Mixed views in top of south

comes and better care for our populations is a good thing, and I think that will be the case.’’

Black said she didn’t think the people of Te Tauihu would ‘‘see a lot of difference’’, especially in the short term.

‘‘We will continue to provide fabulous services from our secondary hospitals. And likewise our primary care partners will continue to do what they do, and they do it really well.’’

There wouldn’t be a huge change for the frontline workforce, Black said.

The board was awaiting details of interim arrangements, and what impact the changes would have on jobs within the board, she said.

Marlborough Primary Health Organisation chief executive Beth Tester said she understood Little ‘‘felt strongly’’ the need to create a fairer system.

‘‘Perhaps the scale and pace is brave . . . But it’s more of a structural change than service provision . . . The devil will be in the detail,’’ Tester said.

‘‘We certainly don’t disagree with where it’s heading, but there is a lot of work to be done.’’

She was pleased to see prevention through primary health made a priority, as GPS were ‘‘under the pump’’ with ever-increasing expectations of the scope of their work in the community.

‘‘So we do need to look at the system. But Nelson Marlborough is already quite forward-thinking ... We’re already working together more as a health system, more closely with community groups and NGOS [non-government organisations], Ma¯ ori providers and iwi, and through Covid we all pulled together and helped each other.’’

Tester’s main interest was how the ‘‘localities’’ would be defined – areas in which primary and community care will be organised.

She understood each locality would be 50,000 to 100,000 people.

‘‘Marlborough is at 46,500 – we’ll be at 50,000 before you know it . . . I think it’s a good size to have our own locality.’’

Statisticians have projected that 34 per cent of Marlborough residents would be aged 65 and older by 2043.

The median age was 45.5 years in the 2018 census, compared with the national median of 37.4.

Rangita¯ne o Wairau general manager Corey Hebberd said the ru¯ nanga was encouraged by the changes, particularly the establishment of a Ma¯ ori health authority.

About two years on from a damning Waitangi Tribunal report that highlighted the consistent failure of the Crown in the care and wellbeing of Ma¯ ori, the independent Ma¯ ori health authority would have commissioning powers, and would make joint decisions alongside Health NZ.

That would help Ma¯ ori have a greater say on the services they received, similar to the successful Wha¯nau Ora initiative that provided commissioning powers for a ‘‘by Ma¯ ori, for Ma¯ ori’’ approach, Hebberd said.

The Treaty had guaranteed Ma¯ ori full rights and benefits, yet their health and wellbeing outcomes were still significantly poorer than for non-ma¯ori New Zealanders, Hebberd said.

Ma¯ori died on average seven years earlier, were more likely to die from preventable diseases, more likely to have diabetes or cancer, more likely to die from violence or accidents, and more likely to miss GP appointments due to lack of transport, or to not fill a prescription due to cost.

‘‘The reforms announced give us hope that through empowering Ma¯ ori, we will begin to turn the tide on inequitable health outcomes,’’ Hebberd said.

The new organisation needed to give Ma¯ori tino rangatiratanga (absolute sovereignty), and the wider reforms needed to ensure the Crown met its obligations under Te Tiriti o Waitangi, he said.

‘‘We’re excited by the changes outlined, to achieve pae ora – good health for all ... We’ll be keeping a watching brief on next steps.’’