In this edition:

• Parliament's Scrutiny Week

• Latest New Zealand Health Survey

• Directions to fluoridate water supplies reconfirmed

• Whooping cough epidemic declared

• Consultation on the use of puberty blockers

• Apology for abuse suffered in State care

• Looking ahead to 2025

• Recent news and publication releases

As one example, in September the UK Government published the Darzi report on the state of England’s National Health Service.  It noted that the NHS was in ‘serious trouble’ and that staff were doing their best to cope with ‘enormous challenges’.

Many of the challenges in the Darzi report are familiar to us in New Zealand. But as we approach the end of the year, it’s worth reflecting that our health system continues to perform well for most New Zealanders. 

This year I have seen many examples of the hard work and commitment of those working throughout the health system to address the difficulties we face.  

Health New Zealand has just released its first quarterly report on the progress towards the health targets. The data, covering the July to September quarter, highlights increased patient volumes and shows the system is providing more care for New Zealanders than ever before. Winter is always a difficult time for the health system, and planned care wait times usually go up. Despite the winter pressures, four of the five health targets remained relatively stable over the quarter, with more work to do on childhood immunisation rates.
 

New Zealand Health Survey

We have recently published the 2023/24 New Zealand Health Survey, which captures information about a range of topics across the health sector, including alcohol use, vaping and smoking, mental health, eating habits, and access to health services.

I'm grateful to the 9,719 adults and 3,062 children (via their primary caregiver) who participated in the survey between July 2023 and July 2024.

The data shows that most New Zealanders continue to be in good health, and good progress is being made in areas such as reducing young people’s rates of hazardous drinking.

This year, the publication included over 200 data indicators, so there are plenty of interesting stats to delve into. For instance, young people have some of the lowest smoking rates; the only age group with lower rates is over-75s.

Nearly half of adults (47.1%) ate the recommended amount of fruit a day, while 9.1% of adults ate the recommended amount of vegetables. (Perhaps something to think about as you contemplate possible New Year resolutions.)

And 46.6% of adults met physical activity guidelines (at least 2.5 hours of moderate-intensity activity in the past week, spread out over the week); similar to last year.  

The findings are published in the Annual Data Explorer web tool, allowing the results to be compared to previous years. There’s a lot to explore, and it is a key resource to help the Ministry, wider health sector and government agencies to plan health services for New Zealanders.

Directions to fluoridate water supplies reconfirmed

On Wednesday 4 December I reconfirmed directions issued to 14 local authorities to fluoridate one or more of their water supplies. This follows the completion of a court-ordered Bill of Rights Act assessment.

In February, a High Court judgement directed me, as Director-General of Health, to assess whether each of the 14 directions issues in July 2022 was a justified limit on the right of persons in those districts to refuse medical treatment. That right is provided for in section 11 of the New Zealand Bill of Rights Act 1990 (the Act).

The assessment has now been completed. Following this, I wrote to 14 local authorities confirming I have assessed the directions in terms of section 11 of the Act and that I am satisfied they remain justified.

The decision provides clear confirmation that local authorities under directions continue to be legally required to fluoridate their water supplies. We continue to work with these local authorities to support them to comply with their directions.

Whooping cough epidemic declared

A whooping cough epidemic was declared on 22 November, and a nationally coordinated response is now in place.

Health New Zealand’s National Public Health Service is well prepared to manage the epidemic, with a national response team stood up to coordinate and support activity across health services.

About half of babies who catch whooping cough before the age of 12 months need hospitalisation, so it’s vital people who are unwell avoid visiting pregnant women and babies.

The best protection for infants is for their mother to be vaccinated during pregnancy. This is most effective when given from 16 and 24 weeks of pregnancy – and should be done during each pregnancy from 13 weeks to provide the best protection for each baby.

Childhood vaccinations to protect against whooping cough are needed at ages 6 weeks, 3 months and 5 months, with a booster at 4 years. A further booster is given at age 11 years (school year 7).

Whooping cough (pertussis) cases across the motu have been closely monitored over recent months. Ahead of the announcement, case numbers had consistently increased for several weeks across the country, reaching a level that met the threshold for a national epidemic to be declared.

