Tatau Kahukura: Māori Health Chart Book 2024 provides reliable and easy-to-access statistical information on key Māori health indicators.
Tatau Kahukura has been designed as a tool for all parts of the health sector. The results highlight areas the health system needs to focus on to improve the health of Māori and reduce Māori health inequities.
It will be of value to the health and disability sector in policy, research, and service design. This information is also helpful for students and the wider community in gaining a better understanding of Māori health.
Tatau Kahukura also promotes Māori health analytical procedures and provides a reference point for analysts conducting Māori health focused analysis. Many of the more regular reporting, for example Whakamaua reporting, rely on methods specified in Tatau Kahukura.
Key findings
Tatau Kahukura shows that Māori have higher rates than non-Māori for many health conditions and chronic diseases, including cancer, diabetes, cardiovascular disease and asthma.
Findings include:
Māori adults were almost twice as likely as non-Māori adults to have experienced any type of racial discrimination.
Māori boys and girls (aged 0 to 14 years) and Māori adults (aged 15 years and over) had daily vaping rates that were around three times higher than their non-Māori counterparts.
Ischaemic heart disease rates were twice as high for Māori adults compared to non-Māori adults.
Māori females had a lung cancer registration rate over three times that of non-Māori females.
Māori males and females were around one and a half times more likely than non-Māori males and females to have diabetes.
Māori aged 5–34 years were more than twice as likely as non-Māori in the same age group to have been hospitalised for asthma.
How to access Tatau Kahukura
You can access Tatau Kahukura online, or download the document versions.
This is the fourth annual report on abortion service the Ministry of Health – Manatū Hauora has published.
As the steward of the health system, the Ministry of Health plays an important role in ensuring public safety and quality through our regulatory functions and activities and then monitoring them – including for abortion services.
The Abortion Services Aotearoa New Zealand: Annual Report provides a snapshot of abortion services for the 2023 calendar year. The findings in this report highlight continued improvements following both the 2020 law reform and the 2022 health reforms.
Key achievements include increased accessibility through continued growth of the abortion workforce, and a decrease in average drive-time to in-person services. Access to early medical abortions through telehealth services have also increased.
Along with greater access, people from all ethnic backgrounds are accessing abortions earlier in their pregnancy. These reductions in barriers to access, and earlier terminations, are associated with safer outcomes.
While these improvements signal better access and outcomes for individuals seeking abortion care in Aotearoa New Zealand, barriers continue to disproportionally impact some groups, including Māori and those living in rural areas. Eliminating health disparities is an ongoing focus for the Ministry of Health.
The Ministry of Health – Manatū Hauora has developed a snapshot report to monitor and report on the progress the health system made on delivery against the Interim Government Policy Statement on Health 2022–2024 (iGPS). The iGPS set the Government’s priorities and expectations for the health system for 2022–2024 as well as the framework for the interim New Zealand Health Plan | Te Pae Tata 2022 (interim NZ Health Plan).
This snapshot report presents national results for iGPS measures from the second and final year (2023/24) of the two-year interim period.
In addition to the results in the iGPS snapshot report, supplementary data for the measures by district, ethnicity and other breakdowns can be found on the Ministry of Health – Manatū Hauora GitHub page.
This final snapshot shows whether measures with pre-existing targets have met those targets or not. Most of these measures did not meet their targets. Five of these measures are part of the new Government Health Targets for faster cancer treatment, timely access to specialist care, shorter stays in emergency departments and childhood immunisation. The Government has also introduced 5 mental health and addiction targets.
The new Government Policy Statement on Health 2024–2027 (GPS) sets the direction for the health system and incorporates the Government’s priorities. The Ministry has responsibility for measuring, monitoring and reporting on the GPS annually.
We published an addendum to the iGPS in May 2024. The addendum is an update of Appendix 3, which contains detailed definitions of the measures used for reporting on the iGPS.
