A significant reduction in the number of New Zealand's District Health Boards (DHBs) is more or less a certainly, given the Health Minister's assurance that he was "absolutely committed" to reducing the numbers.
And David Clark has promised that if Labour is re-elected come September 2020, New Zealanders can expect the Government to put into practice some of the significant changes recommended in a major new report.
But not everyone is happy – the Green Party is critical of a proposal to scrap the democratic voting system which elects people onto DHB boards.
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A report into New Zealand's health and disability sector, spear-headed by former Prime Minister Helen Clark's chief of staff Heather Simpson, outlined major flaws in the health care system.
The 300 page report recommended:
• New Zealand's 20 DHBs to be reduced to between eight-10
• The movement to a system where DHB board members are appointed, rather than publically elected
• The creation of a new entity, Health NZ, to focus on the operational and financial side of DHBs
• The creation of a Māori Health Authority, to advise on Māori health
Although Clark said the Government agreed with the "direction of travel," it has yet to accept any of the recommendations laid out in the report.
But, speaking to reporters this morning, Clark said he was "absolutely committed" to reducing the number of DHBs across the country.
"The direction of travel is very clear and the opportunity is huge."
He said the reforms would "certainly" be a key part of the next Labour Government's reforms.
The Government would legislate for any of the recommendations it chooses to adopt after the election, if re-elected.
Clark is sounding markedly upbeat about the likelihood of the recommendations becoming law.
He said the creation of a new health agency, as well as the reduction in overall DHB numbers, would help fix the woeful financial positions of DHBs.
According to the 2020 Budget, the Treasury is expecting DHB deficits of $1 billion a year, for the next four years.
In fact, the Budget said: "There is a significant risk that DHBs' deficits may be higher than what has been included in the fiscal forecasts, which would adversely impact the Government's operating balance and net core Crown debt".
Clark said the changes to the health care system – as proposed by Simpson – would help stem the fiscal bleeding.
"I expect DHBs to return to surplus over time."
Greens health spokeswoman Julie Anne Genter said local democracy is a core value for the Green Party and, as such, the party was opposed to the recommendation to scrap DHB voting.
"Local communities, and the health workers and their unions that serve them, must be fully engaged in the decision making steps following this report."