September 3, 2024 • 17 mins
Several weeks ago, the Government dramatically moved to take control of Health New Zealand by appointing Professor Lester Levy as a commissioner.
He has the unenviable task of finding 1.4 billion dollars in savings, while also improving services and meeting the Government’s national health targets.
In the weeks that have followed, the dire state of our healthcare has become clearer, with patient wait times dragging mid-winter, back office staff facing voluntary redundancy, and new mums struggling to get post-birth toast.
It begs the question, will this cost cutting inevitably be put ahead of healthcare?
Today on The Front Page, I’m joined by New Zealand Herald senior health reporter Isaac Davison, to find out what the troubled state of Te Whatu Ora means for the future of healthcare in New Zealand.
Follow The Front Page on iHeartRadio, Apple Podcasts, Spotify or wherever you get your podcasts.
You can read more about this and other stories in the New Zealand Herald, online at nzherald.co.nz, or tune in to news bulletins across the NZME network.
Host: Georgina Campbell
Sound Engineer: Paddy Fox
Producer: Ethan Sills
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:04):
Kilda. I'm Georgina Campbell in for Chelsea Daniels and this
is the Front Page, a daily podcast presented by the
New Zealand Herald. Several weeks ago, the government dramatically move
to take control of House New Zealand by appointing Professor
(00:24):
Lester Levy as a commissioner. He has the unenviable task
of finding one point four billion dollars in savings while
also improving services and meeting the government's national health targets.
In the weeks that have followed, the dire state of
our healthcare has become clearer, with patient wait times dragging midwinter,
(00:49):
back office staff facing voluntary redundancy, and new mums struggling
to get post birth toast. It begs the question will
this cost cut inevitably be put ahead of healthcare? Today?
On the Front Page, I'm joined by New Zealand Herald
senior health reporter Isaac Davidson to find out what the
(01:11):
troubled state of tafata Aura means for the future of
healthcare in New Zealand. Isaac, why did the government appoint
a commissioner at House New Zealand?
Speaker 2 (01:28):
Yeah?
Speaker 3 (01:28):
So really from day one, government started expressing concerns about
Health and Z or Tafuta Aura's performance. It had already
talked about being skeptical about the reforms, and so it
began to act in December broad on this Crown Observer.
And this was just because of concern about the amount
of time people waiting and workforce gaps, and these concerns
then really intensified around March, and this is when it
(01:49):
became evident how much Health then Z was overspending by
so said at the time it was around one hundred
and thirty million dollars a month that it was overspending.
And it put in place some of these initial responses
en Z, did you know, hiring freeze around non frontline workers,
cracking down on overtime and taking leave, but all those restrictions,
so it weren't enough. And then at the same time
(02:10):
you had unrest on the board. Three board members didn't
seek reappointment, another couple resigned before their term is up.
All these issues just came to a head in July
and Shane Retty stepped in, brought in the commissioner, Lester Levy,
who had already been appointed chair at Health end Z.
Two remaining board members were effectively sacked and the rationale
that was given at the time, Retti said it was
(02:31):
basically financial mismanagement that was going to lead to a
deficit of about one point four billion. They didn't have
enough oversight and also these reforms that were coming through
were being mismanaged too.
Speaker 1 (02:41):
So that's pretty serious intervention, right, like a commissioner. Can
you just put that into context for me?
Speaker 3 (02:48):
Yeah, it's the most serious thing Retti can do in
terms of the legislation which governs health end zed. He
has a few options which escalate. One of them was interim,
one was the Crown Observer. The most serious is bringing
in a commissioner, which he's now done.
Speaker 1 (03:00):
And Lester Levy was already the chair previously. What else
can you tell us about who he is a little
bit about his background?
Speaker 3 (03:08):
Yeah, so he has a long record in these sorts
of roles in health and academia and local government. So
he's a trained doctor, that's his background. It's originally from
South Africa and he's had sort of over twenty five years.
He's headed up the Blood Service, the old Mercy Ascott Hospital,
Auckland Transport.
Speaker 2 (03:23):
He also cheered three of the DHBs.
