Major health sector shake-up: Govt scraps all DHBs in favour of one national authority

All of New Zealand's 20 district health boards will be replaced by one, single national health body responsible for the running of all hospitals, the Government has revealed.

Key points:
• All DHBs will be replaced by one national health body, Health New Zealand to fund and run the health system
• A new Māori health authority will be created, with power to commission health services
• The Ministry of Health will become an advisory and policy agency only
• A new Public Health agency will be created within the Ministry of Health

All of New Zealand's 20 District Health Boards will be replaced by one, single national health body responsible for the running of all hospitals, the Government has revealed.

It will be called Health New Zealand and is part of the biggest changes to the country's health care system in history.

And a new Māori Health authority will also be set up, with the power to commission health services and monitor Māori health, as well as developing policy.

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This will all be overseen by the Ministry of Health, which will be "strengthened" by the review.

This morning, Health Minister Andrew Little unveiled the major changes – "the reforms will mean that, for the first time, we will have a truly national health system".

The changes will begin to come into effect in July next year and will do away with the "postcode lottery" of different care provided depending on where you live.

The major announcements are:

• All DHBs will be replaced by one national health body, Health New Zealand to fund and run the health system
• A new Māori health authority will be created, with power to commission health services
• The Ministry of Health will become an advisory and policy agency only
• A new Public Health agency will be created within the Ministry of Health

Today's announcement is not the full extent of the Government's major healthcare shake-up and there will be further announcements on the disability sector.

"We are going to put the emphasis squarely on primary and community healthcare and will do away with duplication and unnecessary bureaucracy between regions," Little said.

He added that the reforms "herald a change in focus for the health system".

Health Minister Andrew Little will this morning outline the Government's plan to fix New Zealand's healthcare system. Photo / Mark Mitchell

When it comes to the DHBs, today's announcement actually goes a lot further than the recommendations in last year's Heather Simpson health report.

That report advised the Government to slash the number of DHBs in New Zealand from 20 down to between 8 and 10.

The announcement means that the 20-year-old system, whereby the public vote for DHB board members, will be scrapped.

Although Little said DHBs have served their communities well for 20 years, having separate organisations and competing priorities has led to "unacceptable variability in health services".

"That is," he said, "the type of treatment you get can come down to where in the country you live.

"That's why it's become known as the postcode lottery – in a country as small as New Zealand, we just don't need it."

He stressed that the reforms will not mean funding to hospitals will get cut, Little said.

Health New Zealand will comprise the 12 public health services across the country.

The new Māori Health authority will be an "independent voice", which will aim to change Māori health outcomes in New Zealand, according to Associate Health Minister Peeni Henare.

The Government is unveiling a significant 'once-in-a-generation' health sector shake-up. Photo / Supplied

"It will have joint decision-making rights to agree national strategies, policies and plans that affect Māori at all levels of the system," he said, adding that it will work alongside Health New Zealand.

Little said the Covid-19 pandemic was one of the reasons for the new Public Health Agency.

"Population and public health present some of the largest opportunities to address inequality, tackle the causes of health need and manage future demand."

Its main role will be to lead New Zealand's overall health strategy, policy, analysis and monitoring of the entire health system.

"It will monitor threats to our health and ensure we are ready to deal with them," Little said.

In other words, there will be a shift in the Government's health priorities towards prevention.

Little said: "The reforms will ensure the system is able to cope with the effects of an ageing population and respond more quickly to public health crises like the Covid-19 pandemic".