District health boards will be slashed and new government health agencies created in a massive overhaul of the health system.

The government has released its final Health and Disability System Review which aims to bring the biggest change to the health system since DHBs were created nearly 20 years ago.

It proposes a series of changes to reform a system which it describes as complicated and often failing Maori, disabled people and rural communities.

The key changes are:

  • Slashing DHBs from 20 to between 8 and 12
  • No longer having elected DHBs, they will be appointed instead
  • Creating Health NZ - a new crown entity that will oversee services and finances and report to the minister
  • Create a new Maori Health Authority
  • Have greater sharing of services between DHBs

The report recommended cutting the number of DHBs in the next five years, with the democratic voice on them gone. At the moment there is a mix of elected and appointed members on most boards.

It wanted them to work together better to end the lottery of post code care.

With a country of just five million people, highly specialised services could not be in every area and they should be shared and integrated across the country, the report said.

The new Health NZ crown entity would focus on finances and operational work.

It would have eight board members and a chair, with an equal number of Maori and Crown representatives.

The Ministry of Health would still focus on health policy.

The new Maori Health Authority would sit alongside the Ministry of Health to focus on Maori outcomes.

It would work to build kaupapa Maori health systems and a greater Maori workforce.

It would not be possible to improve Maori health, which is worse as a population than the rest of the country, without making the system more suited to Maori values, the report said.

The report's lead author, Heather Simpson, said there was not yet a consensus among the panel that created the report about whether that authority should control the funding and commissioning of services for Maori health.

The health system had to shift focus in all areas from treatment to wellbeing, the report said.

District health boards should clearly and transparently set money aside for primary health care - that's GP level care, it said.

And it wants the disability system simplified, saying it did not serve disabled communities well.

Rural communities were also disadvantaged and DHBs needed to work out how to serve them better, it said.

There should also be a focus on recruiting and retaining staff, simplifying IT systems and planning better for building work.

The government says the Cabinet has accepted the direction of the review and the need for reform.

However, decisions on the individual recommendations would be made in the coming months.

Via RNZ.co.nz

https://www.rnz.co.nz/news/national/419106/government-aims-to-slash-dhbs-create-maori-health-authority-in-overhaul-of-health-system