Southern leaders mixed on reforms
Southern leaders have largely welcomed sweeping changes announced for New Zealand’s healthcare system, but with the caveat that it will require careful planning to succeed.
Health Minister Andrew Little announced yesterday morning that New Zealand’s 20 district health boards will be replaced by a central health governance agency.
A Ma¯ ori health authority and a public health authority will also be established and locality networks will be set up so that regional and community needs don’t fall through the cracks.
Invercargill-based Labour MP Dr Liz Craig said the DHB model had not always worked well for Southland – particularly since the Southland and Otago boards were merged without proper support in 2010. ‘‘Despite [the Government] investing hundreds of millions more into the Southern DHB over the past three years, difficulty accessing basic health services – things like specialist appointments, scans and operations – has remained one of the common reasons for people visiting my Invercargill office,’’ she said.
However, Invercargill MP Penny Simmonds, of the National Party, said centralising health management in Wellington would add bureaucracy to the system, rather than removing it as Little had said was the intention.
Healthcare needed accountability and performance from frontline health services and this would not be achieved under a centralised system, she said.
Simmonds said the National Party strongly opposed the establishment of a Ma¯ ori health authority, as it believed health should be based on need, not ethnicity.
‘‘To do this during a pandemic recovery is unbelievable,’’ she said, adding that dissolving district health boards had not worked in the past. ‘‘It’s a costly mistake at the best of times,’’ Simmonds said.
However, Peter Crampton warned against making sweeping statements about the past.
Crampton is a professor of public health at Ko¯ hatu, the Centre for Hauora Ma¯ ori at the University of Otago. He is also a member of the Health and Disability System Review expert panel, as well as the newly appointed Southern DHB deputy chairman.
Speaking in his capacity as an academic, he said the changes come after 20 years of stability in healthcare. But without the details, it was too early to sort through the pros and cons.
Some services – such as specialised burns care – needed to be managed at a national level, but engagement with communities would be needed to set local priorities.
Southern DHB chief executive Chris Fleming said the new entities would be formally established from July next year.
‘‘Our focus now is on preparing for our important work for the transition phase ahead, to help ensure the best outcomes for our people,’’ Fleming said.
He said there would be no immediate changes, and the DHB would try to make the transition a smooth one.
Southland-based Southern DHB member Kaye Crawther said the board was expecting to learn more about what the announcement meant in the coming days. ‘‘Overall it will be positive, but it has to be managed properly so nothing falls through the cracks,’’ she said.
WellSouth chief executive Andrew Swanson-Dobbs said he had already raised his hand to help guide what locality networks may look like. The minister had made it clear that he was interested in working with primary health organisations (PHOs) that had built strong connections with communities and iwi – as WellSouth did when it merged nine PHOs into one, Swanson-Dobbs said.
‘‘It’s an exciting opportunity to look at the building blocks.’’
Gore Health chief executive Karl Metzler said he believed a centralised health system would level the playing field for rural patients and improve access to specialist services.
He was ‘‘delighted’’ to see Ma¯ ori and Pasifika health equity prioritised, calling it ‘‘long overdue’’, but said the changes were a major disruption at a time when the system was rolling out its biggest vaccination programme ever.