Pae Ora: Better healthcare for Aotearoa

In New Zealand, we’re very fortunate to have a public healthcare system. But for too long, it's had some major flaws: our system doesn’t care for all our communities equally, services are often disconnected and it doesn’t look after our healthcare workers – the people who work hard every day to support our health – with fair pay and conditions.

Right now, Aotearoa is undergoing the most significant reform of our healthcare system in 20 years, to try to address these problems. At the PSA, we're committed to making sure we use this opportunity to secure the best possible outcomes for healthcare workers and ensuring that all services across primary and community care and hospitals are linked up and people of all communities receive the treatment they need when they need it.

The first step in the health reforms was creation of new health entities; on 1 July 2022, Te Whatu Ora and Te Aka Whai Ora were created. For those who are working in the system little has changed so far. Instead, more stress has been put on health workers, with the continued impact of COVID, shortages of workers, and limited ability to have their say in how to deliver services better. Changing the health system will take time and it’s important that workers’ voices continue to be central to the health reforms.

Find out more:

The Health Charter

The Health Charter is a key part of the health reforms. It will be a charter for the whole health workforce across primary and community care and hospitals. It will set out values, principles and behaviours that organisations in the health sector and health workers, individually and collectively, are to demonstrate. It is intended to be a core part of how the health workforce is supported and valued.

Te Whatu Ora and Te Aka Whai Ora have begun to develop the health charter, after initial consultation. The Charter will be called Te Maui o Rongo and have four Pou – key ideas that will support the project:

Wairuatanga: When we come to work, we are able and supported by others to be our whole selves. When we return home we are fulfilled.

Rangatiratanga: As organisations we support our people to lead. We will know our people; we will grow those around us and be accountable with them in contributing to Pae Ora for all.

Whanaungatanga: We are a team, and together a team of teams. Regardless of our role, we work together for a common purpose. We look out for each other and keep each other safe. Together we are whānaunga, we are the workforce, kaimahi hauora.

Te Korowai Manaaki: A cloak woven with purpose embraces and protects us in our work and embodies the physical and spiritual elements of Te Mauri o Rongo. The wearer of the cloak has responsibility to act and embody those values and behaviours.

Members have been using their voices to outline what they want throughout the process of the health reforms and the charter is an important opportunity to promote these key ideas:

Te Tiriti is the baseline for health workers
Worker participation throughout the health system
Health and safety is paramount across the health system and all aspects of work, particularly safe staffing
Providers of contracted out services are accountable for the public money they spend
Procurement is guided by fair requirements and appropriate funding to enable the workforce to deliver high-quality services
Equity
Transparent, authentic and emotionally intelligent leadership which is representative of the workforce

Te Whatu Ora and Te Aka Whai Ora are required to report on the charter at least every five years. It’s really important that workers are involved in that reporting and the actions that follow to ensure that the workforce is supported and valued.

The next step will be Te Whatu Ora and Te Aka Whai Ora beginning consultation with health workers to develop this framework so that it sets out values, principles and behaviours. The PSA does not know yet when this consultation will begin. As soon as we know, this website will have more information about the timetable and how you can be engaged. The PSA does know though that every single voice counts to create a true health charter created by and for workers collectively.

PSA Member Action

PSA members have been active in preparation for the health reforms, making sure a worker perspective is central in the government's planning. As we get closer to 1 July, there will be increasingly more opportunities for you to engage - check back here for regular updates about how you can get involved!

PSA Health Reform Working Group

Our Health Reform Working Group is made up of members from across healthcare - from our elected DHB and CPS Sector Committees and Te Tira Hauora.

This group meets fortnightly to advise PSA engagement on the reforms.

PSA submissions to government

PSA members certainly had a loud and clear voice in the government's consultation on the Pae Ora Bill! In total, the PSA delivered five submissions to the Legislation Committee. These submissions were based on member feedback through a survey in late 2021, where over 1000 PSA members had their say.

In our submissions, we said:

The proposed NZ Health Charter (a charter that is to be designed with health and care workers, to set down the values and principles of the national system) should apply to all people who work in healthcare, not only those in DHBs as is currently in the draft legislation;
The Charter needs to be developed by the people who work in our healthcare system, and it should embed equity, worker participation, and standard terms and conditions across the health system.
Workers' voices need to be listened to in the new system - from the level of local workplaces and communities right through to national level boards, advisory committees and working groups - and a tripartite model will help to achieve this.
As well as retaining their employment, workers transitioning to the new system must retain all their current entitlements.
We need to see an increase in Kaupapa Māori services; everyone in Aotearoa deserves high quality care that meets their needs.

You can read each of the submissions in full here:

PSA Health Reform Resources

PSA member reps meeting with the Interim Chief Executives - 17 May 2022

In May we had our first meeting between PSA members and the Interim Chief Executives of the Māori Health Authority and Health New Zealand. Members from our health sector committees and our Health Reform Working Group presented members' key priorities for the reforms, and heard from Margie and Riana about their vision for tackling the challenges ahead.

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Health Reforms - PSA members meet with new health Chief Executives

Webinars

In 2021 we held a series of webinars about the health reforms, putting PSA member questions to the staff in the government's Transition Unit. You can watch these webinars here:

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Webinar 1 - The Case for National Reform

We're joined by Martin Hefford from the Transition Unit to talk about why we're reforming our national healthcare system - and why now.

Click here to download a copy of the presentation, and here to download a copy of the webinar Q&A.

Watch our webinar on the case for national reform here
Webinar 2 - The New Zealand Health Charter and the New Zealand Health Plan

We speak to the team at the Transition Unit about the New Zealand Health Charter and the New Zealand Health Plan, and how people who work in healthcare can shape them!

