Opinion: Three cheers for Andrew Little's health reforms

Health Minister Andrew Little announcing the Government's health reforms at Parliament. Photo / NZME

Three cheers for Andrew Little, a government minister who has actually decided to govern as if they do have a big majority. Let's hope he sparks a flurry of activity from his fellow cabinet ministers in other areas needing bold moves, and there are plenty of candidates, Transport, Housing, Electricity, MBIE and the SOEs to start with.

I've had plenty of experience with health bureaucracies having been parachuted in to fix Northland Health, get Auckland City Hospital up and running and as a commissioner to fix Tairāwhiti DHB in Gisborne, so I've experienced appointed boards, elected boards and no boards and I can tell you that no boards works best.

At Tairāwhiti, I found the most positive senior doctor and the most positive nurse leader, added in the most effective Māori health workers from the two local iwi and with a fresh new chief executive from the sector (a former nurse) we sorted out what had to be done and the results were so good I topped the poll in the next board election without doing any campaigning at all.

Most DHB-elected board members are just there for the salary, and the proliferation of committees and meetings means senior admin staff spend more time managing the boards than delivering health. DHBs squabble and lack cohesive policies, not even using the same IT systems and nobody could ever explain why Auckland had three of them. Good riddance to all that bureaucracy. I just hope it doesn't lead to growth in health department numbers in Wellington.

The usual suspects are complaining about Little's proposal to put Māori in charge of their own health delivery, but this also seems a good move as the current system hasn't improved Māori health statistics in spite of the best intentions of those involved. Maybe it is the system at fault.

As a hefty taxpayer I look to get the best value back for the money they take and I hate to see waste. I see this as a move to optimisation, although National party critics are labelling this as centralisation, which is a bit rich given Steven Joyce's great centralist moves like creating the mega bureaucracy MBIE with the ludicrous title of Ministry of Business, Innovation and Employment, the three things it is designed to frustrate. Let's hope the chainsaws start up with this one.

New Transport Minister Michael Wood's recent lesson about the doubling of the costs for Transmission Gully motorway should have opened his eyes to the need for a clean-out at NZTA or Waka Kotahi as it is now known. This organisation has little practical experience at board level and its organisation chart looks like the government structure for a small African state rather than a road and rail provider.

National's electricity reforms created a series of appalling monopolies called lines companies that have done nothing but increase risks and costs. This I know having been called in to fix two of the biggest ones. Clean these boards out too, please.

If we want NZ to perform as well as Singapore then the simple move of making all our SOEs trade in the interests of NZ, rather than the interests of their boards, should get the results they got from putting their SOEs under the control of Temasek.

Lastly, Housing could do with moves to allow owners to move in once the house is watertight, rather than forcing them to wait until a Code of Compliance is granted. This allows for sweat equity as the house gets plastered and painted by the owners, just like their parents did.

Come on fellow ministers. Be brave and follow Andrew Little's lead.

■ Wayne Brown has been chairman of several hospital boards, transport, electricity and broadcasting companies and was Far North Mayor.