Speaker 3 (03:25):
Under the old system, in Auckland, including counties Minico where
he met he first met Marjori Uppo, who's now head
of Health end Z. Just one thing just worth plucking
out of his background as biography is that when you
grow up in South Africa, he lived in Sharpville and
this is where this sort of infamous massacre was when
police open fire and black protesters. The reason I mentioned
that is because he said it was only six at
(03:46):
the time, but it really shaped the rest of his life,
both his personal life and professional life. Just to pluck
out a couple of things, he said, I developed a
mindset of not necessarily it's accepting the status quo, never
to fall victim to complacency and different rance. Never had
a great desire to fit in. And he also said
they don't need to be popular or part of the establishment.
Speaker 2 (04:06):
Yeah.
Speaker 3 (04:06):
I mentioned that because it gives you a bit of
a clue about why he's taken on this hard roll
and my government might bring him in. And also just
when he's facing so much resistance from the health system,
that's sort of the background that he's bringing in.
Speaker 1 (04:17):
Yeah. Absolutely, And look you've mentioned Marjie Arper. How is
Lester Levy getting on in terms of working alongside the
chief executive and management at health en Z to funt Aura.
Speaker 3 (04:30):
Yeah, yeah, he knows her well, so he was chair
or while she was chief executive at Counties. I think
they got off to a pretty bad start. In that
very first press conference when he was brought in commissioner,
he was asked directly did he have confidence in his
chief executive? And his first response was fair question, Professor Levy.
Speaker 4 (04:47):
I know this is a kind of brutal question to
ask in this context, but then don't you've moved of
them as a County's actually said three years to get
speeding with him, two years just to cret years to
get to spend with in constraints. Do you have confidence
in her long term? So yeah, to answer that and
fair questions, so I've just been appointed.
Speaker 2 (05:09):
What I can and will say is that.
Speaker 4 (05:11):
I've been impressed by Margie's willingness to readjust to a
new direction and the effort that she's making to do that.
I'm not fixed on outcomes about any of these things,
open on outcomes, so we see how it goes. Right
at the moment, Do I have confidence in Marjorie to
do what we need to do? Yes, I do, because
(05:32):
she's already doing it.
Speaker 3 (05:35):
It went on to say that it being impressed by
a willingness to sort of take how things had in
a new direction. But that's not exactly a ringing endorsement,
and since then it has got worse in some senses.
There was this moment last month when health Ing ZIR
bosses gave a presentation internal presentation which Margie was part of,
and they outlined how thousands of jobs were being reviewed,
including specialists and nurses, and this led to Leicester Lee
(05:58):
by giving a pretty extraordinary public critic of the leadership,
including Marjorie Arpa. It used words like unacceptable, deeply disappointing.
It's a direct conflict with commitments he had made around
not cutting the front line, so that relationship already had
a few wobbles.
Speaker 1 (06:13):
Yeah, it was pretty public criticism. Is there any indications
to what their relationships like now or have we seen
anything else play out in public since then?
Speaker 2 (06:23):
We haven't.
Speaker 3 (06:23):
That has sort of really been the last we've heard
on it. I guess one thing to add was that
Upper might have reason to be concerned if you look
at the way that government has acted in other sort
of underperforming or what it sees as underperforming areas. If
you look at Kaiing Aura put out a big review,
came back with damning results, and then rarely was quite
ruthless and rolled the entire boards. So she would surely
(06:44):
have one eye on that sort of thing.
Speaker 1 (06:46):
And you have mentioned some of the financial difficulty. Can
we just dig into that a little bit more? What
do we know about the state of House New Zealand's books.
Speaker 3 (06:57):
Yeah, so when the commissioner was brought in there was
sort of two distinct arguments. Government said this is financial
mismanagement and the opposition or labour said, well, actually it's
underfunding how things. He is underfunded. So if we look
back we can see that how things he had ran
a deficit in its first year, so this is twenty
twenty two to twenty three, but these were one off problems,
mostly costs related to COVID, so nothing too major. It
(07:19):
was then projected to make savings in its second year.
