Former SDHB member welcomes devolution plan

John Chambers
John Chambers
The Health Minister’s plan to hand more decision-making power to the regions has been welcomed by a former Southern District Health Board member, who warns the current approach cannot continue.

Dr John Chambers said local accountability and public awareness of issues had eroded following the abolishment of district health boards in 2022 and the establishment of Te Whatu Ora Health New Zealand (HNZ) and the Māori Health Authority.

A local body of some kind was needed to improve the situation, he said.

His comments follow Health Minister Dr Shane Reti’s announcement earlier this week that the health reforms — aimed at ending geographical differences in care — had gone too far. He said more decision making would be shifted back to the regions.

"There are some parts that need to be owned by the centre, absolutely, but we need to be very careful because what has happened here is we've lost local accountability," Dr Reti said.

Dr Chambers, an immediate past SDHB member who spent three decades as an emergency department specialist before retiring last year, said he thought some sort of backtracking was inevitable.

Centralised decision making was too slow and too far removed from local populations, he said.

"I think there's a lot to be said for the monthly board meeting to attend to ask questions of what's happening in the region."

People were somewhat in the dark about health system issues, and HNZ’s online presence was upbeat rather than informative.

Before the SDHB was abolished, the public sections of the meetings had been increasingly long — a positive thing, he said.

He had thought the new system would mean there were still two boards in the South Island, but at the moment there were none.

The question now was whether the new government would act to make improvements, or if it would continue kicking the can down the road.

"Maybe what's going to happen here, if they don't come up with local boards, [is] councils will have to start stepping in and speak up for their local population on health matters."

Immediate past SDHB chairman Pete Hodgson said there was quite a lot of central input even before the boards were abolished, but the reformed health system was now "lacking a degree of local input".

An important part of the health reforms was supposed to have been local networks, which the government at the time had intended would provide accountability. However there had not been anywhere near enough progress on this, he said.

"The solution to that might be to progress with the local networks as originally planned and and see how that goes.

"I think it's too early to judge them to be a failure when they've yet to be formed."

Dr Reti also confirmed the government would scrap the Māori Health Authority and replace it with Māori directorates within HNZ and the Ministry of Health.

He did not say whether more regional decision making would mean a return to regular publicly accessible meetings when asked by the Otago Daily Times.

HNZ chief executive Margie Apa said the organisation was talking with the minister about his priorities and working to implement them.

HNZ was committed to transparent decision making and public engagement, she said.

"The Pae Ora Act envisaged that local voice in service planning and co-ordination would be enabled through the establishment of localities which are still being established.

"One of the pilot localities is in the Southern region covering Gore, for example."