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The role of PHARMAC, the agency which is responsible for managing and procuring pharmaceuticals prescribed in the community in New Zealand, is being extended. PHARMAC is to take over procurement and management of all hospital medicines from the 20 District Health Boards. The government is also proposing that, over time, PHARMAC will become responsible for managing the prioritisation, assessment, standardisation and procurement of selected medical devices.
A program called Releasing Time to Care: The Productive Ward has been introduced into 62 public hospital wards in 10 of the 20 District Health Board regions. The program, which was developed in the NHS in England, takes a patient-centered approach to improving the quality of care on acute care nursing units by freeing up caregivers' time for more direct patient care. It gives frontline staff the opportunity to design safer and more reliable care by improving ward processes and environments.
In December 2007, the Minister of Health released a high-level national medicines strategy and accompanying action plan for New Zealand. The broad objectives of this strategy are to implement processes that secure quality, access and optimal use of medicines. Significant progress has been achieved on the first Action Plan. Details of the Plan have therefore now been reviewed and updated.
The government is supporting the establishment of new Integrated Family Health Centres which house a wide range of primary health and social services. The aim is to shift some services (such as minor surgery and first specialist assessments from the hospital setting into the community, thereby reducing pressure on public hospitals and providing a more accessible and streamlined service for patients. Consolidation of Primary Health Organisations is also being encouraged.
The New Zealand health workforce is under pressure from a number of sources. In 2009, the government released five reports, all of which agreed on the need for more coordinated and longer-term health workforce planning. Three new initiatives have now been introduced: a voluntary bonding scheme for graduates who work in under-serviced areas, an increase in the number of medical training places, and the establishment of a new agency to coordinate education and training.
In October 2009, the new National Party-led government responded to the recommendations of a Ministerial Review Group regarding the structure of the health system. Three notable aspects of the government's response are the creation of a new National Health Board (NHB) to be located within the Ministry of Health, the creation of a Shared Services Establishment Board, and a refocusing of the role of the National Health Committee.
On 24 June 2009, the government amended protocols which set out the circumstances under which District Health Boards might purchase publicly-funded medical and surgical services from private sector providers. The objective is to encourage greater collaboration between the public and private sectors in the planning and provision of services, thereby maximizing use of available capacity and improving access for patients.
A Commission has made recommendations for improving the recruitment and retention of medical and dental specialists employed in public hospitals. Recommendations include: strengthen clinical leadership and improve clinical-management partnerships, regularly adjust medial school student intakes, link workforce planning more systematically to regional and national service planning processes, support immigrant doctors seeking vocational registration, and improve the work environment.
In January 2009 a Ministerial Review Group (MRG) appointed by the incoming Minister of Health was asked to report on reform options for New Zealand's publicly funded health system. The MRG report was publicly released in August 2009. Its major recommendation was a partial restructuring of the health system. New national agencies would be responsible for service planning and support services, functions previously undertaken by District Health Boards and the Ministry of Health.
In May 2009, six months after a change of government, the incoming Minister of Health announced a revised set of health targets as an indication of key government priorities in health. The revised list reflects a shift in emphasis towards performance indicators focusing on hospitals and specialist care, and away from population health goals.