Yesterday, Health Minister Simeon Brown said Health New Zealand Te Whatu Ora (HNZ) would move from a centralised approach to funding, employment and task delivery to a more "devolved" approach broken down into health districts.
The announcement has been several months in the making, after HNZ hinted about the "new model" in correspondence for some time.
This "new model" would be more nimble and able to respond to projects and issues at a local level, HNZ has said in the past.
Dunedin will be part of the South Island/Te Waipounamu health region, and the HNZ Southern district.
Mr Brown said about 85% of all health services would be based in districts, directly supporting local service delivery.
"This ensures health services provided in districts are connected and integrated, so that patients can experience a more seamless continuum of care, and health service delivery is more efficient.
"Each district will have appropriate management committees to support local decision-making."
The four health regions (Northern, Midland/Te Manawa Taki, Central/Te Ikaroa and South Island /Te Waipounamu) would ensure services provided across districts were tightly integrated and efficient, undertaking some functions that could not be undertaken in districts.
Meanwhile, national teams would lead strategy, planning, policies, standards and system integration.
Executive dean of Bond University’s business school Prof Robin Gauld said it all seemed a bit "back to the future", as the approach was relatively similar to the old health boards system.
"People always suggest that having strong local input and especially clinically led decision-making, as the Minister has talked a lot about clinical leadership, you know, these are positives.
"I guess one of the most fundamental components of all of this will be ensuring that the government really gets behind strong clinical leadership.
"And that's actually quite an undertaking. It's much, much more than just saying we support strong clinical leadership and decision making."
Prof Gauld said devolving health services actually required a lot of resources to work smoothly.
"The people who support strong clinical leadership have been made redundant.
"There are shortages in everything from HR through to all of the other sort of back office support functions.
"You know, the system is pretty, pretty strained."
Association of Salaried Medial Specialists executive director Sarah Dalton was also cautious about the upcoming changes.
"If you're going to push things back down to the districts, they need to be resourced to do that work.
"So, and from what I heard on the radio this morning, the report that HNZ commissioned suggests that it's not something that can happen quickly."
Prof Gauld was not optimistic for a smooth changeover.
"We just have an incredible history in this country of the politicians just sort of going at each other and failing to do any long range planning for health.
"If it were a business, shareholders would have walked away years ago."
Mr Brown said he hoped the new system would come into effect in July.
“This is the most significant structural change our government is making to improve how the health system operates.
"It is not a return to the district health board model, but it will reduce bureaucracy and give hospitals greater authority to make decisions that ensure delivery of the health targets within their budgets..."
