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Ian Macara (65), who is stepping down after eight years of managing WellSouth, said primary health was the engine room of the health system.
The ongoing Government-ordered review of the health system provided an opportunity to ensure primary health was properly funded, Mr Macara said.
"This foundation must be protected and solidified under whatever structure emerges.
"Also, an increased focus and investment is needed for a `healthy start to life', such as increased investment in health promotion, especially from ante-natal and for the first three years of a child's life.
"In every aspect, but especially to ensure mental and physical resilience, genuine actions need to be agreed and resources provided to address the adverse social and environmental determinants of health.''
WellSouth, the local primary health organisation for Otago and Southland, oversees primary health services for more than 300,000 patients and serves 84 general practices.
Mr Macara leaves just as a major policy - the regional primary and community care strategy - begins implementation.
He called it a "bold landmark'' for health in Otago and Southland and said he was tempted to stay on to see initiatives such as healthcare homes and community health hubs implemented.
"My view is that refreshing senior management in any health organisation is a good thing and it's a question of timing.
"Leadership expertise that strengthens and supports improvement is vital as partnerships develop across the health sector in Southern.
"It is the appropriate time for the torch to be passed to [incoming chief executive] Andrew Swanson-Dobbs, whose skills will be invaluable as he leads the very capable WellSouth team in the evolving
There used to be nine PHOs in Otago-Southland, and merging them to become WellSouth happened under Mr Macara's watch.
Other changes he oversaw included greater use of streamlined IT services, achieving regulatory requirements for general practices; introducing diabetes and cancer screening and emphasising falls prevention programmes,
"Most of these were planned as advances, supported by WellSouth, for the benefit of patients and service providers,'' Mr Macara said.
"But what is elusive and critical importance is what are improved health outcomes achieved for patients?''
New Zealand's health system was a sickness-based model and multi-disciplinary approaches to support people's overall long-term good health were undervalued, he said.
"We know the wisdom of `prevention is better than cure'- a rebalance is necessary to underpin the overall effectiveness of our health system.''
Mr Macara has relocated to Queenstown and planned to take a sabbatical from work, to travel and holiday.