sbiddle:

 

The DHB ideology had been something Labour had been obsessed by for several decades before finally implementing it in 2001. After our health reforms in the '90s lots of people had warned of the risks of moving down this path but they seemed to be ignored at the time, and we ultimately ended up with a system that was fundamentally flawed and that no Government since has wanted to touch because of the risk of change.

 

Right now the risk in the change, and whether this can actually be accomplished.

 

DHBs were a damn sight better than the even more ideologically driven CHEs that they replaced. Thank goodness they got unwound as they would likely have ended up as functional as the electricity market is now.

DHBs were largely a return to the Area Health Board system which existed before 1993.

floydbloke:

 

Should be a blank canvas right, with no (or minimal) legacy systems to support or adapt, and a great opportunity to leverage contemporary technologies? Although not without its complexities of course with legacy data imports, security and privacy considerations.

 

That's one of those things that sounds easy but is nearly impossible to implement and pipedream to implement quickly.

afe66: Health NZ otherwise known as Auckland and the others Health.

Expect local decision making to be devolved to auckland. Now faceless decision making will be made 100s if not 1000km away.

Geektastic: One thing is for sure: there’ll be good money to be made from implementing all this!

Handle9:

 

sbiddle:

 

The DHB ideology had been something Labour had been obsessed by for several decades before finally implementing it in 2001. After our health reforms in the '90s lots of people had warned of the risks of moving down this path but they seemed to be ignored at the time, and we ultimately ended up with a system that was fundamentally flawed and that no Government since has wanted to touch because of the risk of change.

 

Right now the risk in the change, and whether this can actually be accomplished.

 

 

DHBs were a damn sight better than the even more ideologically driven CHEs that they replaced. Thank goodness they got unwound as they would likely have ended up as functional as the electricity market is now.

 

DHBs were largely a return to the Area Health Board system which existed before 1993.

 

I've only spent probably 30 mins reading up on this last night but to me what the Govt is planning shares many similarities with what the intended outcome was of the CHE model - while the individual boards are going, the focus is also going to be on primary healthcare and focused regional resources which was a key part of the CHE model.

Biggest problem we've had is close to 40 years of health under funding by every Government. If that doesn't change, a restructure isn't going to fix anything.

sbiddle:

 

Biggest problem we've had is close to 40 years of health under funding by every Government. If that doesn't change, a restructure isn't going to fix anything.

 

Yes.
Its going to make zero difference to those needing health care , with just a few exceptions .
The govt is going to fork out the big $ for this change in management structure (thats all it is) , but no announcement of any major change in health spend

So, $$$$$ spent on change in Management & IT & infrastructure. That money would have been better spent on actual health services .
If anything , waiting lists will get longer as patients from(say) Gore can get onto Ak hospitals waiting list (yes an extreme example)

It will also mean faceless bureaucrats even more removed from the regions they look after .
And I bet , in 10-15 years it will all be reverted back to how it was , to some extent.
And whats going to happen with all the DHB's huge debt ? Will the new dept cut services to pay off all that debt (they really would need to)

Re-arranging deck chairs on the sinking ship .
Im not saying it didnt need to happen, but we are kidding ourselves if we think its going to solve any of our health system problems .

Handle9:

 

floydbloke:

 

Should be a blank canvas right, with no (or minimal) legacy systems to support or adapt, and a great opportunity to leverage contemporary technologies? Although not without its complexities of course with legacy data imports, security and privacy considerations.

 

 

That's one of those things that sounds easy but is nearly impossible to implement and pipedream to implement quickly.

 

Having spent time in government IT I totally concur.  It will not be easy, it will not be quick and it will not be cheap.

My earlier comment also said strong leadership is needed.  I include technology in this.  It's going to need a CIO with autonomy and decision making ability.  Responsible, educated, informed decisions.  Oh and ownership, someone who is willing to grab it by the cajones and say "yep, this is mine, leave it with me, I'll get it sorted"

1101:

 

Yes.
Its going to make zero difference to those needing health care , with just a few exceptions .
The govt is going to fork out the big $ for this change in management structure (thats all it is) , but no announcement of any major change in health spend

So, $$$$$ spent on change in Management & IT & infrastructure. That money would have been better spent on actual health services .
If anything , waiting lists will get longer as patients from(say) Gore can get onto Ak hospitals waiting list (yes an extreme example)

It will also mean faceless bureaucrats even more removed from the regions they look after .
And I bet , in 10-15 years it will all be reverted back to how it was , to some extent.
And whats going to happen with all the DHB's huge debt ? Will the new dept cut services to pay off all that debt (they really would need to)

 

Re-arranging deck chairs on the sinking ship .
Im not saying it didnt need to happen, but we are kidding ourselves if we think its going to solve any of our health system problems .

 

unfortunately i think you're going to be right.

the only hope is the rejig doesn't make things worse.

if it stays the same i can cope with that.

invisibleman18: Haven't read much of the detail so sorry if this is dumb, but what actual difference to healthcare will be made beyond all the money that will need to be spent on changing signage, uniforms and stationery? For the guy in the news who couldn't access specialty cancer care in Southland, what difference does this make if there is still no specialty facility in the region?

as someone hinted, these people all go to AKL/CHCH for treatment?

we don't know at this stage however

floydbloke:

 

Should be a blank canvas right, with no (or minimal) legacy systems to support or adapt, and a great opportunity to leverage contemporary technologies? Although not without its complexities of course with legacy data imports, security and privacy considerations.

 

You still have to accept data from and send data to all the existing systems (e.g. labs) which are configured for the DHB's existing system. And you really don't want a big-bang cutover, so you need to shift one DHB at a time to the new system, whilst keeping all the others going.

Batman:

invisibleman18: Haven't read much of the detail so sorry if this is dumb, but what actual difference to healthcare will be made beyond all the money that will need to be spent on changing signage, uniforms and stationery? For the guy in the news who couldn't access specialty cancer care in Southland, what difference does this make if there is still no specialty facility in the region?

as someone hinted, these people all go to AKL/CHCH for treatment?

we don't know at this stage however

afe66: Health NZ otherwise known as Auckland and the others Health.

Expect local decision making to be devolved to auckland. Now faceless decision making will be made 100s if not 1000km away.

And? Auckland has been hamstrung by neglect from central government and a civil service who have been quite happy to pretend there is no world north of Porirua.