In response to the iGPS, Health New Zealand | Te Whatu Ora and Te Aka Whai Ora | Māori Health Authority developed the interim NZ Health Plan. The interim NZ Health Plan included actions to deliver better outcomes in the priority iGPS areas. Reporting on progress and delivery of actions in the interim NZ Health Plan is on the Health New Zealand website in their official publications over 2022-2024 (eg, quarterly reports, annual report).
Centres of Excellence (CoEs) are often established to fill a gap in existing services for a specific condition, such as for a rare disorder or for conditions where high levels of inter-disciplinary expertise and integration of multi-disciplinary care are required to ensure optimum treatment regimes. Establishing a CoE requires strategic planning; the literature provides guidance on the essential foundations and operational elements for sustainability and meeting continuing standards of excellence.
Evidence examining the effectiveness of ‘centre of excellence’ or ‘co-ordination hub’ approaches for the management of specialised health or disability needs is limited with research still emerging. There was some evidence that well managed CoEs are able to deliver better health outcomes for complex conditions.
In Aotearoa New Zealand there are some comparable specialised services. Of the five services analysed there were alignments to the CoE as a concept. Community leadership, strong public funding partnerships and the ability to quickly respond to health and disability system changes were a visible strength for all of these services.
This Evidence Brief was completed in November 2023. It includes an examination of the provision of healthcare, diagnosis, access to treatment, cost, quality of life and the role of research for rare disorders. There is a large body of international research and evidence dedicated to rare disorders but very little that is Aotearoa New Zealand-specific.
Rare disorders are a highly varied group of conditions that are referred to as a whole due to the low prevalence of each disorder. Rare disorders tend to be chronic multi-system disorders which can have a substantial impact on a person’s wellbeing. The complex and unique problems faced by people with rare disorders are experienced in similar ways across the globe, and there is substantial international, often community-driven, work occurring to address these problems.
In New Zealand, people with a rare disorder may access services through their local health, disability and social support service providers, generally through a referral from their general practitioner. Organised support for different disorders is largely provided through community-based organisations, many of which are affiliated with the Rare Disorders NZ consortium. While not all rare disorders result in a disability, many do.
People with these rare disorders are likely to be included within the wider population cohort of disabled people. Barriers to accessing health care are a significant issue in some regions, particularly for rural and poorly served lower socioeconomic communities.
High level recommendations from the evidence were:
Te Tiriti o Waitangi and equity need to be at the centre of a strategy
specific diagnosis and treatment pathways need to be developed for people with a rare disorder
a nationally coordinated approach to research focused on rare disorders is required
dedicated infrastructure development is required to meet the specialised needs of rare disorders. These include registries, biobanks and genomic databases.
This notice authorises Medical Referees to permit cremations to be carried out without complying with the requirement in regulation 7(1) of the cremation regulations for a medical or nurse practitioner to complete form AB or to see and identify the body after death for the purpose of completing form B in situations when:
the death is not unexpected; and
the medical history and current conditions of the decease are known by a medical or nurse practitioner undertaking their role in accordance with section 46B(2) or 46B(3) of the Burial and Cremation Act (the Act); and
the deceased had been a resident in one of the following settings prior to their death, where a registered nurse is available on site:
residential care facilities
rest homes,
other long term-in-patient facilities.
This authorisation comes into force on 20 December 2024 and will expire on 31 December 2025.
Pursuant to regulation 12(b) of the Cremation Regulations 1973 (the Regulations), I, Dr Shane Reti, Minister of Health, for the reason of there being a shortage in the medical workforce servicing aged residential care settings, authorise Medical Referees to permit cremations to be carried out without complying with the requirement in regulation 7(1) for a medical practitioner or nurse practitioner to complete form AB or to see and identify the body after death for the purpose of completing form B in situations when:
the death is not unexpected; and
the medical history and current conditions of the deceased are known by a medical or nurse practitioner undertaking their role in accordance with section 46B(2) or 46B(3) of the Burial and Cremation Act 1964 (the Act); and
the deceased had been a resident in one of the following settings prior to their death, where a registered nurse is available on site:
Residential care facilities,
Rest homes,
Other long term-in-patient facilities.
