Security classification: In-Confidence

Advice on Workforce Governance

To: Hon Dr David Clark, Minister of Health

Purpose

Quill record number: File number: AD62-14 2018

Action required by: NIA

This paper sets out options for governance of the health workforce function, and assesses their ability to deliver effective workforce strategy planning.

Key points

• You met with Dr Ashley Bloomfield and Professor Des Gorman on 26 September 2018 to discussoptions for strengthening health workforce functions. At this meeting you requested further informationabout the most effective governance mechanism for supporting these functions.

• Professor Gorman identified a range of governance options for the health workforce function and hasprovided you with his initial advice (Appendix 3). The Ministry has undertaken a high-level analysis ofthe options identified by Professor Gorman.

• Because we expect the Health and Disability System Review (the Review) to examine workforcematters in detail, our initial high-level analysis has focused on identifying options that will make animmediate impact and will be easy to implement.

• On balance, the Ministry's advice is that the most effective way of making progress on the workforcechallenges outlined in our previous briefing [HR20181913 refers] is to refreshihe current HealthWorkforce New Zealand (HWNZ) Board membership and tem1s of reference. This would allow HWNZto be more clearly focused on strategic governance, with the Ministry's recently-established HealthWorkforce directorate leading on more operational matters.

Recommendations

The Ministry recommends that you:

a) note that Professor Gorman has identified a range of governance options forhealth workforce functions

b) note that we have completed an initial high-level analysis of the options, with afocus on identifying approaches that are low cost and high-impact.

c) note that, on balance, the Ministry's recommended option is a non-executiveHWNZ advisory board as recommended in HR20181913.

d) agree to meet with Dr Bloomfield and Professor Gorman to discuss next stepsfor varying the HWNZ Board's membership and reference.

_j)f. flf!:,,v�Ashley Bloomfield Director-General of Health

Minister's signature:

Date: 0'2 (12 /1 f

more levers across the decision-making and system. accountability. Medium. The Ministry holds most but not all High. Accountability Low. The sector

Option 3: Collective of the levers required and decision-making expects to be High. No additional

High. Infrastructure

responsibility to drive the work would be clearly set out represented in cost to the Crown.

and resourcing is programme. Progress in the terms of decision-making and already in place. would be contingent on reference. strategic direction. sector consultation. High. An independent Unknown. The

Medium. Additional Option 4:

unit would have High. Accountability

Ministry would need to resourcing (e.g. CE)

Autonomous unit significant agency to

and decision-making consult with the sector

required, but would Low. Cabinet approval

within the Ministry progress the work

would be clearly set out to ascertain its views

make use of existing and recruitment of key

programme in by Cabinet.

on this option, but has Ministry infrastructure

personnel required. consultation with the the potential to be well

where possible. sector. supported. High. A dedicated Crown Agency would have significant agency High. A dedicated and to progress the work

High. Accountability well-resourced Crown

Low. A significant

Option 5: Crown programme in

and decision-making agency is likely to be Low. Significant start-

approvals process consultation with the

would be clearly set out well received, provided up and ongoing costs

would need to be Agency sector. However, its board is to the Crown. distance from the

by Cabinet. representative of the

undertaken.

centre could create sector. challenges for the work programme.

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