Excellent to have an insider's perspective. Thanks.
The fact that "As soon as a global pandemic was announced, a major restructuring of our public health system should have been shelved" is undoubtedly true. Many — including me — thought that a major impetus for setting up Health New Zealand/Te Whatu Ora was to enable the Maori Health Authority to be set up at the same time as a parallel organisation (which initially at least had the power of veto over HNZ decisions). That wouldn't have been possible with 20 DHBs.
It's the only plausible reason in my mind to explain why Labour, which was dedicated to co-governance, went ahead with it in a pandemic — and at huge cost.
You certainly have confirmed my biggest concerns about those healthcare changes. I always thought authoritarian control over healthcare was the goal, and control of the narrative from 1 podium of truth. Why else would you make all those changes in the middle of a pandemic ? It wasnt about being kind.
Interesting commentary - I always thought the 'partisan' who was put in charge of Health NZ found the job too hard and so cooked up a way that led to his sacking, all while he could shine his own image...
Ka pae. And Shortland Street Hospital would be more credible if it were cast as a small private hospital. It has occurred to me that the public hospital system is being allowed to run down. A cynical political option that costs nothing and produces a vacuum. A vacuum which can be filled by international private companies like AIG.
When I had an eye op last year, in a small efficient private hospital, I had to wait less than a month from start to finish instead of potentially 2 years waiting for public and getting an ansa phone message asking me "to come in tomorrow," when I'm out of town or dead. The opthamologist in both cases being the same person...
All of which is to say I expect the continued deliberate run down of the public service to continue, with a few placating knee- jerks for cancer drugs, until AIG puts it's hand up.
AIG will however demand ACC and it's $10 billion putea investments as a prerequisite.
Good to read about your in-depth knowledge of this and your now changed view of the promised benefits of amalgamation.
Key to your revised opinion appears to be the lack of willingness in Wellington to cut the number of middle management jobs needed to achieve the greater efficiencies promised.
I’m acutely interested in this and in parallel how the centralised Health Services model might benefit if applied to some functions of local government. In particular there are large numbers of people in about 30 Territorial Authorities in NZ processing Building Consent applications - all under the same rules on the Building Act, all requiring standard information contained in all manner of related documents to be repeated under each Consent application. The quagmire of duplication in the process and repetition of information insisted upon by legions of Council officers is exasperating.
If the centralised model of the reform were carried out with more steely eyes on the prize and many more jobs had been cut, would your view be any different do you think?
Another failure of our system resulting from the 3 Year parliamentary term!
I think the current government is actively investigating the performance of the health reform implemented by labour and we would have seen a better model if it was not for “reform fatigue”!
For some districts the problems remain. Waitaki's main hospital in Oamaru spent years holding off funding cuts and reviews from the Southern District Health Board as they attempted to slash costs. We had hoped that the creation of Health New Zealand would herald a better relationship with better communication and equity. However, in the last few months Health NZ has pulled the rug out from under Oamaru Hospital's feet by threatening to cancel its funding contracts. The council owned hospital is now in Ministry care, a decision made in 3 months with no opportunity for community consultation or time to consider alternative ownership structures. In my view the difference between the SDHB and Health NZ is the difference between the devil and the deep blue sea.
Thanks Haimona for another thought provoking opinion piece.
Who would have thought?
Here is a service that would have benefitted from a 3Waters style reform.
Five geographical authorities, two South Island and three North Island, rather than four would have provided a “competitive model where performance could have been benchmarked by the health authorities and by the public health ministry. (Even North and South would have worked much better. A public sector duopoly is not a threat to health outcomes)
For those who are self interested and those who insist on better performing health services, it is not too late! Why the hell dabble in equality of outcome when what we need is equality of opportunity.
Excellent to have an insider's perspective. Thanks.
The fact that "As soon as a global pandemic was announced, a major restructuring of our public health system should have been shelved" is undoubtedly true. Many — including me — thought that a major impetus for setting up Health New Zealand/Te Whatu Ora was to enable the Maori Health Authority to be set up at the same time as a parallel organisation (which initially at least had the power of veto over HNZ decisions). That wouldn't have been possible with 20 DHBs.
It's the only plausible reason in my mind to explain why Labour, which was dedicated to co-governance, went ahead with it in a pandemic — and at huge cost.
You certainly have confirmed my biggest concerns about those healthcare changes. I always thought authoritarian control over healthcare was the goal, and control of the narrative from 1 podium of truth. Why else would you make all those changes in the middle of a pandemic ? It wasnt about being kind.
You a member of the flat earth society?
Interesting commentary - I always thought the 'partisan' who was put in charge of Health NZ found the job too hard and so cooked up a way that led to his sacking, all while he could shine his own image...
The man put in charge was a self declared Marxist sympathiser.
What more can be said!
Ka pae. And Shortland Street Hospital would be more credible if it were cast as a small private hospital. It has occurred to me that the public hospital system is being allowed to run down. A cynical political option that costs nothing and produces a vacuum. A vacuum which can be filled by international private companies like AIG.
When I had an eye op last year, in a small efficient private hospital, I had to wait less than a month from start to finish instead of potentially 2 years waiting for public and getting an ansa phone message asking me "to come in tomorrow," when I'm out of town or dead. The opthamologist in both cases being the same person...
All of which is to say I expect the continued deliberate run down of the public service to continue, with a few placating knee- jerks for cancer drugs, until AIG puts it's hand up.
AIG will however demand ACC and it's $10 billion putea investments as a prerequisite.
And the news today is that @shortlandStreet is to be shortened to 3 days a week next year
Good to read about your in-depth knowledge of this and your now changed view of the promised benefits of amalgamation.
Key to your revised opinion appears to be the lack of willingness in Wellington to cut the number of middle management jobs needed to achieve the greater efficiencies promised.
I’m acutely interested in this and in parallel how the centralised Health Services model might benefit if applied to some functions of local government. In particular there are large numbers of people in about 30 Territorial Authorities in NZ processing Building Consent applications - all under the same rules on the Building Act, all requiring standard information contained in all manner of related documents to be repeated under each Consent application. The quagmire of duplication in the process and repetition of information insisted upon by legions of Council officers is exasperating.
If the centralised model of the reform were carried out with more steely eyes on the prize and many more jobs had been cut, would your view be any different do you think?
Another failure of our system resulting from the 3 Year parliamentary term!
I think the current government is actively investigating the performance of the health reform implemented by labour and we would have seen a better model if it was not for “reform fatigue”!
For some districts the problems remain. Waitaki's main hospital in Oamaru spent years holding off funding cuts and reviews from the Southern District Health Board as they attempted to slash costs. We had hoped that the creation of Health New Zealand would herald a better relationship with better communication and equity. However, in the last few months Health NZ has pulled the rug out from under Oamaru Hospital's feet by threatening to cancel its funding contracts. The council owned hospital is now in Ministry care, a decision made in 3 months with no opportunity for community consultation or time to consider alternative ownership structures. In my view the difference between the SDHB and Health NZ is the difference between the devil and the deep blue sea.
Thanks Haimona for another thought provoking opinion piece.
Who would have thought?
Here is a service that would have benefitted from a 3Waters style reform.
Five geographical authorities, two South Island and three North Island, rather than four would have provided a “competitive model where performance could have been benchmarked by the health authorities and by the public health ministry. (Even North and South would have worked much better. A public sector duopoly is not a threat to health outcomes)
For those who are self interested and those who insist on better performing health services, it is not too late! Why the hell dabble in equality of outcome when what we need is equality of opportunity.