Tuesday, June 16, 2020

Ending the DHB scam?

The government has announced the results of its review of the health system, and it looks like a thorough shake-up:

The Government is backing a proposal for the biggest reforms to healthcare in a generation, which includes culling the number of District Health Boards around the country and dropping elections for their members.

Two years in the making, a review team of experts - led by health economist and former Helen Clark confidant Heather Simpson - has proposed a complete overhaul of the health system.

Among the review’s main recommendations are:
  • A new health authority, Health NZ, to take control of the health system.
  • A reduction in the number of district health boards, from 20 to between 8 and 12, in the next five years.
  • Ending elections for DHB members and making them all Government-appointed.
  • A Māori health authority to sit alongside Health NZ and the Ministry of Health.
Good. Because the current system - where DHBs are elected but have no power or independence - is just a scam designed to prevent accountability. When people complain about health funding, the Minister - who makes all the decisions and decides what gets funded where - gets to point the finger at the DHB and say "their fault", while the DHB can do the same right back. The result of this mutual blame-shift is left as an exercise for your next visit to your local hospital. A return to appointed membership will make it clear that they are servants and functionaries and that the real decisions are made by the Minister who appoints them - and that that Minister is the one who should be held accountable for failures of resourcing. So I expect the way this will go is that the government will adopt all the plans - greater centralisation, fewer DHBs - but keep the pointless elections, because Ministers love having a permanent blame sink.