Mike Hosking: Do we really need 20 district health boards?

Derek Wright strikes me as a nice bloke.

I interviewed him last week.

He is the interim boss at the Waikato District Health Board.

He is the interim boss because if you have even a passing acquaintance with the New Zealand Herald you will have read of the last boss Dr Nigel Murray and his exploits with other people's money.

There are two problems here.

One, Nigel Murray and his use of money that wasn't his, all of which is slowly but surely being detailed by the myriad investigations now underway.

In fact, perhaps depressingly, the Audit NZ report out last week suggested we may never know how bad it actually was because he booked things like his own travel so there is no real paper trail, not to mention the fact he's disappeared and no one has a contact for him so it's not like he's around to answer questions.

And two, how this has been handled by the DHB -the chair of which, finally … finally ... fell on his sword last week.

Accountability in this country is becoming increasingly a skill or trait of depressing rarity.

The fact all the board's members haven't got up and acknowledged their role in hiring a bloke who has turned out to be a record-breaking disaster speaks volumes about their self interest and desire to collect taxpayers' money for doing clearly diddly squat.

But back to Derek.

Derek ... and I ask this question of everyone I interview that has any association with public health these days ... I asked him, "Do you broadly think the idea of having 20 DHBs in a country this size is a good one?"

What I am increasingly excited to report is that they all say no.

Derek said if he was Minister of Health he'd change it.

I talked to a current board member at Waikato: She couldn't work out why we have 20.

Peter Dunne, former MP, has written recently of his dismay.

When you actually inquire of the people who are part of the system, turns out they are not fans of the system they are part of.

The one person I have asked who has defended it is the newly minted Health Minister David Clark, who rolled out the usual line about boards representing communities and their specific needs and interests.

All of which is ideologically driven bollocks given at four and a half million people in a country this size we are not so dramatically different healthwise as to require this vast array of bureaucratic apparatus.

The simple truth that has been exposed in this practice is the talent pool is too thin.

Democratically no one is interested, given the appalling voter turnout for the elected members of these boards.

So you end up with the earnest, bewildered and incompetent.

There are now too many examples of too many boards that simply aren't up to the standard you would expect in the 21st century.

From Waikato to Otago to Capital to Canterbury, you have huge swathes of the population being represented needlessly by people and boards that are mired in troubles, whether they be financial, reputational, medical or all three.

The answer, of course, is efficiency.

A smaller number of boards with actual experts, who actually know what they're doing.
Who are focused on doctors and nurses and operations - you know, the stuff that health is supposed to be all about.

Look at Waikato, look at the waste, the waste of time and energy and resource that's gone and going on into a debacle brought on by incompetence.

A debacle entirely avoidable if you had the right people pulling the strings.

Look at Waikato and tell me 20 DHBS, with all its duplication and scraping of the barrel for talent, is the way you want your health system run in 2017.