1 July 2019
DHB numbers a distraction from the real issues of funding and workforce
“Reducing the number of district health boards will not magically resolve the heavy burdens of financial deficits and
workforce shortages in our hospitals,” says Ian Powell, Executive Director of the Association of Salaried Medical
He was commenting on an article arguing for a reduction in the number of DHBs to save money and time on both governance
and senior management (https://www.stuff.co.nz/national/health/113866554/we-need-to-slash-the-number-of-district-health-boards
“Having fewer DHBs might look attractive at first glance but it’s erroneous to think it will make much difference as the
number of DHBs has nothing to do with deficits,” Mr Powell says.
“Costs have been more or less static during periods when there have been no deficits, as well as periods of deficits.
The deficits we’re seeing now are actually due to a significant rise in acute demand which is higher than both
population growth and funding increases, coupled with eight years of under-funding of public hospitals by the previous
“We’re seeing more seriously ill patients with a range of complex health conditions flooding our public hospitals, and
the health service is struggling to cope.
“In the case of Canterbury DHB, for example, the deficit there has been worsened by the ongoing aftermath of the
Christchurch earthquakes. The Government’s population-based funding formula has been unable to cope with the impact on
patients, including reliable enrolment data, of national disasters.”
Mr Powell says a radical reduction in the number of DHBs means decisions will probably end up being made at some remove
from where health professionals work, thereby increasing the risk of errors and creating added expense.
He pointed to the merger of the former Otago and Southland DHBs as a move which was supposed to reduce costs but instead
had resulted in a bigger than ever deficit for the new Southern DHB.
“Focusing on the number of DHBs is just a distraction from the real issues, which are to do with the proper level of
resourcing required to run a high quality, accessible and equitable public health service,” he says.