Te Whatu Ora / Health NZ has been working on the plan for many months but is now in a financial crisis.
Photo: UnSplash/ Stephen Andrews
A plan to transform health care across the country with fewer specialty hospitals, more ambulances to connect them and more community-based care is on hold.
Te Whatu Ora / Health NZ has been working on the plan for many months but is now in a financial crisis.
“Health NZ is still working out the details of how the organisation will deliver its services as part of the recently announced restart,” a spokesperson told RNZ.
“We expect to be able to provide more information on these topics in the coming months.”
The National Service and Campus Plan (NSCP) was the organization’s overarching attempt to follow the example of countries such as the United Kingdom, Denmark and the Netherlands.
The goal: “fundamental changes” in the way people receive medical care, including to curb the demand for inpatient beds that is overwhelming the system.
It is “the first phase in developing a well-considered plan for the future” to adapt services to geographical and demographic needs, said a briefing on the NSCP sent to the government in April and published under the Official Information Act.
“The design of our health services and facilities must be planned at a national level to ensure that all New Zealanders have equal access and treatment opportunities.”
This resulted in complex treatment being shifted to fewer specialist clinics, while less complex treatments – so-called “walk-ins” – were shifted to “less complex facilities” with greater frequency.
One disadvantage is that sick people “may have to travel long distances”, so that the ambulance on the road and in the air must be better equipped.
The NSCP also called for more partnerships with private providers and investments in “hospitals at home.”
“Virtual healthcare will play an increasingly important role,” the briefing said.
This depended on widespread use of telemedicine, but that hasn’t worked so far either. Telemedicine peaked during Covid-19, being used about 20 percent of the time for primary care appointments, but fell to just 8 percent last year, other reports showed.
It also depended on a much more costly digitalisation within Health NZ and a new national health information platform called Hira. But that programme was cut by $380 million in the 2024 budget and was also in limbo.
Both the digitization work and the NSCP were part of a 10-year investment plan that is currently being worked on and is at the heart of the “reset” that followed the dismissal of the Board and the appointment of Commissioner Lester Levy.
Lester Levy.
Photo: RNZ
The NSCP stressed the need to “create a system.” Levy and Health Minister Shane Reti have renewed the focus on the four regions.
However, the Health NZX spokesperson told RNZ: “As with many other functions, there will be a national perspective as we look at the future design of service delivery and care models in our community and in hospitals.”
The old NSCP was supposed to be run by the Hospital and Specialist Services Unit, but the national director of that unit has just been dismissed.
The problem facing every plan is of tsunami proportions: in all regions, the number of people over 80 – who are ten times more likely to need hospital treatment than 45-year-olds – will double by 2043, the briefing said.
And by 2043, almost 5,000 new hospital beds would be needed if the care model does not change.
“An increase of 4,900 beds is not financially viable and does not take into account the care cost model we are aiming for.”
The solution was seen in more clusters of complex care and better networks of non-complex care, starting with Northland and Tai Rāwhiti/Hawke’s Bay.
It would be cheaper and faster to expand the networks in the communities. This would “reduce referrals to general and specialised hospitals” where capacity pressure is greatest, the briefing said.
The dismissed board approved the NSCP in December. Reti asked to see it earlier this year. How much of it will remain after the restructuring remains to be seen.
