Once in a Generational Health and Disability System Reform

30 Sep 2021

In April 2021 the New Zealand government confirmed its decision to embark on a once in a generational health and disability system reform that included the creation of two new organisations, Health New Zealand and the Māori Health Authority.

HG, in partnership with Atahaia Consulting, were commissioned by the Health and Disability Review Transition Unit, led by Stephen McKernan QSO, to assist in establishing the inaugural Boards for Health New Zealand and the Māori Health Authority.

Earlier this month both Boards were announced by government and their profiles, along with greater detail about the reform, can be found here https://www.futureofhealth.govt.nz/

For my team and I it has truly been a great privilege to be part of the first phase of the reform journey and now the journey continues as we turn our focus to recruiting the inaugural Chief Executive for Health New Zealand.

Health New Zealand

From 1 November 2021 through to 30 June 2022 Health New Zealand will become a Departmental Agency hosted by the Ministry of Health, supported by an interim Board established under section 11 of the NZ Public Health and Disability Act and initially the Chief Executive will engaged under this interim arrangement.

From 1 July 2022 Health New Zealand will become a Crown Entity governed by the recently announced Board, taking over the functions of all 20 District Health Boards, the Health Promotion Agency and current Ministry of Health operational functions.

It will become the largest organisation ever established in New Zealand, public or private. It will employ approximately 80,000 staff and be responsible for $20 billion of annual operating expenditure and $24 billion (replacement value) of assets.

Chief Executive Health New Zealand

The Chief Executive will be tasked first to lead the establishment phase of Health New Zealand and prepare it to take on the full powers and responsibilities that it will acquire as a Crown Entity from 1 July 2022.

To enable that the Chief Executive will work closely with the Minister of Health, interim Health New Zealand Board, the Director General of Health and the Chief Executive of the Māori Health Authority to ultimately ensure the successful migration of functions from DHB’s and the Ministry of Health into Health New Zealand.

Going forward to Chief Executive and their team will strengthen the health and disability system to ensure every New Zealander can access the right care at the right time and the needs of Māori, Pasifika and a number of priority populations are met.

It will require exceptional, dynamic leadership and a comprehensive briefing pack for candidates can be found here https://hardygroupintl.com/job/251/

Stephen McKernan

We asked Stephen McKernan QSO, former Director General Health New Zealand and Director of the Health & Disability Review Transition Unit, within the Department of Prime Minister and Cabinet for brief comment.

The reforms have a number of goals such as achieving equity, sustainability, person centred care, partnership and excellence. In order to make real change to deliver on these dimensions it will require some fundamental shifts in how we plan, prioritise and deliver services for consumers in New Zealand.

An enhanced focus on localities, primary and preventative care, intersectoral integration, consumer involvement in care planning and design and use of new technologies and digital services are just some examples.

A national network of high quality specialist services where access rates and outcomes are equitable for all populations must also be the goal.

The drivers for change are many and are well described in the Health and Disability System Review and also the Cabinet paper which is on the Department of Prime Minister and Cabinet website.

For anyone interested in reading about the reform and drivers for change in more detail that can be found here.



Without question, strong motivation and desire to embrace the reform agenda and drive the system change we desire. That means having a real commitment to reducing inequities, and the drivers that manifest these inequities is essential.

They must also have an ability to attract outstanding leaders at national and regional levels and recognise the importance of embracing contemporary clinical leadership.

High levels of motivation and resilience yet a strong empathy for people will also be essential.

A desire to work in true partnership with colleagues in the Māori Health Authority and the Ministry of Health on collective priorities for the system.

Recognition of the need to build strong capabilities inside Health New Zealand to work with Pacifica communities and also ensuring that the needs of disabled people are encapsulated in all that Health New Zealand undertakes.

They must also have an absolute commitment to advancing the digital agenda and accepting that this may cause disruption to the historical ways of doing things.

Political nous, they must have political nous.