Today marked the beginning of the biggest change to our New Zealand health system in two decades. But while those driving the change are full of optimism, those on the healthcare frontline said they still have doubts and questions about the change.
Our two brand new entities were heralded in on July 1, beginning with a service at Waitangi.
Health NZ (Te Whatu Ora) and the Māori Health Authority (Te Aka Whai Ora) are now working as one, controlling the delivery and commissioning of health services nationwide.
And despite the scale of the challenge ahead, those committed to implementing the reforms are resolute.
"Starting in Waitangi was really good this morning because it was dark and no one saw me cry... that's how remarkable this day is," Associate Health Minister Peeni Henare said.
But some question the timing.
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 said several "frontline issues" need to be urgently addressed to ensure the reforms meet expectations.
Health Minister Andrew Little acknowledged the sector is under pressure, but that's even more reason, he said, "things had to change."
"It had to change before Covid, but what Covid has done for us over the past two years is demonstrate, even more so, and even more aptly, why change is needed."
But the president of the New Zealand Nurses Organisation, Kerri Nuku, said delaying the process by mere months would have gone a long way to relieve the pressure facing the sector.
"We could have chosen a better time, not during the winter months, when we've got all this crisis and short staffing and burnout among the staff."
Queenstown Medical Centre chief executive Ashley Light said there's also been a lack of consultation with local care providers, leaving many in the dark.
"[It's] Still pretty unclear what the changes will mean on a local level so yeah we're sort of still waiting for the leadership to step up and let us know what the vision is."
Overall $11.1 billion has been allocated to overhauling the health system, including $1.8 billion to wipe out DHB debt.
But Canterbury tax researcher Dr Michael Gousmett said there's a lack of public information about funding.
"There's no information coming out about that at all and that concerns me that we know nothing."
But Riana Manuel, the interim CEO of the Māori Health Authority, says there'll be careful decision making for money spent.
"There's not an endless pool of money we all know this.
"Health takes up a big chunk of the spend here in Aotearoa."
And while the massive change comes with a hefty price tag, he said the reforms are expected to save money in the long run.
"Our aim is to get really effective, be more efficient... to move resources around."