Heather Simpson, chairwoman of the Health and Disability System Review panel. Photo / Mark Mitchell
Heather Simpson, chairwoman of the Health and Disability System Review panel. Photo / Mark Mitchell
Taxpayers forked out $7.8 million for a health system review that included $2m for personnel, $778,000 in committee fees and $278,000 for travel.
There was also $2.7m paid to 17 consultants and contractors - excluding IT specialists - in the Health and Disability System Review.
Billed as a "once-in-a-generation" reportby the Government, the two-year review was released in June, citing a complex and fragmented health care system in need of major reform.
The review panel of seven, led by former prime minister Helen Clark's chief-of-staff Heather Simpson, recommended New Zealand's 20 district health boards be reduced to between eight-10 within five years, appointing rather than electing board members, creating a new entity to focus on the operational and financial side of DHBs, and creating a Māori Health Authority.
The review panel, including Sir Brian Roche - who together with Simpson was last week drafted by the Government to plug border-testing gaps in the Covid-19 response - was hosted by the Ministry of Health and supported by a secretariat.
Deputy director general of health Sarah Turner said the report was written by Simpson and members of the panel supported by the secretariat, which included input from consultants.
Payment rates for the panel were set at $1062 per day for Simpson, as chairwoman, and $800 per day for the other six members.
Official figures released to the Herald by the Ministry show 17 consultants and contractors were used by the review.
This included several recruitment agencies and various contractors and consultants such as PricewaterhouseCoopers, paid $1.35m, Sapere Research Group, $483,638, Fernhill Solutions, $381,900, and Think Differently Solutions, $107,700.
Other expenses included computer services, $442,853, occupancy and lease costs, $241,059, printing and stationary, $85,612, other professional services, $52,882 and other operating expenses, $162, 269.
National's health spokesman Dr Shane Reti says it is not yet clear which DHBs might be scrapped if recommendations in the Heather Simpson review are implemented. Photo / Mark Mitchell
National's health spokesman Dr Shane Reti said he didn't mind paying "good money, for good value, for a good report that's going to have meaningful and significant impact".
"But I'm always very mindful that none of this money directly touched a patient. We've got $6m [excluding GST] of paper in our hand. I could do an awful lot of hips, knees and glue-ear for that money. Was this the right trade-off?"
He said the report's value for money could only be determined if the recommendations were implemented.
Reti said if the Government was going to follow the recommendations it should tell voters before the election which DHBs would be dismantled.
Chris Hipkins, in his role as Labour Party health spokesman, said Labour was in the final stages of preparing its manifesto for the upcoming election, and this would be released in due course.
Hipkins said Labour had accepted the case for reform and the direction of travel outlined in the review.
The Association of Salaried Medical Specialists, the union for senior doctors, said it was encouraging the review had come in under budget, of $9.5m.
However executive director Sarah Dalton, who attended one of the committee meetings as part of the review, said the big question remained whether the $7m investment would be "converted into actions".
"And actions that make a positive difference to people's access to free and affordable healthcare."
Dalton said the review also highlighted the use of taxpayer money to fund private consultancy work in the public health sector.
"There is so much consultancy used in the public service and it hides the true cost of running our public service."
She said the ongoing reliance on consultants was irritating and questioned whether it was financially prudent or necessary.
"Shouldn't we have a lot of that capacity and capability in the public service and it's just a way of juggling the books in my view, and it probably doesn't save us much money in the long run."
Health systems expert Professor Robin Gauld, dean of the Otago University Business School, called the cost of the review a "tremendous amount of money".
"But the devil is in the detail and there's a not a lot of detail in what will happen next, and there's a long timeline, over about five years.
"The sector is ready for some quite significant change to happen quite quickly."
Gauld also said the amount paid to consultants in the public health sector, who could command between $300 and $700 an hour, was too much.
He said universities could conduct research for much less.
In 2016 he co-authored a paper which found DHBs across the country spent between $10m and $60m annually on consultants with many unable to identify the extent or purpose of consultancies within their organisation.
Gauld said he was in the process of updating the research and that spend had risen significantly.
