The Ministry of Health didn't equitably meet the needs of Māori, Pacific and other vulnerable populations during the Delta outbreak, a review has found.
File photo: Wellington Covid-19 testing station. Photo: RNZ / Samuel Rillstone
The ministry's response to the August 2021 Delta outbreak has been under the microscope during an independent review, which was commissioned by the Director-General of Health.
The report noted that overall, the ministry was successful at containing the spread of Delta, but it did face numerous challenges.
The review found the slow pace of policy meant decisions needed to be made without the necessary guidance, and the workforce nearly universally reported fatigue, burnout and stress.
"Overall, the need for comprehensive planning with a national aim and local focus was seen by respondents as an essential missing element that would support DHBs and localities in managing the system and preventing overload," the review said.
It found a balance had not yet been found between central control, local decision making and innovation, and there was a need for more comprehensive planning.
"It feels like we are flying a plane and building the plane at the same time but not everybody is sure of what sort of plane we're building," one respondent said.
Many respondents noted the Delta response did not equitably respond to the needs of vulnerable populations.
That included the overall design of the Delta response being seen by many as not based on a pro-equity perspective, existing barriers in the health system were seen to further exacerbate inequity, while many acknowledged the strength of the equitable response were attributable to the Māori Health Directorate, Pacific health team, and Māori and Pacific providers.
It did find that many highly skilled people were committed to doing right by vulnerable communities and substantial funding was allowed and distributed quickly to Māori and Pacific providers.
"Historic workforce challenges have been exacerbated by the sudden demand placed on the system as it responds to Covid and the Delta surge.
"Widely raised workforce concerns were capacity, retention, capability, and exhaustion."
The report recommended locally led solutions, engaging more with Māori and Pacific providers and leaders to develop equitable responses to Covid-19, provide more clarity on accountability and responsibility and establishing a workforce development plan.
"There is a clear positive intent and willingness to deliver the best response possible in a deeply challenging environment, with an overarching goal to protect and respond to the needs of the community," the review said.
In response to the issues raised, the Ministry of Health said it has sought to make proactive improvement and progress on the various recommendations.
"The ministry strongly supports an equity-first approach and, building on experience from the 2021 Delta Outbreak, has now adopted a wide range of equity-first approaches.
"The ministry is working to translate our learnings from the Covid-19 response to the new Public Health Agency and influence other aspects of the health reforms to ensure that knowledge and operations that were stood up for Covid-19 response are developed into long-term programmes and structures."
The review is the second published today investigating Covid-19 response issues.