Health ministry found wanting
A damning new report card into the performance of the Health Ministry has found the agency wanting across a number of areas, including financial sustainability, behaviour and culture and the management of its people.
The high-level performance review, led by Dame Paula Rebstock on behalf of the State Services Commission, painted a picture of a ministry that was striving to reduce health inequities across New Zealand, but hamstrung by poor relationships and funding models across a highly devolved system.
The release of the report comes days after director general of health Chai Chuah announced his resignation, halfway through a five-year term.
He said a change of direction was needed for the ministry. Meanwhile Health Minister David Clark has branded the review as a ‘‘damning indictment’’ of the direction of the last government.
The Performance Infrastructure Framework review, or PIF, gave the ministry a ‘‘weak’’ rating for its financial sustainability, and its overall governance.
It was also weak on ‘‘values, behaviour and culture’’. The ministry scored well on ‘‘vision’’ but it needed to ‘‘shift from aspirational statements to bringing the vision, purpose and strategy to life’’.
The executive leadership team itself, under Chuah, while it ‘‘worked together initially’’, had reverted to a ‘‘group of individuals’’.
‘‘They are technically competent, but do not lead in a systemic way at an enterprise level.’’
Vote Health was a significant component of government expenditure and had grown both in real terms, and on a per person basis over many decades. But the rate of growth has slowed since 2010.
The ministry itself identified that the current model for delivery of health services was not fiscally sustainable.
The review noted district health boards had ‘‘increasingly struggled to deliver contracted services within budget with a number of DHBs reporting operating deficits reflecting ongoing financial pressures within the health system’’.
The ministry’s relationship with Canterbury DHB had been ‘‘challenging for a number of years’’, the report stated.
But there were some positives. In implementing the government’s better public service targets, particularly related to improving immunisation rates and addressing issues like rheumatic fever, the ministry’s performance was ‘‘strong’’.
Significant progress had been made. For the quarter ending December 2016, 93.3 per cent of eight month olds were fully immunised.
The ministry was also graded as ‘‘well placed’’ in its efforts to achieve government targets around safety and health of pregnant women and new babies.