Mike Hosking: Time to take a scalpel to big-spending district health boards

More excellent work done by the Herald through the Official Information Act concerning our ongoing alarm over the health system: the DHBs, why we need so many of them and the extraordinary waste it creates.

The latest sorry chapter, once again, involves millions of our dollars. This time on travel, junkets and exotic locations.

In the past three years, executives in our DHBs have spent over $3 million travelling from Washington to Geneva on what I assume they would argue is critically important health work.

On top of the $3 million, CEOs spent a further $1.2 million on similar exercises. That money could have kept an entire hospital ward going for a year, or paid for 123 heart operations.

Now the real point here, for me, is not the junket aspect of it, because conferences can be helpful, contact with the outside world is useful and we can't necessarily expect anyone in the public service to lock themselves in their office never venturing out to spend a cent.

But, and this goes to the very issue around DHBs, there are too many of them. And when you have too many of anything you get duplication and repetition and waste.

We have literally hundreds and hundreds of executives wandering around our hospitals, none of them with a scalpel or a bandage in their hand, but all of them with a plane ticket and hotel bill. And all I have ever argued is that in a country of 4.5 million, without a federal and state system like America or Australia, we simply don't need 20 DHBs - we don't even need 10. I doubt we need more than four or five at a push.

And when you streamline the top end of any system, the waste gets cut. We don't need 250 people on a plane to London doing God knows what at our expense. Everyone essentially does the same thing many times over.

Even if there was knowledge to be gained at a conference in Berlin, one person needs that information, not 25. So once again, we go back to basics and ask: just how many examples do we need for the health minister to grow a pair and do something about the waste?

As we've said, even those inside the system know it's broken. From board members to CEOs, they admit if they were in charge they wouldn't run it the way it is. There is no need for 20 of everything, especially when none of it has anything to do with pills, potions, patients and procedures.

If you could take the 4 million and have a poll: conferences or operations - what do you reckon the result would be? Exactly. So given that, when are they going to do something about it?