The health system overhaul could bring about "monumental change", says a Rotorua GP, but it must be implemented correctly to avoid "complete disaster".
Health Minister Andrew Little yesterday announced New Zealand's 20 District Health Boards would be replaced by a central national body from July 2022.
A Māori Health Authoritywould be set up to monitor the state of Māori health and commission services directly.
Three Lakes GP Dr Cate Mills was astounded when she first heard of the changes.
Mills said she understood and respected the need to overhaul the health system.
"A monumental change really, and hopefully it gives us an opportunity to do it right.
"It is a really brave decision, it is a big and bold decision, and I respect the need to change and to overhaul the system. And I just hope that will be done in a way that remains keeping patient care at the focus."
She said it could be innovative and transformative, and also had "the potential to be a complete disaster".
There was a risk that the local voice could be lost in the health system overhaul.
However, she hoped that it would result in better health care and coordination of healthcare for people in the Lakes District.
Lakes District Health Board member Merepeka Raukawa-Tait, who is also the Whānau Ora Commissioning Agency chairwoman, said the move was a "significant shake-up" and an attempt to fix a health system that had not served New Zealanders well - in particular Māori.
"This is a courageous move by the Government.
"I have watched in despair the lack of improvement in Māori health outcomes for the last 20 years irrespective of how much funding was provided to DHBs. Reports of systemic racism within the health system have hindered progress."
She said the proposed independent Māori Health Authority would have a major role in monitoring the performance of the overhauled, redesigned system.
"I am not sorry to see the DHBs go, they have proved to be costly, with the inability to provide consistent high-quality services across the country.
"There is a lot of detail to be worked through but I applaud the Government and Health Minister Little who know we can do better and are prepared to do something no about it now".
• All DHBs would be replaced by one national health body, Health New Zealand to fund and run the health system; • A new Māori health authority would be created, with power to commission health services; • The Ministry of Health would become an advisory and policy agency only; • A new Public Health agency would be created within the Ministry of Health.
Lakes DHB chief executive Nick Saville-Wood said the organisation was committed to working with the Government on the implementation of these changes.
It would continue to work collaboratively through the transition towards the new structure and system, he said.
"We remain committed to improving health equity for Māori, one of our strategic objectives under our refreshed health strategy Te Manawa Rahi."
Bay of Plenty National MP Todd Muller said he struggled to see how the changes outlined by the Government would help the region.
"I have no confidence that a bureaucracy in Wellington is going to have any ability to support our community.
"I think local DHBs have the ability to understand and fund local services. Losing that connection will reduce health outcomes for my community."
Meanwhile, Māori Party co-leaders Rawiri Waititi and Debbie Ngarewa-Packer welcomed the health reform announcement.
Waititi described it as a "courageous move" in the right direction.
"We applaud the admission that the current system no longer serves our needs and we also applaud the intention to address inequities and living up to the vision of Te Tiriti o Waitangi."
Ngarewa-Packer said they would over the next two and half years they would "keep the Government accountable" to its commitments.
Waiariki Labour MP Tāmati Coffey said a new Māori Health Authority would have a unique, independent Māori voice. It would be able to commission for services, and to grow kaupapa Māori services and innovation.
"By Māori, for Māori ... supported wholeheartedly by our Government."
Bay of Plenty DHB board chairwoman Sharon Shea said the changes had the potential to change the landscape and impact of the health system.
"I think that is an absolute game-changer for New Zealand as a whole if we get that right."
Shea believed the system overhaul was about placing people's health at the centre.
"Sometimes structures need to change to achieve the ultimate goal which is better health and wellbeing for, in this case, the Bay of Plenty community."
She said as the changes went ahead, it would be important to create opportunities to strengthen the local voice.
"The minister was clear that this is about decision making closer to home, and using local expertise. The way I see it is like creating opportunities that are locally-led, regionally and nationally aligned."
Little said: "the reforms will mean that, for the first time, we will have a truly national health system".
"We are going to put the emphasis squarely on primary and community healthcare and will do away with duplication and unnecessary bureaucracy between regions."