Why DHBs should be appointed

Michael Laws in his column (and he is on a DHB) describes the true nature of DHBs:

Every piece of legislation that governs DHBs essentially says the same thing.

Your arse is mine. The minister drives policy and everybody else, whether elected or not, is simply there for show. Kevin Atkinson and his Hawke’s Bay DHB forgot that simple truth. They were never in charge; they were elected/appointed to do the minister’s bidding.

But by having some of them elected, it gives the illusion of local control, and gives the Minister scapegoats.

Expecting Cunliffe to “sort out” health would be like asking Winston Peters to sort out the Middle East. It’s not a case of where you would start so much as a case of the complete system is stuffed. Just like the Middle East. You would need a neutron bomb and the sure knowledge that only starting all over again would have any impact.

That’s a fair call. The demand for health is unlimited, so there will never be a truly sorted out health system.

Ministers don’t have that luxury. Instead they get the dubious privilege of managing all the major and mini crises until some other poor bugger gets allocated the portfolio. So they don’t need stroppy DHBs who think that their primary aim is to expose health contract corruption, run deficits and generally deliver way more health services than they are funded for.

Ouch he used the c word.

The truth is that until New Zealand has just four or five DHBs, with the necessary economies of scale and integrated services, and until the public health sector starts paying internationally competitive salaries, then no remedy will be possible. Health ministers know this. But one of their sacred cows is letting the locals labour under the illusion that they are really running their own health services. Reducing, combining or even co-ordinating the current DHBs is essential but too politically difficult.

Illusion is the right word.