My View - We keep building good things, then defunding them

VIEW - Holly Knill, The Opportunity Party (TOP)

New Zealand ranks fifth in the world for health data interoperability. More than 90 percent of our records can be shared across settings, on the strength of standards work our own people have done through HISO. It is an achievement that says, ‘something is going right’.

Then look at Hira: the national shared-records programme that was paused after a budget recall. What survived is a narrower successor, the Shared Digital Health Record, now rolling out to general practices years later and with a fraction of the original ambition. Its launch has already slipped from 2025 into 2026. Four early-adopter practices, read-only data, a mid-2026 target for critical mass. Useful work, done by good people, but a long way from what was promised.

Funding cycles

That is the pattern that our Health sector lives inside. We build something world-class, then treat the money that keeps it alive as optional.

The reason is not mysterious - health runs on a three-year cycle, and digital is the easiest part of it to defer. It does not show up in a waiting list or an emergency department, so when a Budget gets tight it is the first line cut and the last restored. 

Sixty-five percent of our hospitals still run on paper notes. In practice, around 85 per cent of systems still cannot share information properly: the standards exist, the plumbing to use them does not. 

Health New Zealand is carrying something like 6,000 separate data and digital systems. When Waikato lost its clinical systems for eleven hours in July and staff went back to pen and paper, that was not bad luck, it is what deferred maintenance looks like when it finally arrives.

The vision

None of this is a failure of vision. The 10-year Health Digital Investment Plan, launched late last year with the new Centre for Digital Modernisation, gets a lot right. A single record that follows the patient, serious cybersecurity and a national radiology system with priorities written by clinicians rather than consultants. 

The Opportunity Party has said much the same: New Zealand does not need another attempt to build a digital health system from scratch, it needs to connect and complete what already exists.

But a ten-year plan needs two things to survive, and the announcement was short on both. The first is money. The plan arrived, in this sector's own words, with no budget attached. 

A plan without a funding path is a statement of intent, and intent is exactly what gets paused in the next squeeze, as Hira already has been. 

The second is cross-party agreement. A digital build cannot migrate 6,000 systems, or keep the people who understand them, if it resets every time the government changes. We have watched other health reforms swing back and forth until the policy went with the politics. Digital health cannot afford the same treatment.

Doing things differently

Here is what we would do differently. Fund the build as what it is, capital infrastructure, sequenced over years inside the infrastructure envelope rather than fought for each Budget. Fund the standards, the interoperability work and the cybersecurity assurance from Vote Health, inside a staged path that lifts health spending to 9 percent of GDP and holds it there. 

Put the whole thing inside a costed ten-year Health Plan, agreed across Parliament and given a legislative basis, with progress reported to Parliament rather than to the Minister of the day. 

The Pae Ora amendments this year already require a new Government Policy Statement and a New Zealand Health Plan, the digital plan belongs inside that, not beside it as one more document a future government can shelve. 

The sector does not need another re-invention, or another reset, it needs the one thing politics almost never offers it, a funded horizon long enough to finish what it starts. Fund health for ten years, not three, and mean it. The rest is deliverable.

If you want to contact eHealthNews.nz regarding this View, please email the editor Rebecca McBeth.

Read more VIEWS

Return to eHealthNews.nz home page