Review of the Act and Code 2024

FAQs

• What are the changes you are recommending?

  The Code:

  Overall, we found the Code is generally working well and is flexible enough to adapt to a changing context. We have recommended small changes focused on shifting practice across the sector, strengthening the focus on person-centred care that responds to the diverse needs of our communities, and supporting issues to be addressed early.

  Recommended changes include strengthening people’s right to support to make decisions and to make complaints; changing language in the Code to reinforce accessibility and support inclusion; and adding the right for people to have tikanga taken into account when relevant for the person being provided care. 

  The Act:

  The changes we propose to the Act are designed to improve how HDC operates. They are focused on ensuring our processes are more flexible, and we have the mandate and capability to perform our role in a way that works well for everyone.

  Recommended changes include provisions to ensure HDC has the appropriate leadership to protect and promote the rights of all communities; making the principles for complaints resolution for both HDC and providers more people centred; and giving HDC more flexibility to resolve complaints in a way that works for all parties.

  Read a summary of our recommendations

• Who submitted on the review?

  People were generous in sharing their time and insights. A wide range of people submitted on the review including individual consumers, family members, whānau, consumer organisations, Māori leaders, community leaders, health providers, disability organisations, professional bodies, academics, lawyers and government agencies. 

  We received a record number of submissions (259) – including three in te reo Māori. Of these, 149 were from individuals and 110 from organisations. Almost a quarter of submitters were Māori, and just over a quarter identified as having a disability. 

  A demographic breakdown of submitters can be found on page 14 of our Recommendations report

  Read the submissions we received during public consultation

• What happens next?

  Our Recommendations Report is currently with the Minister of Health. The Report was  tabled in Parliament on the 3rd of March. It is now up to the Minister and Government to decide whether to progress our recommendations.

  One of our key findings was that most of the changes people wanted to see are best addressed operationally. The feedback we received has helped us identify priority actions to make further improvements. We’ll be progressing these changes as our resources allow.

  The review has also highlighted some areas that require further work by the health and disability sectors to better uphold people’s rights. As well as making specific recommendations to others in relation to these issues, we will work with the sectors to share learnings from the review.

• How has people’s feedback shaped your recommendations to the Minister?

  We really appreciated the insights and considered responses we got from people – including many who shared personal experiences with us. In many cases, the feedback we received let us know that we were on the right track with the changes we were suggesting. Lots of the suggestions we put forward for consultation were well supported.

  In some cases though, despite widespread support for a suggestion, people’s feedback led us to amend our proposal to better achieve the intent. For example, while most people supported incorporating the concept of mana into the Code, Rangatira Māori cautioned about its use and the importance of protecting the integrity of the term. To achieve the same intent, our recommendation is to include tikanga in Right 1(3). That means that where it is relevant to the person receiving care, providers need to take account of tikanga.

  In other situations, the feedback we received convinced us not to progress a suggestion further or to take a different approach. For example, we decided not to progress the suggestion that HDC should have the power to withhold information when appropriate. Instead, we’ve recommended that the Government progress the Law Commission’s 2012 recommendation for adding a new time-limited withholding ground to the OIA to protect information supplied during an investigation.

• How long did the review run?

  We started scoping the review in February 2023 and sent our recommendations to the Minister of Health on December 20, 2024. Once he received our Recommendations Report he had 12 sitting days to table it in Parliament, which he did on 3 March, 2025.

• How did you go about the review?

  To scope the review and focus it on what matters most to people, we wrote to 49 organisations and individuals (including a mix of provider and consumer organisations) to ask what was working well, what was not working well, and what could be improved. We received 30 responses and used them to help shape the five topics of the review.

  We then drew on literature to develop these further, and tested our thinking through workshops and wānanga with a targeted but diverse selection of stakeholders.

  We used that feedback to develop a consultation document with suggestions for change, and sought feedback on that document between 30 April and 14 August 2024. We received 259 submissions. We also held over 60 face-to-face and virtual engagements across the country.

  We then summarised submissions and feedback from engagement and used this to consider our response and develop recommendations to the Minister.

  Throughout the project we used a mix of engagement approaches to ensure that we heard a diverse range of consumer, provider, and other agency perspectives.

  We also had a particular focus on ensuring that we heard from priority populations as outlined in the Pae Ora (Healthy Futures) Act — including Māori, tāngata whaikaha | disabled people, and Pacific peoples. We held dedicated hui, workshops, and talanoa and ensured Māori, tāngata whaikaha | disabled people and Pacific representation in the analysis and interpretation of feedback.

• How many reviews have HDC done?

  The Act requires HDC to undertake regular reviews of the Act and the Code. This is the 6th such review.

• When is the next review?

  The Act says that HDC needs to do a review at least every five years. That means the next review is due by 20 December 2029 at the latest.

  One of our recommendations to the Minister is to change the requirements of the Act so reviews have to be done at least every 10 years. If that change is made, then the timing of the next review may well be different.