This report is a review of the Capital and Coast District Health Board (C&CDHB) decision-making processes and frameworks around primary health care and health equity between 2009 and 2012, based on the release of relevant papers requested under the Official Information Act. The review describes a lack of control by the Board over decentralised functions such as primary health care, as well as its losing battle to maintain equity as a high-level goal in the face of operational decisions inconsistent with this goal, as the Board attempts to live within a period of economic restraint. The Board is embarking on a new strategy, Integrated Care Collaboratives, in an attempt to reverse the current trends of increased hospital admissions and decreased support for the primary care sector. However, “this approach will struggle while the national signals remain tightly focused on the hospital sector, and whole system performance and complexity is not seriously considered in the way the system is led”, concludes the review.
