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'We've lost local decision-making': Regions to get more health input

Jan 23, 2024

Health Minister Shane Reti says he'll shift more health decision-making back to the regions - in a big change in direction from the previous government.

District health boards were scrapped 18 months ago to form Te Whatu Ora/Health NZ and the Māori Health Authority with the aim of ending geographical differences in the care people were receiving.

But Reti said the reforms went too far.

"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. We've lost local decision making and it's all owned by the centre," he said.

That applied to the Māori Health Authority too, which the government will scrap, with Reti saying decisions were better in the hands of iwi and hapū.

"The concept of all the decision making and funding being held in Wellington, that Wellington will project out to the north Hokianga and tell Panguru what's good for them, I don't think so," he said.

The authority would be replaced by Māori directorates within Health NZ and the Ministry of Health.

Reti stopped short of saying he would reintroduce district health boards and said IT systems and key services like radiotherapy machines were examples of what should remain centrally managed.

He made the comments in an interview with Nine to Noon about his priorities now he was health minister after years of raising problems with the system while in opposition.

The health system was in "crisis", he said.

"The previous government did not want to call it what it is, I have no issue doing that. That's six letters but what it does is it sends a signal of urgency, that you understand the frontline," he said.

He would keep some hard targets, and add new ones for areas including reducing surgical waiting times, providing faster cancer treatment and cutting down on emergency department waits, he said.

He wanted to improve staffing through immigration, through encouraging people back into the health workforce and through better retention of current staff by improving conditions and pay, he said.

Reti would not be drawn on his personal views on the plans to scrap the radical anti-smoking legislation that would have cut nicotine rates and stopped anyone born from 2009 from every purchasing tobacco.

He continued to deflect questions by saying Associate Health Minister Casey Costello had responsibility for the changes and would be in charge of new policy.

Main image (RNZ/Samuel Rillstone): Local accountability is being ignored in reforms introduced by the last government, Dr Shane Reti believes. 

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