As hospitals experience "extreme pressure" with "abnormally high" patient presentations, NZ Nurses Organisation co-president Kerri Nuku calls on the Government to act. Video / NZ Herald
The country's new health agency will focus on staffing, chair Rob Campbell says, and changes to planned healthcare could be expected reasonably rapidly.
Health NZ Te Whatu Ora has replaced the country's 20 district health boards, though today is the start of a process likely to take several years.
DHB organisations continue to effectively exist behind the scenes until September to help ease the transition, but the elected boards do not.
Health NZ - Te Whatu Ora chair Rob Campbell said changes will take time, but planned care, such as scheduled surgery, was one area where people could expect results fairly quickly.
"That is not just the numbers, it's the way the staff are organised, it's the way the staff are rewarded and valued, it's the way the staff are involved in making decisions about how their area of work is done.
"Restoring confidence of staff is not going to happen in a week or a month, it will take time. We have to make the practical steps that people can see are going to make a difference."
The executive would be starting to make changes from next week, each one of them small but that would make a difference over time, he said.
Increasing staffing levels could not happen immediately, he said. "I can't invent doctors or nurses out of fresh air, no one can." Campbell said obstacles to health staff performing well-included pay rates.
At the heart of the philosophy behind DHBs was the idea that communities would make decisions about their own healthcare through a board made up in part of people elected by locals.
But having each one doing its own thing has created disparities.
Auckland GP Jodie O'Sullivan has seen first-hand what is described as the postcode lottery of care, with different treatments and outcomes depending on where you live.
"I have patients that are over three different DHBs, each DHB has different rules, different ways of accessing care, it's just an administration nightmare alone."
Cancer Society medical director George Laking hoped over time the new body would create the same level of care for people no matter who they are or where they lived.
"If you live rurally, if you're less well off financially, and of course if you're Pacific or Māori you have a disadvantage in terms of access to services that have been intended to be universally available."
Disparities in treatment had not come about by chance, Campbell said.
"It's been there a long time, we've known it was there for a long time, it will only change if we take deliberate steps to change it."
"These things are not chance - but they're capable of being changed."
Most of the old DHB chief executives keep their jobs in the new system and are known instead as district leads. Health bosses say that will help keep the local voice, along with so-called locality groups set up to cover places with unique character or health needs.
Gastroenterologist Richard Stein, who was on the Hutt Valley DHB, worries the local voice will be lost in a giant central bureaucracy, and wants a direct, formal voice for health consumers.
"How are you sure that your concerns are going to be relayed to the people governing the system? I don't know those answers."
The launch of the dedicated Māori Health Authority Te Mana Hauora marks the other big change in the health service]. Māori health workers have called the launch of the dedicated authority one of the biggest steps towards equity, but have also warned its success was far from guaranteed.
