The Auditor-General says the plan developed by Health New Zealand did not meet his expectations for a costed plan. Photo: Unsplash / RNZ
The Auditor-General says the country's nationwide health plan for the next two years is not up to his expectations.
He says it lacks important details, including the basic costs of services.
Health NZ is in charge of putting out a plan through to 2027 that shows how public health services will be delivered, and the cost.
But Auditor-General John Ryan, in a letter at the back of the 85-page plan, said it did not do this.
"The plan developed by Health New Zealand does not meet my expectations for a costed plan," he said after auditing it.
This meant he was unable to offer an opinion on whether the plan provided a reasonable basis for delivering public services to improve health.
A bill before Parliament removes the need for future plans to go to the Auditor-General.
"I expected the plan to provide a clear explanation of how the actions have been selected and prioritised, and how the actions will contribute to the achievement of the desired improvements and targets. The plan does not do this," Ryan wrote.
"I expected the plan to be based on clear and reasonable assumptions about health needs and the expected quantity of service demand, the resources needed to provide those services, and the forecast cost of those resources. The plan does not do this."
The plan should describe how investment and service changes would achieve the right outcomes, laying out what assumptions and trade-offs were expected, but it did not.
Health NZ has an out.
In the plan, it said it had been expected to take six years - or two three-year planning cycles - to fully develop systems to ensure full costings and budgets for its core services.
The 2024-27 plan indicated its processes were not there yet.
"It is not costed to the level of traceability and integration between the financials, activities, and desired improvements expected from a fully mature New Zealand Health Plan," it said.
The plan was submitted to Ryan by the former commissioner Dr Lester Levy and deputy commissioners of health in May. Levy now chairs the new board of HNZ.
The plan is titled, "Timely access to quality health care."
Levy said in the foreword it "outlines actions to deliver better health outcomes for all New Zealanders". He does not mention it is not mature or properly costed; this is mentioned on page 44.
Levy oversaw a reset at the beleaguered agency after a financial meltdown in 2024 set it on a path towards a $1.7 billion deficit, following primarily a mess-up over how many nurses it had and what they would cost; spending cuts reined that back to just over a billion by mid-2025. It said it prioritised protecting frontline services while it made cuts. It aims to break even in 2026-27.
The plan said to understand what services were costing, it now had a financial procurement info system in place to track spending; plus it was bringing in a nationwide agreements
and payments system.
It had changed how it budgeted, to base budgets on what it wanted to do, rather than the other way around.
"This change of approach will place service delivery for our patients front-and-centre, allow more accurate service planning for the year ahead, and help us to identify where
cost and/or productivity improvements need to be made to meet our activity targets within budget."
The Healthy Futures (Pae Ora) Amendment Bill repeals the requirement for future such health plans to be audited by the Auditor-General.
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