The formation of a national health board was one of 170 recommendations in the Ministerial Review Group report released yesterday.
Other recommendations include the national provision of "back office" services to district health boards and reducing the number of health committees that advise the Ministry of Health from 157 to 54.
Health Minister Tony Ryall said the Government was not interested in supporting any recommendations that increased bureaucracy or did not improve patient service.
The report, titled "Meeting the Challenge", said New Zealand could not afford to keep increasing its public health spending.
Otago District Health Board chairman Errol Millar said he had not had time to read the report thoroughly but at first glance nothing alarmed him and it seemed a "sensible document".
The approach of the review group had been "refreshing" and interactive as it canvassed the health sector, he said.
Mr Millar believed there was a willingness at the board for change and a recognition the status quo could not remain.
"We have all got to find better and smarter ways to do the job," he said.
Association of Salaried Medical Specialists executive director Ian Powell slammed the report as a "mix of fuddle, muddle and disguised potential privatisation".
The "radical restructuring" proposed in the report would generate destabilisation and uncertainty that could distract the health sector from achieving it health policy objectives, he said.
"It is misleading to allege that the report is only recommending minor restructuring.
"This is major, affecting both national and local decision-making."
It was "bananas" to suggest creating more bureaucracy would reduce bureaucracy, Mr Powell said.
The Government would be breaking election promises that it would not restructure the health system if it adopted the recommendations, he said.
Mr Ryall said the Government had made a commitment district health boards would not be "forcibly amalgamated".
New Zealand Nurses Organisation chief executive Geoff Annals said "careful consideration" would be needed before any decisions were made.
The recommendations amounted to "substantial restructure", but it was not clear why new entities, such as a national health board, were needed.
Casting health managers and administrators as "worthless bureaucrats" would not create open debate or good decision-making, he said.
"It is popular to call for fewer bureaucrats and more nurses and doctors, but the reality is that if our health services were run without good managers and administrators, nurses, doctors and our patients would be lost in chaos and wastefulness."
Much of the work done by back office staff was equally important, just much less visible, he said.
Royal New Zealand College of General Practitioners president Dr Jonathan Fox said he welcomed the acknowledgment of the "critical importance" of primary, or community, health care in the report.
Addressing the "longstanding and erroneous view that the quality and availability of primary care was somehow not directly related to public health outcomes" was something most GPs would think was overdue, Dr Fox said.
Mr Ryall said the Government was under no obligation to accept the report's recommendations and Cabinet would be considering the report during the next "couple of months".
