End of district health boards
Ma¯ori and community health groups welcome equity focus of Government’s bold health reforms
The acronyms DHB and PHO are set to disappear from the health vocabulary, and the chairmen and chief executives of both groups in the MidCentral district are upbeat about it.
In a more radical move than many expected, the Government will abolish all 20 district health boards with their mix of elected and appointed members, replacing them with the national body Health NZ.
The primary health organisations will be replaced or evolve into local networks alongside iwi-ma¯ori boards, responsible for how community and primary health care is delivered.
Midcentral District Health Board chairman Brendan Duffy described the reforms as ‘‘bold and decisive’’.
He said the role of board members would disappear, but he believed communities would be more strongly represented and considered in the new system.
Duffy said Midcentral was already a step ahead of the game in terms of its community health and Ma¯ori equity focus. That would give the new system the best possible platform to build from.
While there would be changes, it was clear there would need to be even more people employed in health, from cleaners through to surgeons.
He said it was fantastic that a separate Ma¯ori Health Authority with its own budget and commissioning powers would be set up.
Duffy said no-one could be comfortable with Ma¯ori health statistics at the moment.
Feilding GP Bruce Stewart, chairman of primary health organisation Think Hauora, said it was possible the group would ‘‘morph’’ into one of the new population and wellbeing networks that would take on responsibility, with iwi, for community and primary health services.
He said Think Hauora’s strategic direction was in line with what the health reforms wanted to achieve.
‘‘We have the people and the tools, but it is too early to tell what the structure will be.’’
Midcentral board chief executive Kathryn Cook said she had not expected the end of district health boards altogether, but rather, some regional amalgamations.
She said Midcentral had already embraced many of the principles behind the reforms, and had many strong foundations the new system could build on.
Cook pointed to a strong relationship with Treaty partner Manawhenua Hauora, and having a single primary health organisation for the district.
She said board managers and staff would continue to be busy, coping with pressure on the Emergency Department, rolling out the Covid-19 vaccine, implementing Palmerston
North Hospital’s surgical services block improvements, building a new mental health ward and developing community mental health services.
The locality plans it had in place would provide a basis for the new approach to primary health services, Cook said.
Think Hauora chief executive Chiquita Hansen said the organisation was already travelling in the right direction, and there would be great opportunities to correct many years of under-investment in primary and community health.
District health board member and chief executive of Whanau Ora alliance Te Tihi, Materoa Mar, said it would have been disappointing if the Ma¯ori Health Authority with its own budget had not been part of the package.
Mar said it was an amazing opportunity to deal with inequity in the health system, and improve the health of Ma¯ori through earlier intervention and prevention of avoidable disease such as Type 2 diabetes and respiratory illness.
The reforms have been welcomed beyond the current system.
Manager and community health worker at Te Ha¯ o Hine-ahu-one, Palmerston North Women’s Health Collective, Jean Hera, is pleased to see district health boards going altogether rather than amalgamating.
As chairwoman of the former Central Region Consumer Representatives Forum and consumer representative on the Central Regional Leaders Committee, she had seen the challenges of achieving uniformity and co-operation across district boundaries. Districts could not even agree on compatible IT systems, or protocols for handling patients’ intravenous lines.
Hera said a legacy of the former crown health entities that preceded district health boards was a spirit of competition. She was pleased to see the Ma¯ori Health Authority and the emphasis on community health care separated from hospital-centred decision makers.
Spokesman for Patient Voice Aotearoa Malcolm Mulholland said he hoped the reforms would simplify the process of negotiating for new medications to be funded through Pharmac, and ensuring uniform access to drugs throughout New Zealand, but that would depend on increased funding supporting the reforms. Manawatu¯ Chamber of Commerce chief executive Amanda Linsley said business members supported the reforms in principle. ‘‘This reform should streamline what is an overlycomplex system and provide a more equitable national public health service. ‘‘