Northland Māori and disabled health advocates are welcoming a damning new review of New Zealand's health sector.
The Health and Disability System Review, released yesterday, recommends a considerable overhaul of New Zealand's district health boards with a focus on population health and servicing communities often let down by the health sector such as Māori and the disabled.
• 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 to between eight and 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
"I'm excited about the recommendations," said Ngāti Hine Health Trust chief executive Geoff Milner.
"They are consistent with what we were looking to see, which is change and reform."
Milner, who was an appointed member of the Tairawhiti District Health Board for nine years, said having appointed instead of elected DHB board members would give Northland's various communities targeted, appropriate healthcare as well as improving community participation.
"The health requirements of places like Hokianga, the health requirements of places like Muriwhenua, are vastly different to the health requirements of people like myself who live in Whangārei and the system just doesn't allow for that level of tailoring solutions to populations.
"DHBs with the best will in the world will always struggle to find innovative solutions to the pockets of the Northland population that really require out-of-the-box thinking."
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Milner, the Ngāti Hine Health Trust chief executive of three years, believed there were realistic solutions available to service a range of Northland communities under the same level of funding.
"As long as the system enables conversations where communities are coming up with solutions to their needs, which the current system doesn't allow, and then the system creates innovation to try different things in those communities within existing resources then that's got to be a win."
Milner saw the review as an opportunity for Māori, and others such as the disabled, to see their healthcare needs understood at a more intimate level.
While he accepted any material changes from the review would likely come after the September election, Milner expected changes to be implemented within the first 100 days should the current Government win another term.
"Certainly, Māoridom will be holding the Government to account around that expectation."
The chief executive of Northland disability advocacy group Tiaho Trust, Jonny Wilkinson, said the review was promising in the way it addressed equitable health outcomes between disabled and non-disabled people.
"I think it's definitely a positive sign," he said.
Wilkinson, who's led the Tiaho Trust for 17 years, referenced a historical divide between mainstream medical services and disability services and said the review highlighted the need to provide easily accessible healthcare for the disabled.
With calls to increase disabled workers in healthcare, Wilkinson said many would jump at the chance to work in the health sector.
"I think that there are a lot of disabled people who want to work full stop ... so absolutely there will be people who will want to work in the health sector."
The Northland DHB declined to comment on the review because it would take time to read and digest.
Northland primary health entity Mahitahi Hauora did not respond to questions from the Northern Advocate before deadline.
Health Minister David Clark said the review was a "once in a generation opportunity", particularly for improving Māori health.
"I think Māori have been not well served in our health system historically," he said.
"Māori have amongst the worst health statistics in this country. That is a national shame."
With respect to disabled New Zealanders, Clark said their poor access to services had been a failure of the current system and said more disabled Kiwis should be employed in the health sector.
Yesterday's review came after last week's National Asset Management Programme (NAMP) report, commissioned by Clark in 2018, which identified a need to fix New Zealand's hospitals to the tune of $14 billion.
In light of yesterday's recommendations, Clark confirmed the current Government was committed to rebuilding hospital infrastructure.
In the report, Whangārei Hospital overall scored "good" which referenced mean building condition and the mental health units. It indicated that while some assets were maintained well, others were in poor condition.
However, NDHB chief executive Dr Nick Chamberlain told the Northern Advocate on Friday, the DHB's own independent assessments showed Whangārei Hospital was in worse condition than indicated in the report.
"The mean building condition score in the NAMP report also does not reflect that the worst-condition parts of the main block at Whangārei Hospital [are those] that accommodate the most vulnerable patients, including the emergency department and ICU," he said.