Health overhaul wanted ‘straight after election’

Halving the number of district health boards (DHBs) in a proposed health system shake-up doesn’t go far or fast enough, some health experts say.

A key recommendation in the health and disability system review report made public yesterday was to reduce the number of DHBs by about half (eight to 12) from the current 20.

But Charity Hospital founder and surgeon Phil Bagshaw said the cull should go further with a maximum of five DHBs retained across the country.

‘‘One effective DHB in the South Island would be plenty.’’

He said funding the administration of so many DHBs was a waste of money, that should be spent on unmet health needs. ‘‘The level of performance of some of these DHBs has been absolutely atrocious.’’

Health systems expert Robyn Gauld from Otago University said the time frame for the proposed restructure – within the next five years – was far too long. ‘‘Five years is a very long time. My preference would have been to see action straight after the election.

‘‘People are frustrated with the DHB system. I think they should get on with it and do it straight after the election.’’

Gauld also wanted to see the name DHB dropped.

‘‘I think it smacks of these elected boards that don’t do much, aren’t accountable to the public, that haven’t really brought the public voice in, that no-one votes for, that are basically focused on hospitals.

‘‘I think they should rebrand it.’’ Gauld said one or two DHBs would probably suffice for management of the South Island. ‘‘We’re a small country. I don’t think we need all this local governance and oversight.’’

Good managers in local networks around the country could report to the proposed new national Health NZ entity.

A bolder pace of change was desperately needed to address many problems with the system including obsolete IT systems, Gauld said.

Bagshaw said much of the ‘‘aspirational’’ review recommendations were welcome, including an acknowledgement of the system’s ‘‘chronic underfunding’’. But implementation of the proposals would take two to three Government terms and cost ‘‘billions.’’

‘‘The problem with all aspirational things in health is they take a long time to be achieved and when we’ve got a three-year term for Government they often barely get off the ground before the Government changes and the emphasis changes.’’

Wha¯ nau Ora commissioning agency for the South Island Te Pu¯ tahitanga te Waipounamu chief executive Helen Leahy said a proposed Ma¯ori Health Authority would need greater control of funds to achieve the outcomes it would be responsible for.

‘‘It’s about resources but it’s also about independence and authority.’’

‘‘We’re a small country. I don’t think we need all this local governance and oversight.’’

Robyn Gauld Health systems expert