Speaking at the NZNO 2021 conference, former director-general of health Stephen McKernan outlined his role as head of the transition unit for the Government’s health shake-up.
He said the new system must fix the problems facing the likes of emergency departments and mental health services.
Nurses, he said, would “absolutely” be involved in shaping the changes.
“We have nursing expertise in the transition unit now, and we’re engaging with nursing groups through our work.”
He said he had been encouraging nurses to be involved in the New Zealand Health Plan, the document setting out models of care for the entire new system.
In April, the Government announced it would consolidate all 20 district health boards into a single entity, Health NZ (HNZ). It would also create a Māori Health Authority (MHA), with its own budget to commission health services.
He said the bill underpinning the reforms would likely go to Parliament in mid-October. Between now and July 1 next year, HNZ and the MHA would work with DHBs and the ministry to shift functions to the new entities.
These would include workforce planning, and data and digital functions.
McKernan said moving to a national service meant inevitably people would talk about “a centralised bureaucracy”.
“I’m at pains to stress that this is not a centralised bureaucracy. But… what we did is we took time working through where the placement of functions needs to occur on the system.”
He said in a country of only five million people, “there are some things you should only do once”. This included long-term workforce planning, and information technology.
Hospitals would operate as a national network, where service planning could halt some of the ‘perverse behaviours’ of inter-district flows of patients.
McKernan said there was a six-fold variation in waiting times between DHBs around the country for some specialty health services.
It took a long time to roll out government programmes across multiple DHBs, such as bowel screening, immunisation and mental health support. “Much has been made of the postcode lottery impact,” he said.
Nurses did not necessarily see the variations in day-to-day practice, but this could be seen at a system-wide level.
“It’s also a system that’s struggled for long-term sustainability, and our funding settings haven’t necessarily supported… aspirations.”