National's Erica Stanford says the major health reforms kicking in on Friday are just giving "different names" to the "same problems" in the system and continues to blast the Government over the "raw deal" given to overseas nurses wanting to come to New Zealand.
But new Immigration Minister Michael Wood argues the changes in health are about shaking up a system that isn't currently "fair or reasonable for Kiwis".
From Friday, the 20 District Health Boards (DHBs) that previously oversaw health services across New Zealand are no more, with a new entity called Health NZ established to take responsibility for day-to-day operations nationally.
A Māori Health Authority has also been set up to deliver improvements for Māori health, while the Ministry of Health moves to being more focused on policy and strategy.
As Wood told AM on Friday morning, the reforms are intended to bring an end to the so-called postcode lottery that has riddled the DHB system, while also addressing areas of concern raised by the Health and Disability System Review in 2020 such as a lack of equitable outcomes.
He said it is about tackling "the long-term challenges in health".
"This is about the fact that we currently have 20 different DHBs with their own governance, their own bureaucracy, a postcode lottery where people in different parts of the country get different standards of care. I don't think that anyone would say that that is fair or reasonable for Kiwis."
By having a centralised organisation, Wood said workforce challenges can be addressed at a national level rather than through many different DHBs with "their own approaches to training and recruiting nurses and dealing with the immigration system".
"This will lead to a better health care system for all New Zealanders."
But Stanford, National's immigration spokesperson, doesn't expect much positive change anytime soon.
"Different names, same problems, same overworked nurses, critical healthcare shortages, hospitals around the country that have cancelled everything apart from emergency work, nothing will change today."
She wants to see Wood, who became the Immigration Minister in June, move to make it easier for nurses who migrate to New Zealand to become residents.
In May, the Government unveiled its immigration reset, including revealing a fast-tracked path to residency for people in a number of occupations. However, nurses found themselves on a pathway that requires them to be a nurse in New Zealand for two years before they can become a resident.
The move was pilloried by the sector and by the Opposition, with a number of groups calling it "sexist" for including male-dominated industries on the fast-tracked list, but not including the likes of nurses and mid-wives.
Then-Immigration Minister Kris Faafoi fought back, saying it was an improvement on what nurses faced previously. He said the move also reflected advice about the need to ensure any nurses who come to New Zealand are retained in that profession - though the sector has taken issue with that.
Stanford said on Friday that fast-tracking nurses to residency was a "simple fix".
"What we needed to see was, especially from the new Minister of Immigration, we needed to see nurses put on the fast track to residents so we can compete with Australia, for example, and attract more nurses here.
"Instead, nurses have got the raw deal having to wait two years for residence. We're not going to attract more of them, which means we're just going to continue on with these critical health workforce shortages that we've got."
The National MP also said now is not the right time for a health overhaul. There's currently a great strain on the system with a shortage of workers and the dual challenge of COVID-19 and the flu creating significant demand for services.
"In the midst of a global pandemic, when we've got one of the worst flu seasons we've had - it was predictable because our borders have been closed - there was not a worse time to do this."
Wood, who acknowledged there are "shorter term challenges", said Stanford's comments reflected "typical National Party thinking".
"Forget about the long term, just focus on immediately what's there. That's how we got into these challenges, because they put these challenges off for too long. They underfunded the health system. We've got record funding going in now and we are making sure we end that postcode lottery."
Health Minister Andrew Little said on Thursday that "a hell of a lot of work has gone" into the reforms and they would "address some of the longstanding, chronic problems of our health system".
"I am very confident that it will make a difference. It will make a difference having one principal decision-maker rather than 20 or more."
Kiwis interacting with the system won't notice any immediate changes, but there will be improvements over time, he said.
"Tomorrow, pretty much the changes will not be visible to the naked eye. It is about structure change, it is about management structures and where decisions will get made," Little said.
"Over time, however, [the public will notice changes], because we need that structure and that decision-making apparatus to change the way we are doing things, what we are doing and how we are doing it."
Fepulea'i Margie Apa, the chief executive of the interim Health New Zealand, echoed that.
"If people need care or help from health professionals, from 1 July, they should keep going to the places where they would usually get care, whether it's a GP or specialist appointment in hospital," she told Newshub. "Care and delivery will continue."
