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Health Reforms: Baby Thrown Out With Bathwater

Amalgamation of DHBs is necessary, but going from 20 DHBs to just one authority takes centralisation too far, says the New Zealand Taxpayers’ Union.

The Union’s 2019 report Productivity in the Health Sector: Issues and Pressures argued in favour of DHB amalgamation on the basis of productivity gains. [1]

But Union spokesman Louis Houlbrooke says, “In our healthcare report we suggested a model of five DHBs. The goal should be to remove duplication of functions without throwing out the benefits of a decentralised approach.”

“The unification of 20 DHBs into a single monolith goes too far. It’s emblematic of the same Wellington-driven centralising instinct that saw the complete amalgamation of the country’s polytechnics.”

“We are likely now to see a loss of local accountability and internal competition, along with less flexibility to test different service provision approaches in different parts of the health system. This is not a recipe for more efficient health services.”

[1] The Government should consider amalgamating some DHBs. Currently there are 20 DHBs, each of which must manage their own administrative and support services. If DHBs were amalgamated, duplication of back-office functions could be limited – saving taxpayers money and freeing up resources for actual healthcare provision. (Page 9)
 

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