A return to a district health board-type system is not yet on the cards, despite a government move to transfer some planning towards regions.

Health Minister Simeon Brown has outlined a new approach to delivering health infrastructure in the wake of projects such as the problem-plagued new Dunedin hospital.

One of these proposals is to create 10 "service delivery networks" across the country in order for infrastructure work to be planned to meet "future population needs in the most clinically sustainable and affordable way".

"Under this plan, smaller-scale projects and routine maintenance are managed at a local level, while larger infrastructure projects are managed nationally," Mr Brown said.

"All of this is delivered within Health New Zealand Te Whatu Ora’s existing structure, ensuring resources are used efficiently and putting patients first by delivering the infrastructure our regions need."

The previous government abolished the 20 district health boards in 2022 and replaced them with the overarching national agency HNZ.

"In the past, 20 separate district health boards made decisions about infrastructure investment in isolation, leading to piecemeal and unco-ordinated delivery.

"The new health infrastructure plan replaces that with a clear, long-term pipeline for renewing and expanding facilities nationwide," Mr Brown said.

Former head of the Dunedin hospital emergency department Dr John Chambers said the plan for 10 service delivery networks, of which Otago-Southland was one, "seems like a move towards re-establishing a 10 DHB-like organisation".

Dr Chambers said HNZ had been a "disaster" since its inception.

"Health continues to be the lead issue for the country week after week. It’s arguably what lost Labour the last election, and it could be the reason why National loses the next one.

"I think it's inevitable it will return to a district health board-type model. You can't expect one organisation to plan the whole country, it's just too much."

Dr Chambers said the Heather Simpson report, which the Labour government used to justify reforming the health system, suggested fewer district health boards but not abolishing them entirely.

"Eventually, both major political parties are going to realise they've got to sort out the health system, and the only way they're going to sort it out is by putting more money into it."'

Richard Thomson, a former chair of the Otago DHB and a deputy commissioner of Southern, said he still believed there was some merit in centralising services such as IT and human resources, and core infrastructure planning needed a national overview.

However, he also felt there needed to be some local knowledge and accountability factored into making decisions about a region’s health.

"This might reflect my age and I'm not sure that many people would agree with me, but I look back at the old Ministry of Works model that used to exist.

"You had a workforce that moved on from one project to the next.

"There was a continual programme of work.

"You prioritised what you were going to do. I think there are some lessons that could be applied to that without necessarily reinventing perhaps some of the less desirable aspects of that sort of model."

Mr Thomson said the government needed to stop the constant churn of staffing, which led to confusion at a local level and projects being stalled at a national level.

Green MP Scott Willis said while there were some good suggestions in the government’s health infrastructure report and strategy, released last week, ultimately it would be meaningless without action and funding.

The report was "simply writing things down" and another list.

"So there's nothing in what I can see so far that says ‘we are actually going to do something’."