This authorisation is subject to the following conditions:
the Medical Referee must receive advice from a trusted source who has seen the body and has a reasonable level of assurance of the cause of death; and
the Medical Referee must record the identity, contact details and occupation of the trusted source; and
the trusted source must verify:
The identify of the deceased; and
That the deceased died of natural causes; and
the Cremation Authority must confirm whether there is a biomechanical aid in the body.
For the avoidance of doubt, this authorisation does not exempt a medical practitioner or nurse practitioner from their performing their obligations under section 46B of the Act.
The authorisation comes into force on 20 December 2024 and will expire on 31 December 2025.
Dated at Wellington this 27th day of November 2024
Hon Dr Shane Reti Minister of Health
Minimum legislative information
Title
Authorisation under the Cremation Regulations 1973
Empowering Act and provisions
The cremation regulations are made under Burial and Cremation Act 1964. Under regulation 12b of the Cremation Regulations, the Minister of Health may in the event of an epidemic or for other sufficient reason, permit cremations to be carried out, or authorise Medical Referees to permit cremations to be carried out, in any place, without complying to regulation 7 of the Cremation Regulations.
This current review updates the evidence regarding CWF published since the OPMCSA report of 2021.
The current review supports that conclusion on the basis that;
the evidence that has been published since 2021 indicates ongoing clear benefits from CWF even during the period when alternative forms of fluoride (such as fluoride toothpaste) are available and
CWF promotes equity by decreasing the incidence and severity of dental caries in individuals in areas of high socioeconomic deprivation as much as, or more than individuals in areas of less deprivation and
there has been no high-quality evidence published since those 2014 and 2021 reports to suggest a causal link between fluoride exposure at the levels used in Aotearoa New Zealand for CWF and significant harm to health.
Individuals living in countries with high naturally occurring fluoride in drinking water are at greater risk of dental fluorosis. However, the risk and severity of this complication in the setting of CWF is very low. Aotearoa New Zealand does not have high naturally occurring fluoride levels in drinking water.
The Code of Practice for Diagnostic and Interventional Radiology: ORS C1 2024 (C1 2024) is issued by the Director for Radiation Safety under section 86 of the Radiation Safety Act 2016 (the Act).
C1 2024 specifies the technical requirements that a person who deals with the diagnostic and interventional radiological equipment outlined in the scope of C1 2024 must comply with in order to comply with the fundamental requirements of the Act.
This code came into force on 1 December 2024.
Scope
C1 2024 applies to radiation practices associated with radiological equipment used for diagnostic radiology procedures, interventional radiology procedures, and the use of cone beam computed tomography enabled equipment in dentistry and research. Practices include manufacture, possess, control, manage, use, service and repair, transport, store, import, export, sell, supply and disposal of equipment.
Compliance with C1 2024 does not imply compliance in related areas such as health practitioners’ clinical competence, occupational safety, hazards in the workplace, resource management and transport of hazardous substances.
Consultation and notification
In September 2023, the Ministry of Health reviewed the now revoked C1 2018 and concluded that revisions were required. In August 2024, a second round of consultation was conducted on the changes made to the public consultation version of C1 as a result of the submissions received.
On 19 November 2024, the Director for Radiation Safety gave notice in the New Zealand Gazette that C1 2024 is issued and comes into force on 1 December 2024.
Changes in C1 2024
Holder of a source licence
C1 2024 replaces the term ‘managing entity’ used in the revoked C1 2018 with terms referred to in the Act. In almost all cases, the new term used is ‘holder of a source licence’.
Equipment requirements
C1 2024 no longer provides a definitive set of tests and conditions that must be met irrespective of the local clinical situation. The C1 2024 equipment-related safety and performance requirements must now be established by the source licence holder, in conjunction with clinical staff and a medical physics expert, that are specific to the local situation. Equipment reference values must be recorded, regularly reviewed, and be made readily available for compliance monitoring purposes. The holder of a source licence is also required to use the equipment reference values to remedy equipment, or suspend the use of equipment, that is operating outside of acceptable performance parameters based on its reference values.