Click here to download a copy of the presentation.

Watch our webinar on the NZ Health Charter and Plan here
Webinar 3 - Localities

Join the PSA for our final conversation this year about the health sector reforms, with the experts from the Government's Health and Disability Review Transition Unit.

In the reforms, primary and community services will be reorganized to serve our communities through ‘localities’. Every locality is to have a consistent range of core services, but it's proposed that how these services are delivered will be based on the needs and priorities of local communities. Communities, alongside Iwi-Māori Partnership Boards, would be involved in the development of locality plans that set priorities for local health services.

Click here to download a copy of the presentation.

Watch our localities webinar here

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Health Reform FAQs

What's changed since July 2022?

The date that everybody was talking was 1 July, 2022. That’s because on that day, our District Health Boards were officially replaced by two new coordinating bodies: Te Aka Whai Ora (Māori Health Authority) and Te Whatu Ora (Health New Zealand). The idea is that these new entities will have the capacity to coordinate our healthcare resources at a national level, and ensure that they go to where they’re needed most. If all goes to plan, they’ll be able to see at a national level where our communities are doing well, and where they need some support.

There are some other changes taking place too like the Health Charter, so watch this space for more information.
What do PSA members want to see from the reforms?
PSA members see the reform of our healthcare system as an opportunity to create a more integrated healthcare system. It's also an important opportunity to address many of our healthcare system's longstanding inequities for healthcare workers and the people they care for.

Here are some of the specific things we've called for in our submission on the Pae Ora - Healthy Futures Bill:
1. The proposed NZ Health Charter (a charter that is to be designed with health and care workers, to set down the values and principles of the national system) should apply to all people who work in healthcare, not only those in DHBs as is currently in the draft legislation;
2. The Charter needs to be developed by the people who work in our healthcare system, and it should embed equity, worker participation, and standard terms and conditions across the health system.
3. Workers' voices need to be listened to in the new system - from the level of local workplaces and communities right through to national level boards, advisory committees and working groups - and a tripartite model will help to achieve this.
4. As well as retaining their employment, workers transitioning to the new system must retain all their current entitlements.
5. We need to see an increase in Kaupapa Māori services; everyone in Aotearoa deserves high quality care that meets their needs.
As the PSA, what have we done to influence the reforms so far?

We're being guided by your delegates and member leaders

Our PSA DHB and CPS Sector Committees and Te Tira Hauora, alongside a PSA Health Reform Working Group with members from each of these groups, have guided our conversations with government so far. These groups are made up of members with a strong interest in the health sector and commitment to drive change. To find out more about who's in your Sector Committee and in Te Tira Hauora, just log into MyPSA!

We're using your feedback

In late 2021, we sent a survey to all PSA members working in healthcare to ask for your thoughts on the reforms! Your responses informed our submission to government on the Pae Ora - Healthy Futures Bill, which is the law that establishes the new healthcare system structure.

We're advocating to government on your behalf

PSA staff are in regular contact with the Health Reform Transition Unit in the Department of the Prime Minister and Cabinet, to make sure that PSA member voices are heard throughout the decision-making process.

We've also submitted to government through the formal legislative process. You can read our submissions here and watch our members delivering their oral submission here.

We're working with our union colleagues

We hold regular meetings and stay in close touch with our colleagues at other health unions, and through the Council of Trade Unions - to make sure that all healthcare workers, not only PSA members, are heard in this reform. After all, as unionists we know we're stronger together!
How will the reforms address the massive inequities in healthcare pay and conditions?

It’s long overdue that the unjust pay and conditions in the healthcare system are addressed, and that all workers are paid fairly – your experience, expertise and what you do at work should be what matters, not who employs you, or what your job title is!

We know that together, in number, we’re louder, and we’re stronger. With the new healthcare system bringing more workers together, we’ll have opportunities to show our united strength and push for better pay and conditions that fairly reflect the work PSA members do in supporting the health of our people in Aotearoa. As your union, we'll make sure we highlight every opportunity in the reform to push for fair pay and conditions for PSA members.

These changes won’t all come right away – but we’ll be working with you as members to make sure that, as always, when we have opportunities to improve your pay and conditions we take them!
How can I have my voice heard in our new healthcare system?

The health reforms are a massive opportunity for us to reconsider a lot about our health system. We believe the people making decisions about the new system should do so with the benefit of your expertise and experience. After all, you are the people working in our healthcare system every day!

Our new healthcare system needs to truly transform how decisions are made. Until now, opportunities to improve health outcomes for our people – and conditions for workers – have been missed, simply because decisions that affect you or relate to your firsthand experience have been made by senior leaders without consultation.

We are calling for the new system to value workers’ voices and ensure workers are involved at all levels of decision-making. Workers' voices must be an integral part of the new system. We’ll make sure that at every opportunity, decision makers hear from PSA members about what our new healthcare system needs to look like.
What's still being worked out?

Honestly, a lot! This is a massive change, and it will take a long time – sector reforms don’t happen overnight. We’ll be keeping you updated with any announcements, and we’ll be making sure PSA members’ voices are heard in the discussions around the decisions that are yet to be made.

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Official Government Information

The government has released official updates about the reforms. Here are some of their handy links:

Read the full speech by the Ministers announcing the health reforms:Building a New Zealand Health Service that works for all New Zealanders
The People Pānui - this is a regular newsletter for healthcare workers, and you can sign up to receive it directly in your inbox here.
Check out this video introducing Māori Health Authority Interim Chief Executive Riana Manuel and Health New Zealand Interim Chief Executive Fepulea’i Margie Apa.
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Read the government's FAQs for the health workforce here.
Find out more information about the progress of the reforms on the official government website.