Overhaul of DHBs welcomed
The sweeping changes to the health system should create a more equitable and efficient national service, especially for Ma¯ori and disadvantaged people, Wellington region doctors and health experts say.
Many cautiously welcomed the Government’s surprise announcement yesterday that it would be scrapping the country’s 20 district health boards, including Wellington’s Capital & Coast District Health Board and
Hutt Valley District Health Board.
But details were scant, making it difficult to gauge the impact on patients and healthcare providers.
Samantha Murton, an Island Bay doctor and president of the Royal New Zealand College of General Practitioners, said the announcement showed a focus on ‘‘getting patients what they need’’ through a centralised health system.
‘‘The way it is structured now doesn’t cover off the health needs,’’ she said, adding that she was excited with the proposed ‘‘locality networks’’ that would serve as a one-stop shop where patients could access a
GP as well as maternity care, district nurses and optometrists, for example.
Health Minister Andrew Little announced the Government would create a national health organisation, a Ma¯ ori health authority and a new public health authority to centralise public health work.
The Ministry of Health will remain in overarching control of the health system, and the directorgeneral of health, currently Dr Ashley Bloomfield, will continue to lead the health sector.
But the ministry will not be responsible for running hospitals or commissioning healthcare spending, instead focusing explicitly on providing policy advice to the Government.
The radical shakeup, which goes beyond the recommendations from the government-appointed Health and Disability Systems Review, could fundamentally change how New Zealanders receive healthcare. It also comes for a health system tasked with responding to the Covid-19 pandemic and delivering the nation’s largest immunisation campaign.
Porirua GP Larry Jordan, who is also chairman of the Tu¯ Ora Compass primary health organisation, said it
was encouraging that the Government had ‘‘taken the bull by the horns’’.
‘‘But the devil is in the detail . . . how it will work and how it will be resourced. There is still a lot of work in front of us,’’ he said.
Information on how the proposals will work and how it will address the nationwide shortage of GPs – half of whom are due to retire over the next decade – remain unclear.
Hutt Valley and Capital & Coast District Health Board chairman David Smol said in a statement that the DHB would remain focused on care while the changes were implemented. He did not respond to questions about job losses and the impact on patient services.
Hutt Valley DHB board member and gastroenterologist Richard Stein said the reforms were a positive step to deal with ‘‘tremendous inefficiencies in the healthcare system and inequity in healthcare’’.
‘‘For a country our size to have 20 district health boards – there’s a problem on several levels,’’ he said. ‘‘There’s a duplication of resources. There are 20 different administrations, 20 chief executives and 20 chief financial officers.
‘‘I think the population as a whole will benefit, and I think we will have more money that’s better prioritised,’’ he said. ‘‘It will be a lot more efficient.’’
Dr Tristram Ingham, a senior research fellow at the University of Otago’s Wellington campus, said he applauded the Government’s ‘‘definitive action’’ to improve Ma¯ ori health equity and ‘‘the integration of a currently very siloed system’’.
‘‘A key announcement was the creation of the Ma¯ ori health authority in a manner that gives it a real prospect of making tangible gains for Ma¯ ori which neither the ministry nor DHBs have managed in recent memory,’’ he said.
Hawke’s Bay District Health Board chairman Shayne Walker supported the plan.
‘‘Having one Health NZ as opposed to 20 DHBs brings a lot of benefits. It’s certainly better than the current structure we have,’’ he said.
The reforms are expected to take three years to complete.