Postcode health or planned variation?

The idea of “postcode healthcare” is a kind of political memory prompt. It reminds voters of how bad they felt when dear Aunt Mabel had to wait years for her knee replacement at Dunedin Hospital.

If only she’d been able to get to Auckland DHB in the early 2000s when the board chair, that selfprofessed Mr Fixit Wayne Brown, was crowing about slashing waiting times for elective surgery, then Mabel would have been all set. Years of pain-free bouncing of babies on her knee.

Where was the plane to Auckland? There was none of that.

Poor Mabel was a victim of “postcode healthcare”, sentenced to put up with the then-Otago DHB’s waiting list priorities.

Politicians of all stripes promise to do away with that regional variation that so noisily disadvantages some and so quietly helps others. Former health reformer Andrew Little decried the “postcode variation in access and outcomes” that he attributed partly to the relative autonomy of DHBs, so he smashed that autonomy.

Now everything is going to be standardised, isn’t it, with nationally consistent clinical access criteria? Well, no, not exactly.

There’s the matter of 60 to 80 localities that will be expected to listen to their communities and tell the central agencies how they want stuff done, how they want a free plane to Auckland for Aunt Mabel, or maybe they will trade off knee ops for better cancer care.