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Francesca Rudkin: Health system reform a radical and necessary move

Francesca Rudkin,
Publish Date
Sun, 25 Apr 2021, 9:51am
Photo / Getty Images

Francesca Rudkin: Health system reform a radical and necessary move

Francesca Rudkin,
Publish Date
Sun, 25 Apr 2021, 9:51am

It’s been a big week.

The Trans-Tasman Bubble opened on Monday with plenty of interpretative dance and celebration, and by the end of the week traffic was halted between Western Australia and New Zealand as Perth went into a three-day lockdown.

This week also saw new restrictions on travellers from India, Brazil, Pakistan, and Papua New Guinea, and border exceptions changes were announced which will hopefully see more migrant families reunited.

On top of that there was a bilateral meeting between New Zealand and Australian Foreign Affairs Ministers - in person - which led to the debate over how and when New Zealand should criticise China for its human rights record.

Then there’s the health system reform.

A month ago, off the back of challenges hospital emergency departments are facing across the country, I spoke about Minister Andrew Little’s major redesign of the health system and the importance of getting it right.

While the public, and most certainly those in the health sector, felt a significant change coming I don’t think anyone anticipated the ambition of this week’s announcement.

I’m impressed. What a ballsy, radical and necessary move by the Minister of Health.  

The national health organisation Health New Zealand will replace all 20 DHB’s, it will run hospitals, commission primary and community health services, and 4 regional divisions will give a local voice to the organisation. The formation of a Maori Health Authority will take care of Maori Health and commission services for that purpose, and a Public Health Agency will be responsible for public health issues.

Implementing what has been proposed will be a massive task and one in which the devil will be in the detail; and we don’t have that detail yet.

We all want a fairer system, to reduce the postcode lottery of health care, to have complimentary systems working across regions to help with a transient population and avoid duplication, to improve the outcomes for cancer and heart disease and many other diseases where we know we can do better.

It’s been good to hear positive feedback from clinicians – those at the forefront of health care in NZ.

But there are still concerns and many questions still to be answered. Such as rural health and the availability of GPs in provincial and rural areas. No one should be waiting for a month to see a GP - so will people need to travel further for care or is there a plan to increase GPs? 

I’ve heard some say this new national system will be run like Pharmac. Does this mean there’s a possibility some less common services may not be offered?

And how do we ramp up in-demand services to cater to all those who need it? If a service is not available in your area presumably you will be able to travel to access that service elsewhere – but many of our current health care services are already at capacity.

One thing probably hasn’t changed, and that’s the budget. There is a limit on the amount of money that can be put into health - that’s just reality. So in order for this to work, we need to get better bang for our buck. If Minister Little achieves this, and outcomes for Maori improve, this week has been a big step in the right direction.

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