Checkup time for healthcare

The Government is poised to announce a major shake-up of health services struggling with overflowing emergency departments, deep inequities, and long surgical waiting lists, but critics say it is unlikely to be enough to turn around patient care.

Health Minister Andrew Little has signalled a new Ma¯ ori Health Authority is coming, along with a cut in the number of district health boards and a new agency, Health NZ, to oversee those boards that survive the cull.

Further details on the shakeup will be announced this morning, as Little reveals his response to last year’s Health and Disability System Review. The Government has strongly signalled it has opted for a Ma¯ori Health Authority that will have its own budget and buying power, giving it unprecedented heft to fund Ma¯ ori health services.

But it also appears the Government will be unlikely to provide dollar figures on the reforms.

National Party health spokesman Dr Shane Reti said he expected Little to claim ‘‘budget sensitivity’’, and delay talk of cost until next month’s Budget.

The creation of a Ma¯ ori Health Authority had divided the government-appointed Health and Disability Systems Review, which recommended deep reforms to the health system in its report, published in June last year.

A more empowered Ma¯ori Health Authority has also been recommended by the six claimants in the Waitangi Tribunal’s

ongoing Health Services and Outcomes Kaupapa Inquiry, including guaranteeing the authority’s independence and ‘‘enduring funding’’. The Government has expressed a willingness to work with the claimant’s vision.

The health system review also recommended the number of DHBs be slashed from 20 to between eight and 12.

Other recommendations include the ring-fencing of DHB funding that goes to primary and community services. Yesterday, health sector leaders said the changes Little would likely announce were not expected to substantively change health outcomes.

Ian Powell, former executive director of the Association of Salaried Medical Specialists, said he expected the reforms to bring more government control over planning and funding at a regional level. He also expected the announcement to focus on primary care, which is in the midst of a GP shortage.

‘‘Restructuring doesn’t improve things ... Most of health demand and pressures are driven by external social determinants of health.’’

Health systems expert Robin Gauld hoped the Ma¯ori Health Authority would be able to raise justice and inequity issues in the health system but he didn’t expect the incoming reforms to bring real change.

‘‘We will see a few incremental changes to the status quo.’’

Gauld said there were ‘‘deep justice issues’’ with patients’ access to specialists, who often work in both the public system and privately to supplement their income. Doctors are trained in public hospitals, which allows them to specialise and move into private work. Meanwhile, the country’s public hospitals are backlogged with patients waiting for this specialised care.

‘‘Private specialists wouldn’t exist without taxpayers but the majority of taxpayers couldn’t afford to access them privately. People are waiting and waiting in the public sector,’’ Gauld said.

Reti said that Government ministers had, under questioning in the House, been saying the costs of the health reform were ‘‘budget sensitive’’. The amalgamation of DHBs alone could cost $300 million to $500m, he said.

‘‘What I’m expecting is there will be no figures given, because they are going to be big figures.’’