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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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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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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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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?

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• 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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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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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.

1 public health bill health select committee pha april 2008

Documents

public health bill health

public health offensive

promotion of public

monitoring of public

public health issues

maori public health

health of people

public health outcomes