RIP DHBs - The Tuesday Club

Last Wednesday, the government announced that they will disestablish the system of District Health Boards (DHBs) in its entirety…

This follows on from a report that Heather Simpson prepared for the government in mid-2020; you can read her report (warning – 274 pages!) or a summary of the main points.

While Simpson had recommended that the number of DHBs be reduced from the current 20 to between 8 to 12, the government decided to go much further and do away with these organisations altogether.

Stuff’s political journalist Henry Cooke expressed his surprise about one of the most amazing aspects of this proposal: despite its momentous scale, nothing about it had leaked beforehand (which surely must differentiate the Labour Party from National).

Despite having a couple of good members of the CDHB, generally Canterbury folk we suspect will be feeling relieved. Though it would be hoped that some of the patient centred approaches pioneered by our CDHB will become common practice around the country.

Alex Braae, a super-talented journalist working for The Spinoff, wrote a very good explainer of what all these changes mean. The main points are:

that there will be two new entities (Health New Zealand and Māori Health Authority)
the change will get away with the “postcode lottery” of where which health services will be provided
this addresses in a fundamental way the collective debt of over $1 billion across the 20 DHBs.
Another change is that it will take many of the Ministry of Health’s functions away and downgrade it to deal with policy only.

In the big scheme of things, these are very positive changes. I’ve never believed that the elected part of DHBs ever worked (who knew who they were voting for?) and in fact, the underlying legislation prescribing the electoral system for DHBs (they had to use STV or single transferable vote) made local democracy more complex, as it confused voters in those areas where STV wasn’t also used for the remainder of the local elections.

My biggest concern with these upcoming reforms is that they are being organised by the Ministry of Health. Anybody who has followed the Canterbury DHB debacle closely is very likely to arrive at the conclusion that there are some fundamental problems at the ministry. Will this organisation have the nous to organise such a major overhaul? Only time will tell.