The Pae Ora (Healthy Futures) Act 2022 is a New Zealand Act of Parliament that replaces the district health board system with a national public health service called Health New Zealand. It also establishes a separate MÃÂori Health Authority (MHA) and a new Public Health Agency. The bill passed its third reading on 7 June 2022 and became law on 14 June 2022.
The Pae Ora (Healthy Futures) Act 2022 establishes a new structure and new accountability arrangements for New Zealand's publicly-funded health system. Key provisions include:
The Pae Ora Bill passed its first reading on 27 October 2021 by a margin of 77 votes to 43 votes. The Labour and Green parties supported the Bill's goals of replacing the district health boards with a national health organisation and creating a MÃÂori Health Authority to meet the needs of MÃÂori. The National Party opposed the Bill on the grounds that it would reduce local decision making while the ACT Party expressed concern that the creation of the MHA would divide people based on race rather than their needs. The Bill was referred to the Pae Ora Legislation Committee.
By 9 December 2021, the Pae Ora Legislation Committee had received 4,665 submissions from interested groups and people including 178 oral submissions. The Committee made several amendments to the Bill at the advice of the Department of the Prime Minister and Cabinet, the Office of the Clerk, the Parliamentary Counsel Office, and the Regulations Review Committee including the following:
On 5 May 2022, Parliament voted to accept the amendments to the Bill recommended by the Pae Ora Legislation Committee by a margin of 77 to 43 votes. That same day, the Bill passed its second reading by a margin of 77 to 43 votes. While the Labour, Green and MÃÂori parties supported the Bill, it was opposed by the National and ACT parties.
On 7 June 2022, the Bill passed its third and final reading by a margin of 77 to 42 votes. While the Labour, Green and MÃÂori parties supported the Bill, National and ACT opposed it.
On 27 February 2024, the National-led coalition government introduced the Pae Ora (Disestablishment of the MÃÂori Health Authority) Amendment Act 2024 to disestablish Te Aka Whai Ora (the MÃÂori Health Authority) by 30 June 2024. Under the Pae Ora Amendment Act 2024, all remaining roles and functions of the Health Authority would be transferred to Te Whatu Ora (Health NZ) and the Health Ministry. The Iwi MÃÂori Partnership Boards and the Hauora MÃÂori Advisory Committee, which were established under the Pae Ora Act 2022, will remain in place. On 28 February, the Pae Ora Amendment Act 2024 passed into law by a margin of 68 to 54 under urgency.
On 14 June 2025, Health Minister Simeon Brown announced that the Government would be introducing legislation to amend the Pae Ora (Health Futures) Act 2022 including establishing a new statutory purpose to ensure that patients have access to "timely" quality care, legislated health targets to improve accountability and management, stronger financial oversight and governance within Health New Zealand, empowering the Director-General of Health to monitor Health NZ, prioritising skills and delivery in the appointment of board members, reducing red tape and audit requirements, enhancing the advisorial role of the Hauora MÃÂori Advisory Committee, and repurposing the iwi-MÃÂori Partnership Boards to focus on community engagement rather than designing and delivering services.
In early December 2025, the health select committee delivered its report on the proposed legislation, which approved of the Government's plans to remove the independent monitoring of MÃÂori health and centralise the functions of MÃÂori health boards. The proposed amendment legislation would also remain the bill "Healthy Future (Pae Ora) Act." The opposition Labour, Green parties and Te PÃÂti MÃÂori delivered a joint dissenting report arguing that the amendment would disempower the MÃÂori health boards and undermine the New Zealand Crown's partnership with MÃÂori.
The New Zealand Disability Support Network recommended that the Pae Ora (Health Futures) Bill be amended to include that Health New Zealand Board's members have person experience with disable issues; that Health New Zealand collaborate with the Ministry for Disabled People on disability issues; that the Minister of Health consult with disabled people, their families, carers, and disability representative organisations and providers regarding the development of the Disability Health Strategy; that the Health Quality and Safety Commission (HQSC) consult with disable people, their families, providers, representative organisations, and providers.