Consultation on the use of puberty blockers

On 21 November 2024 the Ministry of Health published its evidence brief and position statement on the use of puberty blockers in young people with gender-related health needs.

The evidence brief shows there is a lack of good quality evidence to back the effectiveness and safety of puberty blockers when used for this purpose. 

The position statement outlines a more cautious approach to prescribing puberty blockers for young people with gender-related health needs. This treatment should be initiated only by experienced clinicians working in interprofessional teams that offer a full range of supports. 

The Government has tasked the Ministry with consulting on whether there should be additional safety measures for puberty blockers, such as regulations under the Medicines Act.

The consultation closes on Monday 20th January 2025 at 5pm. More details can be found on our Consultation Hub.

Apology for abuse suffered in State care

Alongside the Government and other Chief Executives, on 12 November I apologised for the abuse suffered in State care between 1950-1999.

This was an important step in addressing the findings from the Royal Commission of Inquiry into Abuse in Care. We need to continue to learn lessons from harm done in the past.

In my apology, I acknowledged the lasting impact of abuse in State care on people’s physical, mental, spiritual and cultural wellbeing.

I noted the health system has moved away from State residential care or custody for treatment to community-based care options. We have introduced new standards and models of care to prevent the neglect and abuse survivors experienced in the past. But we must do more to improve the health system.

We continue to manage historic abuse claims relating to care in mental health facilities prior to 1993, including Lake Alice payments such as reimbursement of legal fees.

The new Mental Health Bill sets out how we provide compulsory mental health care.

The Bill:

• recommends an approach that ensures people’s rights are put first
• empowers people to be active decision-makers in their care, and
• provides measures to make sure that compulsory or coercive treatment is minimised

The Ministry of Health, along with Health New Zealand and other health agencies, will work together with affected communities to make sure the health system continues to improve and provide the care people need.
 

Looking ahead to 2025

As we head towards a new year, I wanted to highlight some continuing pieces of work the Ministry has underway to support the health system and the workforce – and to provide better health outcomes for New Zealanders.

• Work to repeal and replace the Mental Health Act to support a more rights-based and recovery approach to mental health care. 
• A primary care policy work programme to progress the changes needed to achieve comprehensive and accessible care.
• Policy development on the New Medical Products Bill.
• A Long-term Insights Briefing on the topic of ‘Unlocking the Potential of Active Ageing’, to identify ways to create health-promoting environments for older people.
• Our precision health work programme sees us working across the system to guide the use of new and emerging technologies in areas like genomics and artificial intelligence.
• Continuing to strengthen our pandemic preparedness, including developing a new pandemic framework and reviewing our health legislation to ensure it is fit for purpose for a future pandemic.
• Implementing changes brought in through the Smokefree Environments and Regulated Products Amendment Bill. These include banning disposable vapes, vape display restrictions, further restricting where vape stores can open and increasing penalties.
• Developing the design and approach for a new Child and Youth Mental Health and Addiction survey.
• Progressing the proposed strategy to prevent and minimise gambling harm for the next three years, following a period of public consultation.
• Work to establish a cohesive approach to the delivery of clinical trials in New Zealand.
• Progressing a new Hauora Māori health strategy to provide a clear view of the Government’s vision for Māori health.

I hope you are able to enjoy a relaxing break over the summer period. We will look forward to working with you in 2025. 

Recent news and publication releases

• Smoke-free Environments Amendment Act marks 20 years
• Growing risk of antimicrobial resistance infection in New Zealand
• Emergency COVID-19 response legislation ends
• MedSafety Week a reminder to use medicines as directed
• New plan outlines adaptation to the health impacts of climate change
• New data shows the importance of vaccination against Invasive Pneumococcal Disease
• New funding for child and youth mental health survey
• Rollout of new medicines across New Zealand begins
• Medsafe updating advice on nitrous oxide abuse
• Three additional ‘Safe Areas’ announced
• Research into health and wellbeing impacts of adverse weather conditions