This is partly because of it was all streamlining and
reducing duplication and services and so forth. But this is
as I mentioned earlier, it became apparent this wasn't going
to happen. It was by March this year, it was
clear that it was spending sort of one hundred and
thirty million too much a month. It's really important to
look at what's driving this overspend. Its two key factors.
(07:40):
One is the pay equity settlement for nurses, and the second,
which they talked about quite a lot publicly, is overspending
on nurse recruitment. So New Zealand had a massive shortage
of nurses aggressively recruited under the previous government and this government,
and that's now overcorrected. There's still vacancies, but that there's
got a long way to addressing that. I guess the
reason it's important to drive those factors is that no
(08:00):
politician would say we've got too much nurses. So it
doesn't quite fit as easily with that argument of financial
mismanagement and wasteful spending when you know that's what's driving it.
Speaker 1 (08:09):
Yeah, So what does labor have to say in response
to those accusations because this government is blaming the previous
government for what they say is mismanagement.
Speaker 2 (08:22):
Yeah, that's right.
Speaker 3 (08:22):
So it's opposition in particular. So former Health Minister A
Cheverel says the problem stem from inadequate levels of funding
provided by the new government, especially in this year's budget.
She particularly points to health officials saying earlier this year
they'd need a bigger top up than forecasts. So before
the election there was an estimate of what it would
need that has now changed, and that's because of things
(08:43):
like demographic changes and inflation. They didn't get this in
the budget. They got the lower estimate. So to quote
Verril on this to summon it, the government's trying to
pretend this is something to do with health and zed governance.
Speaker 2 (08:54):
It is to do with their budget, she said. And
we saw some backing for this and.
Speaker 3 (08:59):
Editorial and New Zealand Medical Journal a few weeks ago
and where researchers looked and drilled down into this and
said cost overruns were unlikely to be solely caused by
port management and really successive governments had underfunded health.
Speaker 1 (09:22):
So plenty of problems are pretty big mountain to climb.
How does Levy plan to turn all of this around?
Speaker 3 (09:31):
Yeah, so he outlined a few priorities, getting spending under control,
reducing bureaucracy. We had this slightly notorious comic now that
Christopher Luxe and the Prime Minister made around there being
fourteen layers of bureaucracy between the top of tafutor and
the patient has now been shown to be slightly false,
but les Leeves certainly said it's a bloated organization. That's
what he wants to crack down on. Also talking about
(09:52):
better value for spending, so improving performance. That's really around productivity,
and he singled out surgical weightlist or weightlists, which blown
out as really one of his top priorities. He's also
wanting healthcare to become more localized again, so under Health
n Z it feels it's become too centralized.
Speaker 2 (10:09):
In Wellington.
Speaker 3 (10:09):
He's talked about a hard reset and he's made some
moves already in that direction by appointing for regional deputy
chief executives and rationale for that is what he calls
bringing decision making closer to communities. So there's a bit
of devolvement going on there, but 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 and reducing non frontline roles to meet this budgets.
Speaker 1 (10:32):
And one of the things that has been put on
the table is a voluntary redundancy scheme. Can you tell
us more about that.
Speaker 3 (10:39):
Yeah, So last week care was put out by Tafatura
for voluntary redundancies to people working in health administration, advisory
and knowledge roles.
Speaker 2 (10:50):
This is what they would call back office roles. The
union says.
Speaker 3 (10:54):
The jobs like are people that schedule operations, keeping on
top of supply chains HR communications. So people can now
put their names forward. That's the limit of it so far,
but it may be extended further if they do want
to cut more jobs.
Speaker 1 (11:08):
The PSA, in response to that redundancy scheme said, this
looks like and I quote, to be part of the
government's agenda to strip back public services as a prelude
to privatization. Is there any truth to that, any response
from the government to those suggestions.
Speaker 3 (11:27):
It's a big claim and I haven't seen government respond
to it. I guess at the heart of that is
the concern that while politicians would call these back office
roles that by removing them, you desabilize the foundations of
the health system. That's what the union said, So it's
cutting the staff which make diagnosis and treatment possible. The
people to underline that, and also that it's unfocused and
(11:48):
broad it's cost cutting without considering how it to.
Speaker 2 (11:50):
Affect people's health.
