1. 1 Public Health Bill Health Select Committee PHA April 2008

2. 2 5 minutes: 3 things 1.Increase effectiveness - simplify life 2.Te Tiriti o Waitangi 3.Plan for prevention and equity

3. 3 NZ Public Health & Disability Act 2000 Improve, promote & protect health Reduce health disparities s 3 Local Government Act 2002 Well Being Social Cultural Environmental Economic s 3(d) Public Health Bill Improve, promote & protect public health Equitable health outcomes cl 3 1. Simplify life for effectiveness

4. 4 Public Health functions PHA submission 2.5, p30-33 MoH DHB TA ? ? ? Objectives NZPHDA s22(1)a,e,f,h Functions PHB s19(1) NZPHDA s23(1)b,c,g,h,m Role PHB Part 5 LGA s11 Duties PHB s153-159 Functions PHB s6 Minister s7-16 DG s17,18 DPH Responsibilities NZPHDA s13-18 ?

5. 5 Simplify Public Health functions (PHA submission 2.5, p30-33, Appendix 2) Use Essential Functions of Public Health terminology (WHO) Be coherent across legislation

6. 6 Dont trivialise death and disease Groups & populations Risks to Public Health Offensive One individual - leaking toilet - needing care Fraud detection

7. 7 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… ? S 4

8. 8 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)

9. 9 3. Plan for prevention and equity (PHA submission 3.5, p45-46) Yes, react to risks Outbreak of meningitis Border incursion Malfunctioning sewer But also look ahead and plan Neighbourhoods at high risk? Can information, support prevent the problem? Can another agency help?

10. 10 Plan for prevention and equity (PHA submission 3.5, p45-46) LGA NZPHDA PHB ? s 76-97 s 8 s38-40 National strategy Strategic plans Needs assessment Health outcomes Consultation Annual plans LTCCPs Community outcomes Consultation Annual plans

11. 11 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

12. 12 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)

13. 13 Information for planning (PHA submission 3.4, p41-44) MoH DHB TA ? 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 ) ? ? ?

14. 14 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 status Factors affecting Needs Consultation Report, Inspect Community outcomes Situations injurious Consultation

15. 15 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.

16. 16 Co-operative agreements LGA NZPHDA PHB ? s 14(1)eS23(1)b Co-operative and collaborative Collaborate and co-operate

17. 17 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.

18. 18 Advice for planning (PHA submission 3.3, p 40-41) MoH DHB TA PHAC s 14 NZPHDA CPHAC s 34 NZPHDA Director PH cl 18 PHB ? Director PH cl 17 PHB EHO cl 159 b,c,d PHB ? ?

19. 19 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

20. 20 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)

21. 21 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)

22. 22 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 Governments overall direction of the public health sector

23. 23 4. Enable controls of NCD risk factors Ensure Act enables regulation-making power Enable mandatory Health Impact Assessment

24. 24 5. Retain a few things Continue to enable screening of children at school without explicit parental consent –Children dont miss out –Allow parents to opt-off – as with immunisation records –Maintain current practice of seeking consent

25. 25 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.