Government slashes 20 DHBs down to one

The Government will abolish all 20 district health boards and create a single health organisation, in a sweeping plan to centralise New Zealand’s fragmented healthcare system and end the ‘‘postcode lottery’’ of care.

Health Minister Andrew Little yesterday announced the Government will create a national health organisation and also a Ma¯ori health authority with spending power, and a new public health authority to centralise public health work.

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.

‘‘The reforms will mean that for the first time, we will have a truly national health system, and the kind of treatment people get will no longer be determined by where they live,’’ Little said.

The replacement of the country’s health boards appeared not to be anticipated within the health sector in the leadup to yesterday’s announcement, and the move was not a recommendation of the review.

‘‘Our system has become overly complex. It is far too complicated for a small nation. We simply do not need 20 different sets of decision-makers,’’ Little said.

Speaking to reporters afterwards, Little said he briefed health board chairpersons and chief executives on Tuesday of the impending announcement.

‘‘There was a willing acceptance of the need for change. I’m confident they will do their bit in managing the transition responsibly,’’ he said.

The reforms were expected to take three years to complete. The Government intends to make appointments for positions in the new agency from the beginning of 2022 and, if needed, will legislate for the changes by April 2022.

Little said the funding decisions were yet to be made, and health

boards would be expected to continue to appropriately manage their deficits until they were abolished.

The Government would also make an announcement on health targets and how the new health system would be expected to perform in the near future, Little said.

A major reform will see Health New Zealand commission primary and community health services, which Little hoped would ‘‘do away with duplication and unnecessary bureaucracy between regions’’.

The focus on primary care was hoped to take pressure off the nation’s hospitals, which are working through a rising tide of illness.

‘‘We will treat people before they get sick so they don’t need to go to hospital, thereby taking the pressure off hospitals,’’ Little said.

There is a GP shortage across the country that was expected to worsen. On average, GPs are 53 years old and nearly half are due to retire over the next decade.

High patient numbers in Counties Manukau’s emergency department led the district health board to help pay for GP appointments to ease pressure on the hospital last month.

Alongside Health NZ will be the

Ma¯ ori Health Authority, an independent body that will have ‘‘joint decision-making rights’’ for healthcare strategies and policies that affect Ma¯ori – who are currently chronically under-served by the healthcare system.

The authority’s mandate will be set out in legislation and it will have independent commissioning power. It will work with Health NZ to decide where health dollars are spent for services for Ma¯ ori.

The Ministry of Health will remain in overarching control of the health system.

‘‘Our system has become overly complex . . . for a small nation.’’ Andrew Little

Minister of Health