Government's health changes the fourth major health sector revamp in 30 years

The New Zealand Government has today announced a massive revamp of the country’s health system – its fourth overhaul in 30 years.

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From area health boards in the 1980's, through to crown health enterprises, or CHEs in the 1990s, then it was 'not for profit' crown owned companies and finally the now out-going DHBs. Source: 1 NEWS

Health care by region was seen by the then-Labour government as the way forward when it was established back in the late 1980s, when the country’s population was 3.2 million and Auckland’s average house price was just $157,000.

Health Minister David Caygill established 14 area health boards, citing a lack of community input and service co-ordination had led to buck-passing and recrimination in the sector.

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Sarah Dalton is the executive director of the Association of Salaried Medical Specialists. Source: 1 NEWS

“Up until about 1983, we just had hospital boards and GPs doing their thing. They weren't government services but they were paid for by government,” University of Auckland health researcher Tim Tenbensel explained.

More change followed, with the National-led government transforming the 14 boards into 23 Crown Health Enterprises (CHE) run as competitive businesses.

The model changed again in 1998.

“The problem with that system was the efficiencies in competition didn't really work,” Tenbensel said.

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Now, after 21 years, district health boards are going, too.

However, doctors are calling for the plan to reconfigure the current 20 DHBs into four regional and one Māori entity.

“This is a good move to centralise co-ordination. Services were becoming a bit fragmented, potentially inequitable,” emergency specialist Dr John Bonning said.

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Through four regional divisions, the new organisation will run hospitals and look after primary and community health services. Source: 1 NEWS

It’s also seen DHBs come under fire for deficits and issues such as bullying and board instability.

“There's a general view that it’s time for some sort of change,” Tenbensel said.

“We think this is a great opportunity for the Government and the ministry to take leadership of healthcare across the country,” Bonning added.

However, the move will mean no more public voting for local board members.