"If you do not complete the census you deprive the district Health Board of $3800 per person each year," MidCentral Health District Health Board Brendan Duffy (appointed by the Minister of Health) told a Business After Five meeting in Levin last week.

He shared some of the triumphs and problems as well as complexity of local healthcare.

He showed staggering figures: 45 per cent of the population of Horowhenua (14,982 people) is considered deprived according to the 2018 census, meaning in decile 9 or 10. For Tararua that is 34 per cent, and for Ōtaki 28 per cent.

Duffy said funding for DHBs depends on the number of people counted within each district during the census.

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"I know there are lots of issues, such as the level of health service, but we are not solely responsible for state of affairs of deprivation. We need better collaboration with many other agencies, including housing and education for example."

He said many of the 13 health board have brand new boards and have been tasked recently to do better for Māori, 24 per cent of Horowhenua's population.

The MidCentral Health DHB are a 730 million dollar operation with 3000 staff, servicing 180,000 across five local authorities.

"Healthcare is extremely complex and very expensive.

"We are expecting seven days of the week, 24 hours of the day, for every day of the year to be available to provide whatever service any of those 180,000 people want on any affliction known to man," Duffy said.

On the positive side MidCentral Health has had $30m to upgrade the acute mental health ward.

"But one unit in Palmerston North will not solve all issues for our 180,000 customers."

There are two more surgical suites, taking the existing seven to nine. There is $26m more for surgical services.

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But lack of GPs around the region means many people come to the hospital for minor issues.

"The hospital is your last port of call, when you really need it, but many people go to hospital with modest issues, and clog the system as a result and many will find themselves waiting for hours to be seen."

Hospital staff see people around the clock and that means you may find yourself having to wait or being discharged in the middle of the night.

"I have surgeons ringing around in the middle of the night trying to find a patient a way to get home. We need better solutions for this too.

"Why is the DHB responsible to get someone a taxi to go home after being discharged from hospital if no-one can pick them up at 2am?"

He said he is aware Horowhenua wants better access to services, better mental health and addiction services, healthy living and better communication and connection between services.

He said MidCentral Health is performing well within the given restrictions.

"We are on target for a $12m deficit this year, which is allowed for. It means we are performing well."

But a more accurate population count will get the DHB more money for services, he said.