- Urgent is need to update national plans
- Pandemic modelling and health workforce based on 2005 figures
- Slow progress due to staff and budget cuts - Ministry of Health
- Health NZ better set up to distribute PPE than old DHBs
- GPs, community health providers, paramedics need their own pandemic stocks
- Risk that pandemic preparedness could be "deprioritised"
- Need to avoid cycle of "panic then forget"
The government watchdog warns there is a risk New Zealand will have enough antiviral or vaccine supplies if another pandemic strikes, with the Ministry of Health still relying on modelling that is nearly 20 years out of date.
In a letter to Parliament's health select committee on Friday, controller and auditor-general John Ryan said there had been patchy progress on implementing recommendations made by his office in 2020, when Covid-19 exposed major gaps in the country's preparedness.
The health system was "better positioned" than it was five years ago to source, manage,and distribute personal protective equipment (PPE) because these functions had been centralised in Health New Zealand / Te Whatu Ora, he wrote.
"However, progress has not been consistent across all of our recommendations, including the need to update national plans and modelling to determine how much stock should be held in the NRS [national reserve stocks] and who should have access to it.
"The ministry attributes slow progress to the health sector reforms and, more recently, to reduced staff numbers."
The 2020 review found the Ministry of Health did not know what PPE stocks each district health board had in its reserve supplies, the condition of that stock or any system to forecast demand.
At the time, the ministry said it anticipated implementing the 10 recommendations by the end of 2020/21.
Ryan said in his overall assessment, "some progress has been made".
"But further work is needed to address the recommendations from our 2020 report and to give the public assurance that New Zealand holds sufficient reserves for future emergencies."
The auditor-general's recent review of the public sector's response to Covid-19, highlighted shortcomings in the national security, emergency, and health systems, which could have hampered its effectiveness.
"Some of these arose because previous review recommendations had not been implemented. We stressed that New Zealand must avoid what the World Health Organization calls a cycle of 'panic then forget' when responding to emergencies."
Urgent need to update pandemic modelling
Vaccine stocks were still based on pandemic modelling and health workforce numbers from 2005, since which time New Zealand's population and health workforce had changed considerably.
"For these reasons, there is a risk that there are insufficient antiviral or vaccine supplies to cover the current health workforce or the other people eligible to receive it under the current NRS policy.
"In our view, the ministry needs to complete the modelling work with some urgency so that we can all be assured that there are sufficient vaccine and antiviral supplies. "
Ryan noted the Ministry of Health intended to review the National Health Emergency Plan by the end of 2025 "if resources are available to support this work".
The National Pandemic Plan has had a limited update, but further changes have been paused until the second phase of the Royal Commission of Inquiry into Covid-19 Lessons Learned - Te Tira Ārai Urutā reports in February 2026.
The ministry told the auditor-general's office that it may consider providing PPE supplies to primary care, other health and disability providers, and designated first responders "in a large or prolonged emergency".
"Given this situation, we consider it timely for the ministry to reinforce the message that non-hospital based health and disability providers, government organisations, and private businesses are responsible for sourcing their own emergency PPE, to manage expectations well before the next emergency and to clarify any exceptions to this."
As a result of the health system reforms, Health NZ now had responsibility for managing the budget for the NRS. The Ministry of Health was limited to monitoring and providing technical advice, but had no control of the budget.
"With increasing pressure on staffing numbers and budgets, which the ministry told us has delayed progressing recommendations from our report, there is a risk that emergency preparedness, including replenishing the NRS holdings in line with workforce changes and population increases, might be deprioritised."
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