Health and Disability reforms

The Government has announced the  final report of the Health and Disability System Review which makes many recommendations for reforming the health and disability systems, but they will need to be considered by Cabinet and there isn’t much time to do this before Parliament pauses and this year’s election campaign begins.

“The Review makes it clear we have a very good health and disability system – as has been shown by the outstanding performance of our health services in response to COVID-19,” Health Minister Dr David Clark said.

“But it also confirms that our health services and workforce are under considerable stress and our system is complex and fragmented.

The Review’s recommendations include:

  • Shifting to a greater focus on population health
  • Creating a new Crown Entity, provisionally called Health NZ, focused on operational delivery of health and disability services and financial performance
  • Reducing the number of DHBs from the current 20 down to 8-12 within five years, and moving to fully appointed Boards
  • Creating a Māori Health Authority to advise on all aspects of Māori Health policy and to monitor and report on the performance of the system with respect to Māori
  • Greater integration between primary and community care and hospital/specialist services

“Cabinet has accepted the case for reform, and the direction of travel outlined in the Review, specifically changes that will reduce fragmentation, strengthen leadership and accountability and improve equity of access and outcomes for all New Zealanders.

“The Prime Minister will lead a group of ministers that will drive the changes. The group will include the Finance Minister, Health Minister and Associate Health Minister Peeni Henare.

Interesting to see that the Prime Minister will “drive the changes”, not the Minister of health, who seemed sidelined during the Covid pandemic lockdown.

.“One immediate priority will be to lock in many of the positive changes made in recent months in response to COVID-19, such as the greater use of virtual consultations and e-prescribing and the renewed national focus on Public Health.

I have experienced virtual consultations and e-prescribing and I think these are no-brainer options along with in-person consultations when necessary or wanted.

“…reforming our health and disability system is a massive undertaking, and will not happen overnight. Meaningful change and improvement will take concerted effort over many years.

“With that in mind, I will be appointing a Ministerial Committee (under Section 11 of the Public Health and Disability Act) to provide ongoing expert advice.

“An implementation team will also be set up to lead the detailed policy and design work. It will be administered by the Department of Prime Minister and Cabinet.

It is unlikely this will be operating before the election, so will be dependant on the incoming Government probably in October.

There is quite a bit of typical Clark self praise and political palaver in his announcement. Most of that has been omitted from the above extracts. The full release:  Building a stronger health and disability system

The Health and Disability System Review is available at https://systemreview.health.govt.nz/final-report

 

Leave a comment

9 Comments

  1. Geoffrey

     /  16th June 2020

    This is a disaster waiting to happen. Elected officials have little accountability to their electorates e.g why is the Minister of Health still drawing his salary? Appointed officials have no direct accountability, e.g. When was the last bureaucrat fired for incompetence? In the interest of the public good, having our officials elected wins by a narrow margin.

    Reply
    • Alan Wilkinson

       /  16th June 2020

      The Government owns and runs far too much health provision in this country. Anyone who can goes private. The money should go to the people who need it rather than to bureaucracies that don’t.

      Reply
  2. Geoffrey

     /  16th June 2020

    This something of a quandary: many folk cannot go private and therefore are dependant upon an efficient public health system. Perhaps the answer lies in smaller public health with vigorous oversight.

    Reply
    • Alan Wilkinson

       /  16th June 2020

      Bottom up funding instead of top down. Fund through GPs for their patients and let them buy services from the best providers.

      Reply
      • Gezza

         /  16th June 2020

        GPs struggle to cope with their workloads now. They & their patients won’t thank you for adding that responsibility to their load. It would quickly turn the whole public health system into chaos.

        Reply
        • Alan Wilkinson

           /  16th June 2020

          No, it would rapidly turn most of the public health system private.

          Reply
          • Gezza

             /  16th June 2020

            Point me to where this has been done & the result was a better public health system. GPs would end up having to make judgement calls on affordability for their patients among other things. It’s ideological idiocy.

            Reply
            • Alan Wilkinson

               /  17th June 2020

              GPs already make judgements on affordability. They are in a better position to do so than patients alone and don’t have the vested interests of a provider.

  3. Geoffrey

     /  16th June 2020

    I think I like that.

    Reply

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