This page provides answers to the most commonly asked questions the health workforce has asked about the reform programme.

Why is the health system being reformed?

New Zealand has a good publicly funded health system and a highly skilled, dedicated and professional health
workforce. And while the public health system does well in many areas, the system does not serve everyone equally, so not all people get the same access to, and quality, of health care.

A transformed health system will support all New Zealanders to live longer and have the best possible quality of life. It will be achieved by making sure:

  • people are empowered to stay well and get the help they need closer to home
  • the health system caters for a range of complex needs
  • there is greater access and better experiences for those who have traditionally not been well served, including
  • Māori, Pacific and disabled people
  • the most is made of technology and innovative ways of working are developed
  • the system reinforces Te Tiriti principles and ensures a partnership approach better addresses Māori health needs
  • and leads to better health outcomes
  • the health sector workforce is supported, equipped and enabled to keep people healthy and well.

What will this mean for New Zealanders?

Here are just a few examples of the changes expected from the reform:

There will be a greater range of care and support available for people in their local communities, with more care provided outside of hospitals.

Services such as general practice, well-child teams, pharmacists, district nurses, dietitians, physiotherapists and hauora Māori providers will work more closely together to respond to, and meet the needs, of people in their local communities.

  • There will be more options for whānau to access kaupapa Māori and other appropriate services.
  • Those with high or complex health needs will be able to get the services they require to help them get well sooner.
  • There will be access to consistent and high-quality emergency and specialist healthcare, available to everyone in Aotearoa New Zealand, no matter where they live.
  • More virtual and digital services will be available to support the system, such as phone and video consultation, offering people a wider range of personalised support in their homes and local communities.
  • People will be encouraged to get involved in designing health and wellbeing services that work for them, and have real influence over the services they receive, through participation in local planning and the opportunity to engage in national consumer forums.

Is Health NZ and Māori Health Authority just going to be the amalgamation of DHB and Ministry of Health operational roles? How will things work differently for the benefit of NZ as a whole?

The reform is more than just a change in structure. It is about a fundamental transformation of some of the core components of our health system. It starts with giving effect to Te Tiriti and gearing the whole system towards improving equity. It will involve a shift to primary and community services, with tailored locality planning and increased access to integrated models of care.

The New Zealand Health Plan will set out the services people can expect, including those for Māori, Pacific and rural communities and for disabled people, and the system will be held to account in those priority areas.

How will the Māori Health Authority work?

The new Māori Health Authority will give Māori a strong voice in a system focused on improving disproportionate health outcomes.

It will provide an additional opportunity for Māori influence in how the health system needs to perform. Addressing health equity for Māori does not sit solely with the Māori Health Authority – it is the responsibility of all players in the system.

The Māori Health Authority will work with the Ministry of Health on national strategies and policy advice related to hauora Māori. It will work alongside Health New Zealand with a joint role and in a range of ways, like co-commissioning community health services, and kaupapa Māori services.

Meanwhile, it will work with Iwi-Māori Partnership Boards to ensure the voice of whānau and local Māori communities influence locality priorities and services.

What is a locality and what does it mean for the workforce?

A key part of the reform is looking at how health services can be provided and work better at a local level, through the development of a ‘locality approach’. A locality is a geographic community, identified for the purposes of planning and delivering integrated health and wellbeing services. Localities will vary in size, typically covering populations ranging from 20,000 to 100,000 people, and will be set in ways that make sense for the communities they serve. Where appropriate, this may mean localities are aligned with council boundaries, iwi rohe, concentrations of particular population groups, or natural borders.

Localities create an opportunity to drive integration of care models and service delivery around local people. They also offer a platform to strengthen the focus on population health to address the wider lifestyle, environmental and socioeconomic factors that impact on people’s health and wellbeing.

Work is underway on the overall design of localities and will inform the establishment of a small number of prototypes, which will take shape from early 2022. The prototypes will serve as a ‘first wave’ and will be an important way to refine the development of the locality model.

It’s too early in the design phase to know how people across the locality, and health system, will work together. In principle, it should lead to more seamless care, better integrated models of care and a stronger focus on both community and the patient.

What are some of the key things the TU is working on?

The Transition Unit is set up as part of the Department of the Prime Minister and Cabinet. It is engaging across the health sector on a number of workstreams such as:

  • Policy and legislation to create the new system
  • Establishment of interim Health New Zealand and interim Māori Health Authority, including supporting the transfer of Ministry of Health functions
  • Development of the future Public Health Agency and integrated public health service
  • Development of the role and functions of the Māori Health Authority and Iwi-Māori Partnership Boards
  • Pacific health
  • Supporting DHBs to transition to the new system
  • Data and digital enablement and development
  • Development of the interim New Zealand Health Plan
  • Development of new commissioning arrangements, design work on locality networks and the national hospital network
  • Development of the NZ Health Charter
  • Developing and embedding the consumer voice in the new system
  • Funding including budget 2022 and capital settings
  • Accountability and monitoring arrangements

Subscribe to the Transition Unit newsletter to get updates (external link)

What does the new structure and operating model look like?

The interim entities of Health New Zealand and the Māori Health Authority will be responsible for developing their structures and leadership teams. This will be communicated more as it is developed.

What entities are impacted by the health reforms? What will it mean for my role?

The health reform will make structural changes to the 20 DHBs, the seven shared service agencies (Health Alliance, Health Source, Health Share, Central TAS, Northern Region Alliance, South Island Alliance and Health Partnerships) and Te Hiringa Hauora/ Health Promotion Agency.

The reforms will also alter some functions of the Ministry of Health.

For staff currently working for DHBs, the Public Health Units and the shared service agencies, you can expect to transfer to the new entities and can continue to focus on doing the great work you do now, in the new system.

The new health system will need more, not fewer, people working in a variety of roles, including administrators, cleaners, nurses, doctors or orderlies.

We will also continue to need leadership at all levels of the health system, including in our hospitals.

I work in one of the shared services agencies, when will we know what is happening to my agency?

The functions provided by the shared services agencies will transfer to Health NZ, but decisions on the precise model (including whether distinct agencies or subsidiaries are maintained and how they support regional divisions) will be made by Health NZ.

I work at Te Hiringa Hauora/ Health Promotion Agency, when will we know what is happening to my agency?

The interim entities of Health New Zealand and the Māori Health Authority will be responsible for developing their structures and leadership teams. This will be communicated more as it is developed.

I work at the Ministry of Health, when will I know if I am moving to a role in Health NZ?

No decisions have been made yet but if you have any questions please contact the Ministry of Health via email:

The health workforce is struggling in terms of retention and resilience. Will the reforms ensure the health workforce is strengthened and supported through this change process?

There is commitment to making sure the health workforce is supported through any changes. The Transition Unit is working closely with DHBs, unions and other providers and membership bodies to provide as much information as possible on progress and timelines, acknowledging there is uncertainty with change.

One of the key workstreams within the Transition Unit is the development of the NZ Health Charter, which will set out the shared values, standards, expectations and ways of working within the national health system. A key focus is on the wellbeing of staff and being safe in their work environment. There will be more on this next year beginning with a national roadshow in early 2022.

What can we expect to see from the Transition Unit over the coming months?

The Transition Unit has developed a timeline that sets out key milestones planned for the coming months. This will be kept up to date regularly – feedback is welcome on other aspects of the reform programme that you consider important to receive more information on.

Where can I find out more?

The Future of health website will be regularly updated with news and information.

You can also sign up to receive the newsletter(external link) that outlines key progress and milestones on the Transition Unit’s work

You should also expect to see information at your workplace or to receive updates via regular communication channels.

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