Contents

Chapter 4
Central responsibility for the cause of death certification system

Analysis

4.9We have considered a number of agencies for this responsibility, including the Department of Internal Affairs, the Health Quality and Safety Commission, MOJ and MOH.

4.10As we described in Chapter 3, the three primary public purposes of death certification cover health, justice and statistical interests. However, our consultation and research has revealed that by far the greatest current problems, and therefore the main focus of our proposals, relate to the determination of the cause of death. Making improvements in that area requires medical expertise. It also follows that, where public money is required for these improvements, funding should largely come from health budgets rather than from justice or statistics.

4.11Therefore, we consider that responsibility for death certification should lie with the Ministry of Health. In practice, the function could sit within the Information Group, which has operational responsibility for national collections of health and disability information (although we make no formal recommendation more specific than the Ministry of Health).40 National collections provide health information to support decision-making in health policy development and funding. One dataset already under the responsibility of the Information Group is the Mortality Collection, which classifies the underlying cause of death for all deaths registered in New Zealand. It is likely that taking responsibility for the quality of outputs from the death certification process would be an extension of the current strategic direction of that service. However, given the stated function is to provide health information to support health policy decision-making, we see it as a natural extension.

4.12The death certification system is the only aspect of the policy underlying the current Act that we consider should remain the responsibility of the Ministry of Health. As we mentioned in Chapter 1, responsibility for all other aspects—burials, cremations, regulation of the funeral industry and the framework for burial decisions—should be held by the Department of Internal Affairs. Given the retention of this responsibility by the Ministry of Health, it may be thought that the legislative provisions relating to death certification should best reside alongside other health legislation—perhaps as an amendment to the Health Act 1956—rather than alongside burial and cremation legislation.

Recommendation

R2The Ministry of Health should have responsibility for the quality of outputs and outcomes from the death certification process.

40Ministry of Health “National collections and surveys” <www.health.govt.nz/nz-health-statistics/national-collections-and-surveys>.