An open letter to DHB Board members – 2016 elections

This text is from a speech presented by Professor Don Matheson at the launch of the 2016 UCAN Health Charter to the prospective Capital and Coast District Health Board (CCDHB) Board candidates in the 2016 election cycle.

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An open letter to DHB Board members.

This letter comes from a network called UCAN that is supporting action being taken to ensure everyone in New Zealand enjoys the right to health.

One area that Boards can make a difference is Primary Care.

We recommend you eliminate access inequalities (increase availability, acceptability, and decrease price barriers) to primary health care services in your DHB area.

This will require differential investment to promote equity of access, by strengthening the primary care providers whose focus is on the provision of care and improved access for people on low incomes, Māori, Pacific, refugees and those with chronic illnesses, including mental illness.  These providers may be mainstream general practices, Maori, NGO, or publicly provided services. 

In strengthening primary care provision in the Board’s area, support models of care that are responsive to and respectful of the diversity of the Board’s community.  One size does not fit all, and a single organisation outside of the public sector, monopolising primary health care provision in the Board’s area is to be avoided.

The DHB can fund this by stopping the current leakage and underspend that for a number of years has been shifting the Board’s resources from the community and primary care to the Board’s provider arm and the hospital. See this report for the situation in your Board. (Analysis of District Health Board Performance to 30 June 2015, Published June 2016, The Treasury, New Zealand Government)

In addition, we recommend you act collectively with other Boards and the Minster to address the national funding mechanism (base capitation formula, Very Low Cost Access, Services to Improve Access) so practices have money available to subsidise fees for patients who currently are struggling to access services. The current capitation formula is not adjusted to meet the high needs found in deprived areas, those on low incomes irrespective of where they live, or amongst Maori and Pacific populations.