The Government is planning the biggest shakeup of New Zealand's health sector in decades after a mega review found the health system is under "serious stress" and delivers unequal healthcare.
The Health and Disability System Review, led by Helen Clark's former chief of staff Heather Simpson, hopes to address racism in the health sector and fix the entire system through a range of proposals.
It wants the number of District Health Boards (DHBs) to be slashed from 20 to between eight and 12, and the members who sit on the boards wouldn't be elected anymore - they would be appointed by the Government.
There will also be a new health authority called Health NZ which would have a tighter grip on what DHBs can do, and a new Māori Health Authority would be set up with the job of improving Maori health outcomes.
The intention to improve inequities in New Zealand's health sector is welcome news to Harmony Sylvs, whose mother is being treated in Wellington Hospital with terminal lung cancer.
Three days ago they were told she had three days left to live, and Harmony is determined to make sure her mother is treated properly.
"That's why we're here - to make sure that she gets the right treatment and the right respect as well," she told Newshub.
That's because Harmony and her mother's granddaughter Harianna have experienced racism in the health system before.
She said they're "looked down" on and that there is different treatment for Pakeha patients.
Health Minister David Clark says the review provides the opportunity to address these issues.
"This is a once in a generation opportunity to tackle the long term challenges our health a disability system is facing."
Dr Clark said he is "absolutely committed" to having fewer DHBs in the future.
But that's just one of a series of recommendations to overhaul it all.
National's health spokesperson Michael Woodhouse is skeptical the Government can deliver.
"They haven't been able to deliver anything else. I dare say a large reform of this nature is certainly beyond them."
The review wants:
- DHB members to be appointed by Government
- A new Crown entity, Health NZ, to oversee the operational running of services - making sure everything's working in concert
- A specific Māori Health Authority
Newshub asked Dr Clark if he is committed to adopting all of the report's recommendations.
"The direction of travel has been agreed by Cabinet," he said. "The individual decisions on the recommendations will be taken over time."
The Government has kicked to touch until after the election.
Lance Norman, head of Equity and Māori Health Outcomes at ProCare, told Newshub he wants to see the chances implemented sooner.
"Now we need to just get on and do the business and actually implement some of those recommendations tomorrow - not necessarily September."
The review says very few of its recommendations are standalone, saying: "It can not be done piecemeal".
"You can't just pick out two or three of them or five or six and assume everything else will happen," Simpson said.
Norman said it's like "putting half a rugby team on the field".
Under the new system, the focus shifts from a national model to communities and primary health care, and funding would be based on that - taking into account ages, ethnicity, and deprivation levels.
"It's an opportunity to say, actually, we need to make the whole system operate differently," Simpson said.
The review was finished in March but the Health Minister didn't want to see it until COVID-19 alert level 1. But when he finally got it he said he was "pretty excited".
Simpson said she felt "relief" to finally finish the report.