1 public health bill health select committee pha april 2008

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Public Health Bill Health Select Committee

PHA

April 2008

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5 minutes: 3 things

1. Increase effectiveness - simplify life

2. Te Tiriti o Waitangi

3. Plan for prevention and equity

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NZ Public Health & Disability

Act 2000

Improve,promote &

protect health

Reduce health disparities

s 3

Local Government

Act 2002

Well BeingSocial

CulturalEnvironmental

Economics 3(d)

Public Health Bill

Improve,promote &

protect public health

Equitable health outcomes

cl 3

1. Simplify life for effectiveness

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Public Health functions PHA submission 2.5, p30-33

MoH DHB TA

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?

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Objectives NZPHDA

s22(1)a,e,f,h

Functions PHB s19(1)NZPHDA

s23(1)b,c,g,h,m

Role PHB Part 5LGA s11Duties

PHB s153-159

Functions PHB

s6 Ministers7-16 DG

s17,18 DPH

Responsibilities NZPHDA

s13-18

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Simplify Public Health functions (PHA submission 2.5, p30-33,

Appendix 2)

Use Essential Functions of Public Health terminology (WHO)

Be coherent across legislation

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Don’t trivialise death and disease

Groups & populations

Risks to Public Health

Offensive

One individual- leaking toilet- needing care

Fraud detection

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2. Te Tiriti o Waitangi (PHA submission 2.2, p14-16)

LGA NZPHDA PHB

In order to recognise and respect …the

principles of the Treaty of Waitangi… Māori to contribute to …

decisionmaking…

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S 4 S 4

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Te Tiriti o Waitangi

Insert new sections into PHB

• Reference to te Tiriti o Waitangi in Part 1 subpart 1

• Require Maori participation in decision making and service provision (as in LGA and NZPHDA)s

• Principles for action that reflect s 3 purpose• Enable iwi authorities /rununga Maori to employ

Designated officers • Training 158 (1) suitably qualified and trained

(including training in Maori public health)

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3. Plan for prevention and equity (PHA submission 3.5, p45-46)

Yes, react to risksOutbreak of meningitis

Border incursion

Malfunctioning sewer

But also look ahead and planNeighbourhoods at high risk?

Can information, support prevent the problem?

Can another agency help?

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Plan for prevention and equity (PHA submission 3.5, p45-46)

LGA NZPHDA PHB

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s 76-97 s 8s38-40National

strategyStrategic plansNeeds assessmentHealth outcomesConsultationAnnual plans

LTCCPsCommunity

outcomesConsultation

Annual plans

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Principles to guide planning(PHA submission 3.1, p38-39)

Apply principles to the whole Bill

• Māori self management cl 3(1) • Empowerment cl 80 (a) (b) (d); cls 92, 93 • Precautionary principle cl 80 (e) (f) (g)

• Equity cl 3(1)

• Proportionality cl 3(3)c, 91

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Plan for prevention and equity (PHA submission 3.5, p45-46)

Insert cross references in

• PHA Bill

• NZ Public Health and Disability Act (2000)

• Local Government Act (2002)

Refer to Public Health Bill responsibilities

(eg that public health is explicitly included as a community wellbeing)

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Information for planning (PHA submission 3.4, p41-44)

MoH DHB TA

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Outcomes/Status

Hazards /risks

Determinants

Interventions

Community outcomes

Situations injurious (PHB)

Community wellbeing

Health status

Notifications

}Factors }adversely }affecting }health}status

Annual Report (health of all NZ .. section)

Register of regulated activities

(collect data individual health ) ?

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Information for planning (PHA submission 3.4, p41-44)

LGA NZPHDA PHB

DHB can request, TA can charge

for a report

s 91-92 s 11, 23

Assess, monitor

Health statusFactors affecting NeedsConsultation

Report, Inspect

Community outcomes Situations injurious

Consultation

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Information for planning (PHA submission 3.4, p41-44)

Annual Report on the State of Public Health (s11) explicitly covers

• public health outcomes

• hazards to public health

• determinants of public health

• interventions.

Both DHBs and Territorial Authorities provide meaningful information to the DG.

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Co-operative agreements LGA NZPHDA

PHB

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s 14(1)e S23(1)b

Co-operative and collaborative

Collaborate and co-operate

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Information for planning (PHA submission 3.4, p41-44)

Encourage co-operation and collaboration at the district and region level to

assess /investigate /inspect /report on

• public health outcomes

• hazards to public health

• determinants of public health

• interventions.

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Advice for planning (PHA submission 3.3, p 40-41)

MoH DHB TAPHAC

s 14 NZPHDA

CPHAC s 34 NZPHDA

Director PHcl 18 PHB

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Director PH cl 17 PHB

EHOcl 159 b,c,d

PHB

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Advice for planning (PHA submission 3.3, p 40-41)

• Either amend NZPHDA (s14 and s34) • Or insert in PHB (cl 6 and cl 19)

Both PHAC (s14) and CPHACs (s34) advise on(a) public health issues, including factors underlying the

health of people and communities:(b) the promotion of public health:(c) the monitoring of public health:

where public health includes roles and functions under both NZPHDA and PHB

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Advice for planning (PHA submission 3.3, p 40-41)

Insert in PHB cl 19(1)a(i) appoint a District Director of Public Health

Insert in PHB cl 19(4) The District Director of Public Health

– advise the DHB Chief Executive on matters relating to public health (etc cf cl 17)

– Independently advise and/or reporting to the Board on any matter relating to public health (etc cf cl 18)

– Independently advise and/or report to the TA Chief executive and/or Board on any matter relating to public health (etc cf cl 17,18)

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Advice for planning (PHA submission 3.3, p 40-41)

Clarify PHB cl 159 b, c, d

The Environmental Health Officer– advise the TA Chief Executive on matters

relating to public health (etc cf cl 17)– Independently advise and/or report to the

Territorial Authority on any matter relating to public health (etc cf cl 18)

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Strategy for planning(PHA submission 3.5, p45)

Either amend NZPHDA (s8) Or insert in PHB (cl 6)

The Minister must determine a strategy for public health, called the New Zealand disability strategy, to provide the framework for the Government’s overall direction of the public health sector

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4. Enable controls of NCD risk factors

Ensure Act enables regulation-making power

Enable mandatory Health Impact Assessment

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5. Retain a few things

Continue to enable screening of children at school without explicit parental consent

– Children don’t miss out– Allow parents to “opt-off” – as with

immunisation records – Maintain current practice of seeking consent

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Retain a few things

Regulation making power #1 under the Health Act 1956, to “improve, promote and protect health”

Mysteriously absent from Public Health Bill.