Health NZ is in bad shape as big long-running problems are starting to stack up on top of each other.
The commissioner of Health New Zealand Te Whatu Ora is under no illusion about the challenges ahead after asking people to pray for him during his first speech in the job.
The Government has taken the strongest ministerial intervention available under the Pae Ora Act by replacing Health NZ’s board with a commissioner.
Professor Lester Levy now has the unenviable task of cutting $1.4 billion from the system to plug Health NZ’s deteriorating financial position.
Health Minister Shane Reti said there were “serious concerns around oversight, overspend and a significant deterioration in financial outlook” after the previous Government’s “botched” and “mismanaged” health reforms.
New Zealand Herald senior health reporter Isaac Davison told The Front Page Levy’s priorities include getting spending under control, reducing bureaucracy, better value for spending, improving performance, and making healthcare more localised again.
“The main thing is really tackling that overspend and changing the shape of health in New Zealand, making it a bit smaller, changing its structure, reducing non-frontline roles to meet these budgets.”
Reti has instructed Health NZ that any cost-saving measures to keep within budget must not affect the services patients receive.
However, Wellington Regional Hospital recently said it will no longer offer toast with spreads to mums who have just given birth following advice from dietitians that it is “nutritionally sub-optimal”.
Labour’s health spokeswoman Ayesha Verrall didn’t believe it had anything to do with nutrition and said it was a cost-cutting exercise.
The hospital has since U-turned after Reti urged a rethink of the move, which he said made no sense.
Davison said this situation brought to mind something Levy said during his first speech as the commissioner - that the health system needed to be more compassionate.
“He gave this slightly extraordinary quote that the health system needs to be infused with the milk of human kindness. It’s this quite maternal image. I think denying mothers a piece of toast after birth is probably not what he had in mind.”
The toast issue was the funding debate in microcosm, Davison said.
“We’ll see more stories like this and more serious ones as this funding debate goes on.
“It reminds us there are real people behind these decisions and whose experience of the health system might be suffering. We’ve seen a few really serious examples just in the last week of people queuing from 6am to see a GP in Ōtara and hospital EDs [emergency departments] without doctors overnight.”
The bigger picture is that there are big long-running problems which are beginning to stack up on top of each other, Davison said.
New Zealand has a growing, ageing population, people have more complex conditions and there are inequities in terms of access to healthcare depending on where people live and their ethnicity. The workforce is also shrinking and ageing with many people exhausted and burnt out, Davison said.
The shock of Covid-19 meanwhile is still reverberating and affecting shortages and waitlists.
“So, it’s a concern when you look at all that and the biggest health provider in the country is in poor shape”, Davison said.
“Health New Zealand was brought in after a big review and it was meant to be a new way of doing things, tackling inequity and providing consistent health care around the country.
“It’s now just over two years old. It’s already been drastically altered and, now, some of its reforms are being reversed. The Māori Health Authority is scrapped and the board’s gone. So, Levy really needs to get Health NZ working quickly if we’re going to fulfil some of the promise on which it was built and tackle some of these really big picture issues.”
Levy also said in his speech that he wasn’t religious but asked people who were to pray for him.
“I don’t think he’s got any illusions about the task ahead”, Davison said.
“He also said one thing that sort of came as a bit of a warning that the next little while, in terms of the changes he’s making, they’re going to be fast and painful.
“Some of the issues are entrenched so I’m not sure about the fast part, but I’d certainly agree that there’s probably quite a bit more pain to come.”
Listen to the full episode to hear more from Isaac Davison about the state of Health NZ and how the new commissioner is getting on with the organisation’s senior management.
The Front Page is a daily news podcast from the New Zealand Herald, available to listen to every weekday from 5am. The episode is presented by Georgina Campbell, a Wellington-based reporter who has a particular interest in local government, transport, and seismic issues. She joined the Herald in 2019 after working as a broadcast journalist.
You can follow the podcast at iHeartRadio, Apple Podcasts, Spotify, or wherever you get your podcasts.
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