Photo: RNZ / Samuel Rillstone
Health New Zealand's leaked restructure proposal has shone more light on its latest round of job cuts.
It shows jobs near the very top will go - such as two national directors who have not yet been in their jobs two years, and their support staff - with others given new titles.
If you've been affected or have information about changes in the health sector, email: hamish.cardwell@rnz.co.nz
The plan also confirms a freeze on filling vacancies - including, it appears, at the clinical coalface - until the organisation's financial freefall is turned around.
Feedback from staff is open until 7 August and chief executive Margie Apa, who will keep her job, aims to lock in the restructure by mid-August.
"The time frame for implementing these changes is brutally fast," someone close to the situation told RNZ.
There was "a perception that the consultation process is unfair and that decisions are predetermined", they said.
"This has left staff undervalued and disregarded, eroding morale during difficult times.
"The mood among staff is shock and dismay."
The leaked plan, drawn up by Apa, is high level only.
Some of the roles cut include:
- Two national directors of hospital specialist services and of commissioning, and their support staff
- All regional directors of hospital specialist services
- The director of Māori services
- The overall manager of risk and quality assurance.
Under the plan, the four "regional wayfinders", who lead commissioning teams and manage regional relationships, would be renamed "regional commissioners".
The proposal said the problem was that regions and local teams were disconnected from decision-making.
"This has resulted in less ownership of budgets and internal controls to manage resources they have."
Siloed units and lack of data created big blind spots, it said. The solution was to devolve more decisions to four regions (the northern, central, and southern North Island, and the whole of the South Island), with a regional deputy chief executive installed in each.
Health NZ would also "undertake" to devolve revenue from 2024/25.
Lester Levy has been named the new commissioner of Health NZ. Photo: RNZ
On Monday, Health Minister Shane Reti accused Health NZ of lurching into massive deficits while hardly realising it.
However, the leaked proposal contained little about a financial reset. Its budget to the end of 2023 showed spending on the back office was back on track, if not slightly under 2022's spend.
Conversely, paying for work done by outsourcing to private clinics was well over budget, it showed.
The restructure comes just two years after Health NZ's formation from the amalgamation of 29 groups, including the former district health boards.
At that time, Apa embarked on what was touted as a back-office cull of up to 1600 people.
The most recent changes compounded the change and uncertainty swirling at the agency since the 2022 reform, the source said: "Many are feeling uneasy."
In the leaked document, Apa herself said the proposal "could be seen to further complicate change not yet fully implemented".
She said she was not clear what the impacts would be, because Health NZ did not have a "joined-up" payroll or information management system yet.
"I am aware that we may not have totally accurate information in terms of position titles, people in positions etc," she wrote.
"We apologise for any inaccuracies in the data and ask that you draw this to our attention as soon as possible, so we can correct it and assess how that may impact on you and your colleagues."
'We have spending problems all over the show' - Levy
Health NZ commissioner Lester Levy and the government have spoken of possibly 2000-3000 cuts to back office jobs, but the proposal did not go into detail about those.
Levy told Checkpoint on Thursday the numbers were "just theoretical at the moment" and he did not yet have a set figure, as the organisation was "in the process of looking at what we actually need".
The Public Service Association said the latest proposal would see 44 jobs go.
Levy said the organisation needed to "do more with the resources we have rather than constantly asking for more resources... that is the main show".
He repeatedly told Checkpoint that the agency was too big to be financially sustainable: "We have to reduce the size of the organisation."
But he promised, once again, that no clinical roles would go.
The leaked plan was presented to staff just days after the government installed Levy as commissioner and sacked a board it accused of dire financial mismanagement, losing $130 million a month.
"This overspend is a consequence of recruiting clinical staff ahead of budget and having operating models that are not affordable," Apa said earlier.
The extra 2900 nurses recruited in the last year would cost, by a ballpark calculation, $30-35m a month.
Levy told RNZ the number of nurses was "well beyond the budget".