Critics called it ''the single biggest risk to the delivery of public health services in New Zealand in a generation''.
There has certainly been no love lost between the country's district health boards and Auckland-based Health Benefits Limited, the Crown-owned company set up by the Government in July 2010 and tasked with finding $700 million of savings in the health sector over five years.
Its objectives were ''to facilitate and lead initiatives that save money by reducing administrative, support and procurement costs for DHBs'' by working with district health boards ''to identify efficiencies and streamline functions.''
(In effect: cutting staff, centralisation of services and bulk purchasing of equipment.) Savings would be reinvested in frontline services. The Government has said it has achieved $300 million in savings since 2010.
However, new Health Minister Jonathan Coleman yesterday admitted only $200 million in net savings had been made, and it had taken $100 million to achieve them. He said he was winding down the company and tasking district health boards with making $620 million in savings.
The Opposition disputes the cost savings, saying no breakdown has been provided.
There have been long-standing criticisms by the Opposition, DHBs and unions, who say HBL has been heavy-handed, not transparent, its plans have been beset by delays which have created uncertainty, and who fear its proposals will not deliver promised benefits and in fact cost DHBs more.
Major plans for centralising services such as hospital meals have outraged many. In a leaked memo, one DHB manager labelled HBL a Ponzi scheme whose costs had blown out, and with a pay-back period of more than 60 years.
Bearing in mind the overall health budget is some $15 billion, have the upset, costs and further level of bureaucracy been worth it given the relatively meagre savings, which are substantially short of the initial target?
There can be few people unaware of the mammoth challenges facing the health sector. Unprecedented demand is only set to increase with an ageing population, an obesity epidemic, and costs around new technology and medicines.
In this context there can be few health staff and management who do not support objectives such as efficiency to make the finite health dollar stretch further.
Given the looming challenges ahead, planning and reform are inevitable. Change is difficult for many, and pressure to reduce costs was always going to cause friction. However, it does appear HBL's modus operandi has been less than satisfactory.
Its axing will likely be welcomed by those at the coalface. The Government said its plan was always to put the implementation of HBL's plans back in the hands of DHBs, although Dr Coleman did admit this week his decision to wind down the company was in part because of the overwhelming negative response from DHBs. There is no doubt the saga has strained relationships all round.
Whatever the history, the fact is DHBs will now be tasked with making more savings by implementing HBL's business cases for the likes of finance and procurement, laundry, IT infrastructure and food services.
The pain is far from over, and uncertainty remains. But the fact DHBs themselves have more control over outcomes hopefully means they can reduce some impacts by working with their own staff and management, looking at their operations more critically, examining the requirements of their own populations, and collaborating with neighbouring health boards.
With no fat in the system, in some ways the next stage may prove a double-edged sword. But this community has already shown it is prepared to fight - and put its hands in its pockets - to help retain services.
By taking the power back, DHBs at least have the opportunity to do everything possible at a regional level to find a healthy way forward for the communities they serve.
