Centralised healthcare lacks ‘local accountability’
By David Hill, Local Democracy Reporter
Bringing some healthcare decisions back into communities will help plug the gap in local accountability, say two North Canterbury mayors.
Waimakariri mayor Dan Gordon and Hurunui mayor Marie said they were pleased Te Whatu Ora Health New Zealand was considering local solutions for healthcare, but wanted to know more details on the plans.
In a major shakeup of the health system in 2021, locally-elected district health boards were scrapped and replaced with the centralised Te Whatu Ora.
However, in an interview with RNZ in February, Health Minister Dr Shane Reti indicated some health decision-making would return to the regions.
Responding to questions from Local Democracy Reporter, Reti said he expected to receive advice from the Ministry of Health soon.
This included future operating and funding models for primary and community care.
‘‘Community involvement in health service planning, with local solutions to local health challenges will remain essential to the delivery of health services,’’ he said.
‘‘These local groups should be involved in the design and delivery of services, so the healthcare focuses on the needs of, and is effective for, the community.’’
Local primary health organisations (PHOs), such was the Waitaha Canterbury PHO, played a key role in supporting their local communities and were providing input into Health NZ’s primary care development programme, he said.
The Government has also signalled Iwi-Māori Partnership Boards will play a key role in supporting high-quality community-led health care.
Gordon said since the demise of the Canterbury District Health Board (CDHB) there were gaps in ‘‘local accountability’’.
He is the council’s representative and deputy chairperson of the Waitaha Canterbury PHO board.
‘‘I have found since the centralsation of healthcare it has been a struggle to find local accountability. Even a local contact or authority to speak to.
This must be addressed.
Having a local voice close to the issues is vital.’’
The lack of a local board chairperson meant concerns would often be raised directly with the health minister, Gordon said.
‘‘The important thing for me is the patient and ensuring they are cared for and their needs are met, and if we have an issue, where do we go to get answers?’’
Black said retaining a local voice in healthcare was crucial, particularly for rural districts.
‘‘The important thing is we retain what we have and if we can increase health provision, that is where I would be lending my support.’’
She said the Hurunui District Health Services Group had been making good progress working with the former CDHB.
But this work had been on the backburner since the board was dissolved, ‘‘so whether there is the energy to reconsider this, I don’t know’’.
■ LDR is local body journalism co-funded by RNZ and NZ On Air.
Older residents call for Amberley bus service
By David Hill, Local Democracy Reporter
A lack of public transport and access to healthcare were among the issues raised in recent a survey of older residents in the Hurunui district.
The Hurunui District Council surveyed residents aged over 60 during August and September, as it looks to develop an age-friendly community plan to support an ageing population.
There are currently no public bus services in Hurunui, which includes the town of Amberley, about 40km north of Christchurch.
Community development facilitator Vanessa Nelmes said public transport is a big issue for many elderly people, while accessing medical care when needed remains a concern.
While there are a number of community vehicle trusts operating in the district, respondents felt a regular bus service from Amberley to Rangiora and/or Christchurch is needed.
Hurunui mayor Marie Black has been among those advocating for a bus service, but for now Environment Canterbury says there are no plans to offer public transport in the district.
The distance to medical care in Christchurch and the lack of a dentist were also mentioned, Nelmes said.
The survey received 213 responses from residents aged from 60 to their 90s, with half coming from residents in the south ward, which includes Amberley.
Nelmes said the survey found a majority of the respondents felt confident using computers, internet and / or smart phones.
‘‘It kind of puts that myth to bed that old people don’t like using technology.
‘‘I think we really do need to change our mindset compared to what is really happening in our community.’’
Although about 50 respondents said they were not confident using technology, showing there was still a need for providing support.
The survey also asked if people would like to improve their skills with technology and it was ‘‘evenly split’’, Nelmes said.
A concerning trend in the survey was a number of respondents who said they felt socially isolated, especially those new to the community, she said.
‘‘We had half a dozen people who replied along the lines, ‘you have to put yourself out there, but it’s how to make the first step’.’’
The survey has been analysed by the age-friendly steering group, which plans to widen its membership to include different agencies such as district nursing and is seeking a rural voice, Nelmes said.
Council staff plan to do a stocktake of services available for senior citizens in the district, before beginning work on a draft age-friendly plan.
Environment Canterbury public transport strategy and planning manager Sonia Pollard said there are no plans to extend bus services into Amberley or the wider Hurunui district.
‘‘The focus for public transport improvements is on delivery of the core routes in Christchurch and the direct services between the main urban areas in Waimakariri and Selwyn districts and Christchurch City.
‘‘Service improvements are reliant on funding through local rates and the National Land Transport Programme.’’
She said routes outside large urban areas are unlikely to meet the funding criteria in the 2024/27 National Land Transport Programme.
But as part of the 2025/26 annual plan staff are considering how to best serve the rural community, including assessing new routes outside the Greater Christchurch boundary.
■ LDR is local body journalism co-funded by RNZ and NZ On Air.
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