New Zealand’s 2021 Budget marks the end of a generational experiment with a patchwork of 20 decentralised District Health Boards (DHBs). There are high hopes that bringing responsibility back to the Beehive will end a so-called ‘postcode lottery’ of persistent pockets of severe health disadvantage. The overhaul will require significant new investment to upgrade ICT, data, and digital services. 

The restructure of DHBs was announced in April. Having 20 separate districts for a population of 5 million...