DHBs gone by end of week - what it means for you

Nicole Bremner
Source: 1News

As the health service goes through its biggest overhaul in 20 years, 1News takes an in-depth look at what's changing and why.

The biggest change to our health system in two decades is now less than a week away.

On Friday, July 1, two brand new entities will be at the helm of our health system. The days of the country’s 20 district health boards will be over.

Reforms costing half a billion dollars will see the DHBs replaced by Health NZ and the Māori Health Authority. The new entities will be based in Wellington.

Health NZ will take on the mantle of a kind of "overhauled Ministry of Health" with responsibility for planning, delivery and oversight of all health services nationwide.

It also becomes the employer to the sector’s national workforce of around 83,000 and will continue working with all contracted services and providers.

Alongside Health NZ sits the Māori Health Authority - a much anticipated first for Aotearoa. The new authority is tasked with improving outcomes for Māori through better access and service delivery - a not insignificant challenge.

The interim chief executive of the new authority, Riana Manuel, says her agency will make sure "that equitable access and outcomes for our people are a given".

"I think the establishment of a Māori Health Authority is one of those opportunities where we start to see some co-governance and co-leadership, as an entity that will now be there formally," she says.

Health workers.

At the heart of the reforms is a desire to end the so-called "postcode lottery" that currently delivers varied wait times and access to healthcare to patients across the country.

The expectation is that oversight of service delivery through Health NZ will ensure capacity is maximised across regions.

It will potentially see patients travel for treatment within their locale, less constrained by the boundaries of district health boards.

"We are seeing growing gaps in equity of access for some population groups," says Health NZ’s interim chief executive Fepulea'i Margie Apa.

She said the system reorganisation would help to work towards better access to healthcare for those groups.

The reorganisation, alignment with the Māori Health Authority, and close measurement of outcomes are anticipated drivers of change on the issue.

"Here at the Māori Health Authority, we're going to be determined to make sure that we can see changes in progress," Manuel said.

"We do want to improve access for everybody, but let's be mindful that some groups don't have the same playing field right now."

However, across the sector, there are questions over the timing of the reforms.

The health system remains under considerable pressure nationwide due to severe staff shortages, ongoing fallout from Covid-19, early onset of winter flu, and other respiratory illnesses.

In addition, a recently established Health NZ taskforce - launched to address long surgical wait times - has yet to report back with any solutions.

"We’ve been signalling that there’s been problems with recruiting doctors and recruiting nurses and we’re starting to see that the workforce issues are spilling out into other specialties as well," says rural GP Dr Kyle Eggeleton.

"About 40% of rural general practices in New Zealand have a shortage of GPs and some of those practices can be at least two GPs short."

No quick fix in sight

With this in mind, the reforms are looking to get off to a challenging start.

But one positive is the obvious goodwill among those setting a path towards a fairer, healthier system for all.

Change, though, will be slow as there will be no obvious signs of reform on Friday.

It will be business as usual for patients - though we can expect some political fanfare to usher in the biggest health reforms in two decades.