I worry about the future of healthcare in Nelson under radical reforms announced by the Government last week. The risk of centralisation for Nelson is a loss of health services and key decisions being made elsewhere.
Four big changes are proposed. A new national agency, Health NZ, would be created for managing clinical services alongside the existing Ministry of Health. A special and separate Maori Health Authority would be established. All District Health Board (DHB) members would be appointed by the Minister of Health, rather than 7 out of 11 being elected. The number of Health Boards is to be reduced from the current 20 to between 8 and 12.
The problem for Nelson/ Marlborough is that our DHB has a population of 150,000, but the new model requires between 420,000 and 620,000 people. The most likely outcome is our health services being run from Wellington or Christchurch. Ian Powell, an expert voice for hospital specialists says “Hospital services outside the main cities will be reduced” and that these proposals “will be a stuff up.”
Nelson has had control of its own health services for over a century since the first hospital board was established in 1885. It will be harder for our frontline doctors, our nurses and other health professionals to be heard by management from afar. It will be less connected with our GPs, pharmacies, community health organisations and councils. It will make my job as MP in advocating for constituents and services more difficult.
A key issue in healthcare is in ensuring the funds go into front line public services and not administration. These proposals add two new national agencies and two “Regional entities”. This can only lead to increases in the health bureaucracy.
Our Nelson Marlborough District Health Board has consistently outperformed the larger metropolitan DHBs. It did a good job through the Covid emergency. A key to success has been attracting top specialists. I am also proud of our history of innovation in areas like cardiac care that has saved dozens of Nelsonian’s lives. Our DHB has also been a leader in integrating primary and secondary health care.
These health changes are similar to those to polytechnics that has seen Nelson lose control of NMIT - now the Nelson branch of NZIST. This change has already seen the loss of top talent from Nelson like CEO Liam Sloane. NMIT employs 300 and our NMDHB over 2,000. They are Nelson’s biggest employers. I fear centralisation will result in fewer jobs for Nelsonians.
I also share the scepticism of expert health commentators who see the parallel to those changes with what occurred in the UK, known as the Lansley reforms. They failed, particularly in the regions, and are now being reversed.
I am not opposed to all of the changes. I agree with having a consistent Digital Plan across our healthcare system. But Nelson has everything to lose and nothing to gain from losing our DHB. I will fight with every bone in my body for Nelson to retain our DHB.