Part 3: The Ministry of Health’s independent performance reviews

Our insights into five health regulatory authorities.

3.1
The responsible authorities are not subject to the Official Information Act 1982. To provide independent scrutiny of their performance, the Health Practitioner Competence Assurance Act (the Act) was amended in 2019 to give the Ministry mandate to carry out periodic performance reviews of the responsible authorities.13

3.2
The aim of the performance reviews is to provide assurance and better visibility to the Crown and the public that responsible authorities are carrying out their functions effectively and efficiently.

3.3
The Act requires the Ministry to consult with the responsible authorities and manage the review process, including setting the terms of reference. Reviews are conducted by an independent designated auditing agency, which contracts directly with the responsible authorities.

3.4
The independent performance review framework aligns with section 118 of the Act. The framework includes 23 core standards that cover matters such as standards for competence and ethical conduct.14

3.5
Figure 1 shows the most recent review results for the five authorities we looked at in this report. These authorities fully achieved 20 of the 23 core standards (over 87%), with the remainder partially achieved.

Figure 1
Results from independent performance reviews carried out in 2021 and 2022

Figure 1 is a bar chart of data about the number of standards fully and partially achieved when the Dental Council, Medical Council, Nursing Council, Pharmacy Council, and Physiotherapy Board were last independently reviewed. It shows that, for 23 standards, the Dental Council fully achieved 21, the Medical Council 22, Nursing Council 11, Pharmacy Council 20, and Physiotherapy Board fully achieved all 23.

3.6
The recommendations made by the designated auditing agency generally focused on:

  • reviewing and improving the authorities’ processes, including by enhancing their accreditation standards to ensure that they reflect New Zealand’s cultural contexts; and
  • ensuring that authorities’ accreditation standards and key projects are informed by te Tiriti o Waitangi and that they develop and review them in consultation with Māori.

3.7
The Ministry has prepared a report summarising the main findings and insights from the first round of performance reviews, but has not yet published it. This makes it difficult to understand the challenges that the 18 responsible authorities have in common and the challenges unique to particular professions. Publishing the summary report would help the public to better understand the overall performance of the responsible authorities.

3.8
The Ministry should consider providing this reporting as part of its annual report or on its website as part of its broader account of how it is performing its stewardship role.

Recommendation 3
We recommend that the Ministry of Health provide a consolidated summary of findings from the independent performance reviews of responsible authorities to give the public a single, easily accessible view.

13: The first performance reviews were carried out within three years of the Act being amended. Subsequent performance reviews must be conducted at intervals that are no more than five years apart.

14: Ministry of Health (2020), “Core Performance Standards for Responsible Authorities: Consultation document”, page 12, at consult.health.govt.nz.