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, 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.

It won’t be a quick fix. The problems with our system have been baked in over decades, with inadequate funding, political pointscoring, a lack of community consultation, poor leadership and institutionalised racism all contributing to a system which does not meet our communities’ needs. But nevertheless, changes are happening – and we’re making sure that PSA members who work in healthcare have a voice in the changes being made.

Find out more:

Pae Ora FAQs

The date that everybody is talking about is 1 July, 2022. That’s because on that day, our District Health Boards will officially be replaced by two new coordinating bodies: the Māori Health Authority and 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, but that’s the biggest one for now!

These changes are going to affect everybody - whether or not you work in the healthcare system! The goal here is to improve our healthcare system to better serve all people in Aotearoa.

That means that if you work in healthcare in Aotearoa, this reform process might (over time!) change how you do your job. We can't improve our system without making some changes! But - and here's the important bit - your job is secure, and so are your existing pay and conditions.

For most people working in the system, there won’t be much that changes on 1 July. You’re likely to be reporting to the same people, and as healthcare workers, clinical and admin staff, you will largely be performing the same roles you are right now, in the same locations.

While there’s definitely more change coming, it’s not being rushed. It’s important that this is done right! There will be plenty of opportunities to have your say and give input as these changes happen over the coming weeks, months and years.

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.

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!

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!

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.

Honestly, a lot! This is a massive change, and it will take a long time – sector reforms don’t happen overnight. The government will be announcing a lot of details in the lead up to 1 July, as well as in the months afterwards. We’ll be keeping you updated with those announcements, and we’ll be making sure PSA members’ voices are heard in the discussions around the decisions that are yet to be made.

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:

  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.

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.

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:

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

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

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

Official Government Information

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

  • 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.
  • 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.