Top Labour Party Ministers, including the Prime Minister, are sounding an optimistic tone over the likelihood the Government would implement a significant shake-up of the health sector, if re-elected.

This comes after a "once-in-a-generation" report into New Zealand's health care system revealed a number of major flaws in the sector and put forward a number of significant recommendations.

The recommendations include:

• New Zealand's 20 DHBs to be reduced to between eight-10 within five years
• Moving 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

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The report, spearheaded by former Prime Minister Helen Clark's chief-of-staff Heather Simpson, labelled New Zealand's health care system "complex" and "fragmented," and in need of major reform.

"From a workforce point of view, staff are feeling more and more stressed, facing increasing demands and significant shortages in supply," the report said.

Speaking to the Herald, she said the current system does not produce as equitable results as it should.

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"For those who it works well, it works well. But it doesn't work well for everybody."

It is now up to ministers to decide which of the report's recommendations should be adopted and made law.

But those decisions will not be made until after September's election – something the National Opposition says is a "blatant attempt to kick the can down the road and avoid doing their job".

Despite this, both Prime Minister Jacinda Ardern and Health Minister David Clark agree that, if elected to a second term, major changes will be made.

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"I agree that reform is required. Now we're setting up the system to begin the rollout of those plans," Ardern said.

Ardern will lead a team of top ministers – including Finance Minister Grant Robertson and Clark – to drive the changes after the election, if Labour wins.

Health Minister David Clark arriving for his media conference over Heather Simpson's Health and Disability System Review. Mark Mitchell
Health Minister David Clark arriving for his media conference over Heather Simpson's Health and Disability System Review. Mark Mitchell

Speaking in the House, Clark outright said there would be "fewer DHBs" if Labour was re-elected.

Earlier in the day, Clark said the Government 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.

Simpson's report was particularly critical of DHB leadership, saying that it "needs to change" and the effectiveness of elected board members was "not compelling".

She also proposed that a new agency, Health NZ, be set up which would run the ruler over DHB's financials.

Heather Simpson, chairwoman of the Health and Disability review panel. Photo / Mark Mitchell
Heather Simpson, chairwoman of the Health and Disability review panel. Photo / Mark Mitchell

The majority of New Zealand's DHBs have reported deficits for quarter after quarter and are expected to remain in the red for the foreseeable future.

According to the 2020 Budget, the Treasury is expecting DHB deficits of $1 billion a year, for the next four years.

Clark said the changes to the health care system – as proposed by Simpson – would help stem the fiscal bleeding.

Meanwhile, the creation of a specific Māori Health Authority, which Simpson said would strengthen Māori leadership, has also been recommended.

This authority would be the principal adviser on Māori health issues, as well as taking the lead in strengthening the Māori workforce in the health sector around the country.

The reaction to the report and its recommendation has been largely positive.

Council of Trade Unions (CTU) President Richard Wagstaff said the report has shone a clear light on some challenges that our public health system needs to address.

Victoria University senior health policy lecturer Anna Matheson said the report was "heartening" but there were still issues within the health sector.

"We have still not addressed institutional racism, and we have not done well in tackling the social determinants of health, such as liveable incomes and healthy housing."

Clark admitted that there was institutional racism in New Zealand's health care sector, but the Māori Health Authority would help fix that issue.

But NZ First Leader, and Deputy Prime Minister, Winston Peters disagreed with Clark on this point.

"The fact is, if people are unfamiliar with their clientele or their patients, they can come to that sort of conclusion, but I don't think it's deliberate."