‘Do ministry too’

Canterbury Charity Hospital founder Phil Bagshaw has welcomed the Government’s plan to overhaul the health system as ‘‘aspirationally correct’’ – but warns the Ministry of Health needs reforming too.

Health Minister Andrew Little took the sector by surprise yesterday when he announced all 20 DHBs and 30 public health organisations will be abolished under a health system shake-up.

Canterbury District Health Board (CDHB) chairman Sir John Hansen and Māori health providers have welcomed the plan to replace DHBs with a central agency.

Bagshaw, who was both an appointed and elected member of the CDHB from 2000 to 2004, said he thought of the period as ‘‘the wasted years’’ in an undemocratic bureaucracy. ‘‘There was this pretence at democracy which was not genuine.’’

Bagshaw, who is also a surgeon, said he had serious concerns about the ministry’s ability to lead the transformation.

‘‘I have very little confidence in [its] leadership. Trying to work with them is like trying to run around in a vat of treacle.’’

Bagshaw said New Zealand was too small for hyper-local representation, and DHBs had failed to deliver equitable healthcare.

Under the new model, four regional commissioning entities will make decisions on funding based on information and proposals from local providers, consumer representatives and iwi. Little said he wanted the new permanent entities – including a national health agency and Ma¯ ori health authority – in place by July 1, 2022.

Hansen said the changes would better address healthcare inequities. ‘‘This will offer a much more coherent view of health, which my experience suggests has been needed for some time.’’

The current structure created competition among DHBs for capital investment and duplicated services, he said.

‘‘Done properly, this will remove the post-code lottery. It seems to me this is designed to address those issues that have existed for a long time.’’

Ngā i Tahu welcomed the health reforms announcement as ‘‘extremely promising’’.

‘‘Sweeping changes are required to combat this issue, so the prospect of a new Māori-led health authority and an approach that will give Mā ori tino rangatiratanga over hauora is an extremely promising step towards improved whā nau oranga,’’ chief executive Arihia Bennett said.

It was clear the current system was failing Māori, but it was important a centralised system was balanced with ‘‘strong local decision-making’’, she said.

Jackie Burrows, head of Canterbury’s largest Māori nongovernment social and health agency, He Waka Tapu, said she was glad longstanding calls for a Māori health authority had been listened to, saying the Canterbury health board ‘‘tried hard’’ to represent Māori but often did not succeed. ‘‘If they succeeded we wouldn’t have Māori turning up at the emergency department who should be going to their doctors, and we wouldn’t have the statistics of Māori dying well before Europeans.’’

But Christchurch city councillor James Gough, who is also an elected health board member, said the proposed changes were ‘‘terrifying’’ and had gone too far.

‘‘A one-size-fits-all approach is incredibly short-sighted because fundamentally Ranfurly is not Rolleston and Auckland is not Christchurch, and the needs differ dramatically.’’

Canterbury health board member Aaron Keown, who is also a city councillor, said he was shocked by the scope of the reforms. He said they would not improve health outcomes and that people needed to take more responsibility for their own health care. ‘‘The current system is not failing. The current system has actually been quite successful.’’

Burrows disagreed, saying better management would ensure the health budget was spent more effectively. ‘‘Andrew Little talked about duplication of services. That’s basically what you’ve got across 20 DHBs. There must be a cost-saving just on administration, chief executive salaries, buildings.’’

‘‘Trying to work with them [Health Ministry] is like trying to run around in a vat of treacle.’’

Phil Bagshaw

Surgeon and Canterbury Charity Hospital founder