Training and authorisation
C1 2024 introduces explicit training requirements for people who are appointed by the holder of a source licence to perform the radiation protection and safety roles required by C1 2024. Explicit training requirements for a Radiation Safety Officer (RSO) have been set out in a new Appendix 2.
Radiation shielding approvals
C1 2024 introduces a new requirement for the holder of a source licence to ensure that a medical physics expert, or another qualified expert, approves all radiation shielding installed as part of a place or structure.
Standards and conditions for continuous individual monitoring of workers
C1 2024 alters the obligations of the holder of a source licence when it comes to the continuous individual monitoring of radiation doses to workers. Also, the holder of a source licence is required, to the extent practicable, to use a dose monitoring provider that is accredited to an appropriate standard. Continuous individual monitoring is now required if a worker may receive three tenths of a radiation dose limit.
Justification of occupational and public exposures
C1 2024 introduces an explicit requirement for the holder of a source licence to consider occupational and public exposures, as well as patient exposures, when justifying each radiological exposure. This change means that the fundamental requirement set out in section 9(1) of the Radiation Safety Act 2016 are fully reflected in the justification requirements of C4 2024.
Other changes
C1 2024 makes a significant number of technical clarifications and wording changes to improve readability, clarity of meaning, and to adopt the terminology used in the Act.
What this means for clinical practice
The Director for Radiation Safety has aimed to make the minimal amount of change for the people who must comply with C1 2024 while addressing the issues raised in the review of the now revoked C1 2018.
On 1 December 2024, ORS C1 2018 was revoked. The provisions of the revoked C1 2018 no longer apply. However, the provisions of the revoked C1 2018 may apply to any matter that occurred while it was in force from 9 November 2018 to 31 October 2024.
addremovePrevious versions
On 19 November 2024, the Director for Radiation Safety gave notice in the New Zealand Gazette that the Code of Practice for Diagnostic and Interventional Radiology: ORS C1 2018 is revoked on 1 December 2024. The revoked C1 2018 came into force on 9 November 2018 and has been replaced by the Code of Practice for Dental Radiology: ORS C1 2024 (C1 2024). A copy of the revoked C4 2018 is available below.
The Code of Practice for Dental Radiology: ORS C4 (C4 2024) is issued by the Director for Radiation Safety under section 86 of the Radiation Safety Act 2016 (the Act). C4 2024 specifies the technical requirements that a person who deals with the dental radiological equipment outlined in the scope of C4 2024 must comply with in order to comply with the fundamental requirements of the Act.
The requirements of C4 2024 do not limit the general application of the fundamental requirements of the Act.
This code came into force on 1 December 2024.
Scope
C4 2024 applies to radiation practices associated with radiological equipment used for intraoral, panoramic and cephalometric dental procedures. Practices associated with cone beam computed tomography equipment are dealt with in the Code of Practice for Diagnostic and Interventional Radiology: ORS C1 .
Practices can include: manufacture, possess, control, manage, use, service and repair, transport, store, export, import, sell, supply and disposal of equipment.
Compliance with C4 2024 does not imply compliance in related areas such as health practitioners’ clinical competence, occupational safety, hazards in the workplace, resource management and transport of hazardous substances.
Consultation and notification
In May 2023, the Ministry of Health reviewed the now revoked C4 2018 and concluded that revisions were required. In August 2024, a second round of consultation was conducted on the changes made to the public consultation version of C4 as a result of the submissions received.
On 19 November 2024, the Director for Radiation Safety gave notice in the New Zealand Gazette that C4 2024 is issued to come into force on 1 December 2024.
Changes in C4 2024
Holder of a source licence
C4 2024 replaces the term ‘managing entity’ used in the revoked C4 2018 with terms referred to in the Act. In almost all cases, the new term used is ‘holder of a source licence’.
Radiation Safety Officer
C4 2024 introduces a new requirement for the holder of a source licence to appoint a radiation safety officer (RSO). This change means that appointing an RSO is now a general requirement of radiation safety codes of practice. The training requirements for an RSO are set out in a new Appendix 2.
