The Auditor-General has written to District Health Board (DHBs) chairs to outline the main findings from 2019/20 audits of their activities.
Auditor-General, John Ryan said the letter highlighted the challenges DHBs will face in the year ahead under the proposed reforms to the health sector.
He asked DHB chairpersons to focus on management and governance capacity for dealing with change; performance tracking; and risk management.
“It feels something of an understatement to say that the current environment is challenging for DHBs. We remain in a global pandemic. DHBs are on the frontline of the vaccination roll-out as well as any health response to further community outbreaks of COVID-19,” the Auditor-General said.
Mr Ryan said the health sector reforms announced in April would be the biggest structural change to the health system in at least a generation.
“To a large extent, the challenges that existed before these reforms were announced remain. Some challenges might be further exacerbated by the disruptions of COVID-19. DHBs’ financial difficulties also continue to be significant,” he said.
“Each individual challenge is significant in its own right. However, the combination of these challenges increases the risks to achieving the outcomes sought for New Zealanders, using public resources effectively, and the well-being of people working in the health sector.
Under the reforms, all 20 DHBs are proposed to be disestablished by July 2022.
“However, fully implementing the changes will likely take considerably longer. New structures, processes, and relationships will need to be formed before a ‘new normal’ can emerge,” Auditor-General Ryan said.
He said both DHB governance and management capacity would continue to be tested in the year ahead and tracking of performance would be crucially important.
“This would be a useful time to revisit your risk assessments and consider what changes might be needed to meet changed risk levels,” he wrote to DHB chairpersons.