Much of the section of the briefing devoted to the government’s plans to disestablish the Māori Health Authority is blacked out, but the ministry warns of significant organisational change fatigue in the health system.
"The next couple of years will be important for stabilising, consolidating, and refining the new operating roles and functions of key entities, including the changes resulting from the disestablishment of the MHA."
In the section on growing and retaining the workforce, the ministry says setting up the new medical school at Waikato University will involve "some challenges and risks, even with a 2027 start date".
Dr Reti has described the new school as an "absolute priority" for the new government. He said the government would sign a Memorandum of Understanding with Waikato University to progress the school within its first 100 days.
There is also the not so small matter of the Act New Zealand coalition agreement requirement for a cost-benefit analysis to be undertaken before any binding commitments are made by the government regarding the medical school.
The ministry said it was also focused on making all practicable steps to improve health workforce sustainability in the medium term by ensuring both recruitment and retention improved.
It would be briefing the government further on options for better recognising people with overseas medical qualifications and experience for accreditation in New Zealand, including consideration of an occupations tribunal.
Act’s coalition agreement refers to carrying out regulation sector reviews, which could include the primary industries, the finance sector, early childhood education and healthcare occupational licensing. In each case an omnibus bill would be produced for regulatory reform of laws affecting the sector.
During the election campaign, Act proposed an occupations tribunal to assess equivalent overseas qualifications and work histories. It is odd that a party hellbent on reducing bureaucracy would want to set up a new one rather than adapt existing processes.
It also wanted the health minister to have the power to override decisions or processes of regulatory authorities, such as the Nursing Council, if the minister believed they went beyond what was necessary to protect public health and safety. If that is in the mix somewhere now, it is likely to provoke considerable controversy in the sector.
The November briefing mentions the decision to repeal the 2022 smokefree legislation saying it was one of the coalition agreement commitments with "significant flow-on impacts". It looked forward to briefing the minister on this as part of moving toward implementation.
Now the ministry has received a grab-bag of confused ideas forwarded by newbie New Zealand First member of Parliament and Associate Health Minister Casey Costello, sourced from who knows where, we wonder if officials looking forward to briefing her have transitioned to dread.
They could not possibly comment, of course.
Hopes the smoking issue might disappear in a puff of smoke over the parliamentary recess were dashed almost as soon as Parliament returned.
Concerns about where the nicotine-stained fingers of Big Tobacco may have been in the setting of policy are lingering and the Prime Minister must be fed up with the amount of media attention still focused on this.
Somehow, he needs to take control of the narrative to convince the critics the Government is on the right path on smoking cessation, but at the same time stay on board with National’s coalition partners.
His pronouncments thus far come nowhere near that. Instead, they give the impression that the coalition partners' tail is wagging the dog.
