High hopes ahead of NZ's biggest health shake-up in 20 years

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.

New Zealand’s biggest health reforms in 20 years has raised aspiration and expectation across the sector nationwide ahead of its rollout on Friday.

The reforms are driven by the Government’s vision of improved healthcare nationwide and a “levelling of the playing field’ in disadvantaged communities.

The establishment of a new Māori Health Authority (MHA) is a long-awaited nod to an urgent need to address shortened life expectancy of up to 10 years in some Māori and Pasifika communities.

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

The MHA will partner with the another new entity, Health NZ, to effect change and stop the postcode lottery that has long delivered inequitable access and delivery of healthcare.

The reforms are a huge undertaking for a large and complex sector and comes with a price tag of $500 million.

Adding to the complexity of the reforms is a general acceptance that the health sector itself is not in good shape.

Hospitals and other frontline services are groaning under the pressure inflicted by the Covid-19 pandemic, significant staff shortages and a surge of winter illnesses.

The Royal College of GPs believe a number of 'frontline issues' need to be urgently addressed to ensure the reforms meet expectations.

Medical Director Dr Bryan Betty says an ongoing shortage of GPs, the basic funding formula for general practice and better health delivery to high needs areas are three areas in need of immediate attention.

"We’re seeing a lot of structural change," he said. "What we’re not seeing clearly is the vision for 10 years’ time."

Adding to the complexity of the reforms is a general acceptance that the health sector itself is not in good shape.


Betty acknowledges that good things are happening but says the challenge is making them work well and cohesively nationwide.

"What we’re driving towards is unclear at the moment," he said. "We’ve got to stay positive but we need a clear vision as to where we’re going as well."

In some parts of Aotearoa, outgoing DHBs, community health experts and wraparound service providers have established local programmes that work.

In Northland, the DHB is running an antenatal programme with a focus on traditional Māori birthing practices and techniques.

It offers a holistic approach through its co-ordinator Koha Aperahama, who is part of the Northern DHB’s rural, family and community services team.

"A lot of influence for that kaupapa came from my own whānau and really from my grandmother, down to my mother and down to me," Aperahama said. "It’s been created by many people, not just me alone."

Under the reforms, there is widespread aspiration that similar programmes will be adapted for use in other communities. It's believed requirements for overarching national plans will offer flexibility in application.

The challenge now for those leading the reforms is addressing the urgent needs of the health sector while turning aspiration into reality through a vision that is clear, achievable and manageable.