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UC epidemiologist comments on NZ’s major health sector reforms

21 April 2021

The government has announced sweeping changes to the health system. University of Canterbury public health expert, epidemiologist Associate Professor Arindam Basu comments on this major shake-up.


University of Canterbury public health expert, epidemiologist Associate Professor Arindam Basu (pictured above left).

The government has announced sweeping changes to the health and disability system. The changes include replacing the 20 DHBs with a national body – Health NZ – charged with planning services nationwide, establishing a Māori Health Authority, and creating a dedicated agency for public health.

A University of Canterbury public health expert, epidemiologist Associate Professor Arindam Basu, of the School of Health Sciences in UC’s College of Education, Health & Human Development, comments on this morning’s announcement:

 “This is a significant overhaul of the governance architecture of our health system. In particular, abolishing DHBs to establish a unified NHS-UK style centralised system, with parallel arms for Māori health and public health systems, may have important implications for costs.

“In an overhaul of this magnitude, any comment now is premature in terms of the eventual overall performance of the health system – in terms of costs to care, access to care, and quality of care. However, there are opportunities and challenges worth considering.

“On the opportunity side, the administration is simplified by doing away with 20 different organisational elements – the abolition of DHBs – but such centralisation also carries with it the potential to become a complex monolith, and risks losing the efficiency that each individual unit might provide in a federated system.

“I greatly appreciate this change has been made while keeping in mind the perspectives of the providers (the doctors and the caregivers) and the patients. Hence, with this change I believe access to care will be significantly improved for everyone.

“The establishment of the Māori Health Authority is definitely a welcome move as such a structure will help to mitigate the existing inequitable access to care for Māori.

“Equally, the newly created National Public Health Authority replacing the current 12 Public Health Units is likely to improve the coordination of the services. In particular, for the current and future pandemics, such a structure will make backward and forward contact tracing very efficient.

“Overall, as a public health researcher/academic, I welcome this move, and look forward to it. Having said that, how the cost to care will play out for payers and patients is a space to watch.”

(No conflict of interest.)

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