Communities suffered because of healthcare worker recruitment and retention failures by DHBs, doctors representatives say, but they're sceptical of new reforms.
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Two overarching new bodies officially replaced the country's 20 district health boards yesterday - Health New Zealand Te Whatu Ora and the Māori Health Authority Te Aka Whai Ora. It is the biggest health sector reform in two decades.
Resident Doctors' Association head Deborah Powell said she hoped the system overhaul would help end the country's piecemeal approach to hospital services, and years of neglect and underfunding, but she was wary the changes would not address the root problems decisively.
"The workforce is critical to this. District health boards I'm afraid have failed the workforce, and Health New Zealand has to address our workforce and our pipeline issues as a matter of priority - but at the moment we have to get through winter."
In the short term, Dr Powell said hospitals were going to have to ask for the goodwill of doctors, to focus on the regions in most desperate need.
In the medium and long-term, the association wants New Zealand to train more doctors.
Rural General Practice Network chairwoman Fiona Bolden said she had no confidence the pressing issues facing health in the regions would be addressed by Health New Zealand, or that solutions could be delivered in a timely way.
Workforce shortages rurally had resulted in many areas where people had no access to health care at all, and more where there was no access to after-hours healthcare. And there were problems getting enough ambulances to respond to all calls for help.
"At this particular moment [I'm] not confident at all, and that's mainly because of the fact that we've gone for such a long time with nothing happening, and that we have these huge issues around pressure on the workforce."
She said a commitment to increase funding for rural health would give her confidence.
Bolden understood Health New Zealand was keen on exploring the use of phone and online services to help deal with the problem, but she warned that would not be enough.
"It does have a place, but at the same time I would still say that it's not going to replace people - obviously you still need people on the ground,
"I think a key thing is actually having [more] healthcare professionals coming through into rural areas."
Ashburton GP spokeswoman Penny Holdaway said she was concerned the impact of the health reform would be negative for rural communities, general practitioners would continue to be undervalued and rural areas marginalised.