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Two things: I don't think we'll ever see the feared 'privatisation of the health system' that people with no knowledge of the health system keep telling me is right around the corner.

Even in the incredibly unrealistic world where it were to occur, it would likely lead to better outcomes for patients.

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I’d be interested to know how you would rate the health system Japan has. Private delivery seems to work well there. Thank you for your informed insight into the long-term issues in the background of the Dunedin hospital development. It makes you wonder how Wellington hospital and others ever got built.

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Japan is a fascinating system with real pros and notable cons. It's also far more complex than our own, the payments systems and multiple providers are more intricate than anything we have in NZ across any sector, and I think that would be the problem with translating it here.

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A very good piece, Haimona but you do yourself a disservice. What you've written is enough for a royal commission. Molesworth Street Wankerism, a guide. . .thank you.

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A family member started in 2006 at what was then the Otago District Health Board in a management role. That was just before the scandal of Mike Swann was ‘discovered’. Many people at the ODHB knew that fraud was a daily occurrence and Swann was subsequently convicted. Some senior management left and the then National health minister Ryall engineered the merger of the ODHB & Southern DHB’s. The Sothern DHB senior managers effectively took over the running of the new DHB with disastrous consequences for both regions. Their level of incompetence was clear very quickly. The old Southern DHB had a none computerised, paper based payroll system for example!

Most of these new managers ultimately retired or left for other senior management roles around the country. Also, senior competent ODHB managers were effectively pushed out.

For years, senior SHDB management have been invisible. A disaster looms as a partially built new hospital will fail to give what the region needs.

If as you comment, privatisation is the way forward, I would love to hear how?

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