The soon-to-be former Southern District Health Board could be replaced by 10 or more localities when the ongoing reform of the health system is complete.
At the end of this month, the 20 DHBs are to be replaced by central organisations Health New Zealand and the Maori Health Authority.
DHBs will briefly survive as "health locations" but the reforms envisage they will be replaced by localities. A locality co-ordinator is expected to audit and assess their area’s health needs and advise HNZ.
So far, nine prototype localities have been set up, none of them in the South, although it is understood Southland was close to making the initial cut.
The SDHB has just released a "transition strategy", which contains a range of demographic and health system statistics, and suggestions for the incoming health system leaders for what Otago and Southland residents might need.
The strategy said its proposed areas for localities were suggestions only, as if they were endure they could not be developed through a "top-down mandate".
Local communities and health organisations needed to develop structures and solutions that met their needs, it said.
"Health organisations and communities should begin an informed discussion on what are the right localities for the south.
"Health NZ and the Maori Health Authority will facilitate decisions on localities.
"However, it is vital that community understand the issues and own decisions about the choice and establishment of health localities."
The strategy’s proposed localities were:
- Waitaki (which could extend into the former South Canterbury DHB);
- Dunedin (potentially two localities);
- Clutha and Gore as a combined or as separate "health neighbourhoods";
- Central Lakes. Queenstown-Lakes and Central Otago, either as one locality or various health neighbourhoods;
- Southland, possibly with a separate neighbourhood in western Southland;
- Iwi localities, should a Maori community feel their locality not align to its interests.
The document envisaged that a "collective impact" approach, such as that used by the Whanau Ora Commissioning Agency, could be used to establish the final shape of the localities map.
It also proposed that population health units within the DHB also had a role to play in defining localities.
"The National Health Service in the UK has been developing place-based partnerships for many years and has developed some useful principles to work from."
The SDHB, which is seeking public feedback on the strategy, also set out five "key messages" to be considered — support of Maori health leadership, a focus on health outcomes, proactive decision making for the future, building of health networks, and a recognition that Covid-19 showed that the health system needs to be flexible.