The Director for Radiation Safety considers that, for the purposes of C4 2024 only, people who are, or deemed to be, registered with the Dental Council of New Zealand, and who hold an annual practicing certificate, can be considered to have met the training requirements for an RSO. This condition applies only for the activities specified for the registered practitioner in Schedule 3 of the Radiation Safety Regulations 2016.
On this basis, a registered practitioner who meets these conditions can be appointed as an RSO by virtue of being deemed to meet the training requirements set out in Appendix 2 of C4 2024. The holder of the source licence can still appoint an RSO who is not a registered practitioner who meets these conditions, however, such an RSO would need to meet the training requirements set out in Appendix 2 of C4 2024.
Radiation risk assessment
C4 2024 introduces a new requirement for the holder of a source licence to carry out and maintain a radiation risk assessment. This change means that radiation risk assessments are now a general requirement of radiation safety codes of practice. Radiation risk assessments form the basis for establishing a management system to enhance radiation protection and safety. Establishing a management system to enhance radiation protection and safety was a requirement of the revoked C4 2018 that has been retained for C4 2024.
Diagnostic reference levels in optimisation
C4 2024 introduces explicit requirements to use, generate or compare diagnostic reference levels (as the situation requires) for optimisation purposes when equipment is commissioned, serviced, or modified (including software updates). This change means that diagnostic reference levels will be used in optimisation activities under all diagnostic and interventional radiology codes of practice. The use of diagnostic reference levels are the primary means to ensure optimisation of radiation safety. Optimisation of radiation safety were requirements of the revoked C4 2018 which have been retained for C4 2024.
Justification of occupational and public exposures
C4 2024 introduces an explicit requirement for the holder of a source licence, in conjunction with the dental practitioner, to consider occupational and public exposures, as well as patient exposures, when justifying each radiological exposure. This change means that the fundamental requirement set out in section 9(1) of the Radiation Safety Act 2016 is reflected in the justification requirements of C4 2024.
Other changes
C4 2024 makes a significant number of technical clarifications and wording changes to improve readability and clarity of meaning.
What the changes mean for dental practice
The Director for Radiation Safety has aimed to make the minimum amount of change for the people who must comply with C4 2024 while addressing the issues raised in the review of the now revoked C4 2018. In many instances, the new, explicit, requirements of C4 2024 formalise what has been implied by the related, but more general, requirements of the revoked C4 2018.
On 1 December 2024, ORS C4 2018 was revoked. The provisions of the revoked C4 2018 no longer apply. However, the provisions of the revoked C4 2018 may apply to any matter that occurred while it was in force from 28 June 2018 to 31 October 2024.
addremovePrevious versions
On 19 November 2024, the Director for Radiation Safety gave notice in the New Zealand Gazette that the Code of Practice for Dental Radiology: ORS C4 2018 is revoked on 1 December 2024. The revoked C4 2018 came into force on 28 June 2018 and has been replaced by the Code of Practice for Dental Radiology: ORS C4 2024 (C4 2024). A copy of the revoked C4 2018 is available below.
Most New Zealand’s buildings are ‘naturally’ ventilated, meaning they rely on the opening of windows (and/or doors) by occupants. Ventilation habits are often inefficient, probably because we have a relatively poor innate sense of when a room is under-ventilated. Most members of the public under-estimate how effective windows can be in improving ventilation and air quality.
With increased recognition following the COVID-19 pandemic of the role of ventilation in reducing the risk of spreading illness, National Institute of Water and Atmospheric Research (NIWA) were commissioned by the Ministry of Health to:
assess the state of ventilation (inferred from measurements of carbon dioxide) in a sample of mostly naturally ventilated buildings occupied by people more vulnerable to the acute health effects of COVID-19 infection
explore the potential for improving ventilation through changes in ventilation behaviour
explore the potential for using carbon dioxide monitoring data to promote pro-ventilation behaviour change.
