Fewer DHBs may be part of overhaul
Signs Labour-led Govt will bring about major health sector changes if returned
Top Labour Party ministers, including the Prime Minister, are sounding an optimistic tone over the likelihood the Government will implement a significant shake-up of the health sector, if re-elected.
This comes after a “once-ina-generation” report into New Zealand’s health-care system revealed a number of major flaws in the sector and put forward a number of reforms. They include: Cutting the number of district health boards from 20 to between eight and 10 in five years; Appointing rather than electing board members; Creating an entity, Health NZ, for the operational and financial work of boards, and Setting up a Ma¯ori Health Authority. The report, undertaken by former Prime Minister Helen Clark’s chief-ofstaff Heather Simpson, labelled New Zealand’s healthcare system “complex” and “fragmented” – and in need of major reform.
“From a workforce point of view, staff are feeling more and more stressed, facing increasing demands and significant shortages in supply,” the report said.
Simpson said the current system did not produce the equitable results it should. “For those for who it works well, it works well. But it doesn’t work well for everybody.”
It is now up to ministers to decide which of the report’s recommendations should be adopted and made law. But those decisions will not be made until after September’s election — something the National Party says is a “blatant attempt to kick the can down the road and avoid doing their job”.
Despite this, both Prime Minister Jacinda Ardern and Health Minister David Clark agree that, if elected to a second term, major changes would be made.
“I agree that reform is required. Now we’re setting up the system to begin the rollout of those plans,” Ardern said.
Ardern will lead a team of top ministers — including Finance Minister Grant Robertson and Clark — to drive the changes after the election, if Labour wins.
In Parliament, Clark said there would be “fewer DHBs” if Labour was re-elected.
Earlier in the day, Clark said the Government was “absolutely committed” to reducing the number of health boards across the country.
“The direction of travel is very clear and the opportunity is huge.”
He said the reforms would “certainly” be a key part of the next Labour Government’s reforms.
The Government would legislate for any of the recommendations it chooses to adopt after the election, if re-elected.
Simpson’s report was particularly critical of DHB leadership, saying that it “needs to change” and the effectiveness of elected board members was “not compelling”.
The majority of DHBs have reported deficits for quarter after quarter and are expected to remain in the red for the foreseeable future.
According to the 2020 Budget, the Treasury is expecting DHB deficits of $1 billion a year, for the next four years.
Clark said the changes to the health-care system — as proposed by Simpson — would help stem the fiscal bleeding. Simpson said a Ma¯ori health authority would be the principal adviser on Ma¯ori health issues, as well as taking the lead in strengthening the Ma¯ori workforce in the health sector around the country.
Reaction to the report and its recommendation has been largely positive.
Council of Trade Unions ( CTU) president Richard Wagstaff said the report has shone a clear light on some challenges that our public health system needs to address.
Victoria University senior health policy lecturer Anna Matheson said the report was “heartening” but there were still issues within the health sector.
“We have still not addressed institutional racism, and we have not done well in tackling the social determinants of health, such as liveable incomes and healthy housing.”
Clark admitted there was institutional racism in the healthcare sector, but the Ma¯ori Health Authority would help fix that issue.
But NZ First Leader, and Deputy Prime Minister, Winston Peters disagreed with Clark on this point.
“The fact is, if people are unfamiliar with their clientele or their patients, they can come to that sort of conclusion, but I don’t think it’s deliberate.”