Can Health NZ fix the under-funding of health services in South Auckland? (Photo: Tina Tiller)

Will scrapping DHBs remedy South Auckland’s medical woes?

South Auckland leaders are cautiously optimistic the government’s new health reforms can be a ‘once-in-a-generation’ opportunity to get on top of the region’s chronic health issues.

“It’s about time,” said Auckland councillor Fa’anana Efeso Collins. 

The outspoken South Auckland politician isn’t alone in his endorsement for the dramatic health reforms revealed by health minister Andrew Little this week.

The government will abolish district health boards and establish a new Māori Health Authority as part of a raft of measures designed to “have a truly national health system, [where] the kind of treatment people get will no longer be determined by where they live”, Little said at an announcement at parliament on Wednesday.

Collins, who also chairs Ōtara Health, said these changes are an opportunity for decision-makers to tackle “persisting health inequities in the system”.

“This will lead to better informed decisions relating to Māori and address the long-standing issues South Aucklanders have faced due to years of chronic under-funding under the current model,” he said. 

Māori disability rights advocate Dr Huhana Hickey, who had been considering leaving South Auckland on account of difficulties accessing care for her chronic health issues, said the announcement has offered a ray of hope for herself and many others in similar situations.

“We had to get rid of health boards because they haven’t been working for a long time,” she said. “One of the biggest problems we’ve had is this whole postcode lottery. I use ADHB [Auckland District Health Board] services from time to time and we’ve seen postcode discrimination first-hand, multiple times. I love South Auckland, and I’d love to stay, but it all comes down to whether I can be assured of long-term quality services or not.”

However, Huhana is reserving her judgement when it comes to the Māori Health Authority.

“The devil is going to be in the detail in regards to that authority,” she said. “Who is going to be a part of it? Is there going to be nepotism that sometimes happens with these authorities? Or are they going to appoint experts. If so, I want to see if Māori disability experts are on there.”

Former head of intensive care at Middlemore Hospital David Galler said the reforms are a “once-in-a-generation opportunity” that shouldn’t be seen as “a centralisation of power, but actually a redistribution of power”, given how the current system has disadvantaged certain communities.

“I think places like South Auckland, Northland, Tairāwhiti, Whanganui, Porirua, the areas of greatest need, are the areas that are most likely to benefit, because let’s face it, we’re not doing that well now.

“South Auckland, in particular, has the most complex health population in New Zealand, and we do not have access to in-patient services for neurology, ophthalmology, ear, nose and throat services, neurological services, which the populations in Christchurch, Wellington and Dunedin have in spades. I’m seldom moved by government announcements, but I was really moved by what I heard.”

Dr Collin Tukuitonga, associate dean (Pacific) at Auckland University, is circumspect, but optimistic the Māori Health Authority could have flow-on benefits for Pacific peoples given they access many of the same services and face similar health issues to Māori. 

“There’s a lot of detail missing. But in terms of what has already been announced, some would say it’s a good thing, as people in South Auckland have also missed out on a lot because of chronic underfunding, and so a national system might mean everyone gets the same in terms of accessing quality.”

The Spinoff understands the Counties Manukau DHB members are generally positive about the reforms, particularly the Māori Health Authority, but will want to ensure a “South Auckland equity voice is not lost in a centralised structure”.

In a written statement, Counties Manukau board chair Vui Mark Goshe said the board “is developing a programme of work to prepare for the reforms, which are scheduled to come into effect from mid-next year. In addition, the Mana Whenua board, with whom we work closely, will be even more involved in our board processes moving forward.”

He said there will be a focus on “speeding up” of activities related to “facilities development and community-based initiatives”.

“We look forward to receiving the health system review information as it is provided, to support our staff through this process, and to continue to deliver the highest quality healthcare to our community.”




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