health and safety. We know that if we can improve the quality of the care that people in our public hospitals receive like making sure they get the right medication making sure they are seen at the right time and making sure the tests arrive in the right format not only does that mean that people are treated better recover better and get home sooner but also that we save money that can be used elsewhere in the public health service. A very significant role of the Health Quality and Safety Commission will be to work with the sector to provide better-quality services right across aged care primary care and our public hospitals. 
The bill also provides the power to appoint elected district health board members to other district health boards which is consistent with trying to use the very best people we have in the public health service to meet our objectives. 
The bill was introduced in May. As I did earlier I thank the select committee and I commend it for its work and its valuable recommendations. Thirteen individuals and organisations also made submissions. The committee recommended a number of amendments which I will go through. The committee recommends and the Government agrees that the bill should be amended to clarify the commencement date. That change means that parts of the bill will not be brought into force by Order in Council but will come into force 6 months after the date it receives the Royal assent. The change responds to the recommendations of the Regulations Review Committee. 
Secondly in recognition of the readiness of district health boards the Ministry of Health and the National Health Board to implement changes to the district health board planning framework the Health Committee has recommended a change to the start date for the streamlined planning requirements bringing those forward a year and the Government supports that recommendation. 
The committee has also recommended that we provide further clarification on the application of the Crown Entities Act to the new direction powers for shared services and the all-of-district health board direction powers. That recommendation makes a lot of sense and the Government is supporting it too. Fourthly the committee members made a number of recommendations relating to the objectives and functions of the Health Quality and Safety Commission and the Government thinks they are also very sensible. Namely the recommendations were that the commission should take on the objectives and functions previously performed by the National Health Epidemiology and Quality Assurance Advisory Committee which was previously known as the Quality Improvement Committee or QIC and that where it is appropriate the commission should be required to work with the Ministry the Health and Disability Commissioner providers health professionals and consumers and that the wording in the bill be amended so that the description of the commission’s functions is consistent throughout the bill. 
A number of public submissions on the mortality review committees expressed support for the transfer of responsibility for the appointment of those committees from the Minister to the commission. The committee recommends and the Government supports the amendment that the details of the objectives powers and functions of the mortality review committees remain the same. The Health Committee also recommended a number of minor amendments to the bill to correct terminology and grammatical errors remove unnecessary wording and ensure consistency. 
Finally many submitters to the bill wanted to understand more about how and when district health boards would be required to consult the public. The Government is keen to promote public participation in district health board decision-making where it is effective and as such the Government is proposing a set of planning regulations that district health boards will be required to comply with under the Act. Those regulations will describe the details of the plans that they will be required to prepare and contribute to. They will include a requirement to consult with the public where the Minister considers that district health boards are proposing changes to service eligibility access or the way services are provided that will have a significant impact on recipients of services their caregivers or providers. That is quite a step forward from where we are at the moment. 
The Government supports the amendments recommended by the Health Committee. It is important to understand that the bill is not about major restructuring of our district health boards or the public health service; it is about the Government’s desire to make sure the system we have currently works as effectively and efficiently as it can in the interests of New Zealand patients and the public health service as a whole.