A prominent Northland doctor has called for the country's 20 DHBs to be cut down to just one or two.
"I think DHBs are a waste of time," Lance O'Sullivan told The AM Show on Thursday.
"There's way too many and there's way too many CEOs, there's way too many right? A country of 4.5 million, we need one, right? We probably need two - urban and rural."
There are presently 20 DHBs. Around $60 million a year is spent on salaries for executives, NZME reported in January, and $6 million on the boards' 209 members - that's about $29,000 each for only 30 days of work, and doesn't include expenses.
Dr O'Sullivan says there's enough money in the health budget to fund the system adequately, but there's too much bureaucracy.
"We don't have infinite resources or money. How do we be smarter? My argument is there is enough money in the budget for health to afford this if we stop doing dumb shit."
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For example, he says there's new technology which would prevent diabetics from having to do 15 prick tests a day.
"These are digital tools... you put a little device in your arm every two weeks, and it measures your sugars without you having to do anything. You pass your phone over the device and it reads your sugar levels."
The catch is it costs $2400 a year - unaffordable for many. Dr O'Sullivan says it's a no-brainer for it to be publicly funded, as it will result in a "100-fold increase in savings" down the line.
"What's the downside of not having better diabetic control? The downside is kidney failure requiring dialysis, which is expensive, complications of diabetes which cause amputations, complications causing heart attacks and stroke. Massive cost of not investing in something like this."
Not only do the devices make it easier to prevent serious complications in the future, they improve diabetics' lives right now.
"You've got things called insulin pumps that are driven by digital units, you've got digital monitors - these things are starting to talk together. Essentially a type 1 diabetic who needs insulin could have an automated digital glucose measurement going on while they're asleep and their pump's being adjusted - while they sleep."
It's estimated around 340,000 people in New Zealand have diabetes - not all of them diagnosed. It's most common amongst Māori and Pacific Islanders, who have higher rates of obesity than other ethnicities.
"Some are born with it - they have a pancreatic failure, so that's just not working. Then some acquire insulin failure over their lifetime," says Dr O'Sullivan.
"Some are born with it and some acquire it, but at the end of the day, they both have this problem."
The Government established the Ministerial Advisory Group on the Health System in December 2017 to look into ways the DHB model, and other aspects of the health system, could be improved. Its work is ongoing.
Newshub has contacted the Ministry of Health and Pharmac to ask if they're considering funding the new diabetes technology.