Speaker 3 (11:52):
I think psare probably thinking a little bit as well
about the UK, where under a conservative government the NHS
was ground down and underfunded and then services were privatized.
One more thing to mention is that in this underfunded
health system there's already been sort of a quiet creep
of private ownership in some areas. I'm thinking of the
diversion of elective surgeries into private practice of private doctor
(12:14):
has been helping out with backlogs, and also the purchase
of GP clinics by private companies.
Speaker 1 (12:21):
And just on cost cutting. I wrote a story at
the weekend about Wellington Regional Hospital no longer offering to
host with spreads to mums who have just given birth.
They said that they were doing this following advice from
dietitians that toast is nutritionally suboptimal. Labor said it believes
(12:43):
this is cost cutting, and a father whose partner had
given birth that weekend was also told by hospital staff
that it was cost cutting.
Speaker 5 (12:54):
Lead emails seen by One News shows the moves not
just about nutrition than king. A Health New Zealand general
manager wrote to Stuff saying the patient food budget blew
out by one and a half million dollars last year,
part of the reason being staff and members of the
public were eating the food. He said, in the fiscal environment,
these practices are untenable.
Speaker 6 (13:16):
This is such a small cost saving strategy on the
scale of the becasts that a hospital has, but a
massive cost for goodwill.
Speaker 1 (13:29):
So it's an interesting example of what's going on. And
a piece of toast is such a simple thing. A
loaf of bread doesn't cost a lot, but it clearly
meant so much and has meant so much to mums.
Lots of people posted on social media about a cup
of tea or a milo and a piece of toast
(13:50):
after giving birth was just the best toast that they'd
had in their life. Can you tell us a bit
more about that or what you make of it, or
if you have your own experience.
Speaker 3 (14:02):
Yeah, I do bring a little bit of personal experience
to this. When we had our second child at Auckland Hospital,
we went across the road to part our birth care
and it was late at night, about ten or eleven
at night, and we were supplied a brilliant cheese toasty
by the care there. And it's hard to overstate how
good that was. It was sort of this transcendent culinary experience.
(14:24):
And I'm not even the one that did all the
work with having our child, so I can see. It's
just one of those emotional issues of when funding affects
people on a human level, it just brings the mind
as well. When Lester Levy gave his first speech as Commissioner,
and one of the other things he said amongst his
priorities was so the health system needs to be more compassionate,
he gave this slightly extraordinary quote that the health system
needs to be infused with the milk of human kindness.
(14:47):
It's quite maternal image. I think denying mother's a piece
of toast after birth is probably not what he had
in mind, but it's one of those issues. It's sort
of the funding debate in microcosm rearly in one hand
saying it's been done for health reasons, you know, mutual reasons,
the other because there's.
Speaker 2 (15:01):
Not enough money.
Speaker 3 (15:02):
And we'll see more stories like this and more serious
ones as this sort of funding debate goes on. You know,
it reminds us as real people behind these decisions and
whose experience of health system might be suffering. We've seen
a few really serious examples just in the last week,
you know, people queuing from six am to see a
gp in Otara hospital eds without doctors overnight.
Speaker 1 (15:24):
Yeah.
Speaker 3 (15:24):
As I say, see a lot more stories like this
was the health system and transition or someone' say in crisis.
Speaker 1 (15:31):
The toast situation is certainly not what the House Minister
Shane Retti had in mind and he strongly urged the
hospital to reconsider its position and just to say that
it has. In fact you turned and toast will continue
to be offered for new muns. I mean, what does
the current state of House New Zealand mean for the
(15:53):
future of our housecare? Is it that we're just going
to see more and more of these stories as you say.
Speaker 3 (15:59):
Yeah, I mean the bigger picture is you've got these big,
long running problems that are beginning to stack up on
top of each other. You got growing aging population, people
with more complex conditions, iniquities and in terms of access
to health care depending on where you live or your ethnicity.
And at the same time you've got a shrinking, aging
workforce means exhausted and burnt out and laid over that
(16:22):
you've got the shock of COVID nineteen, which is still
reverberating and affecting things like shortages and waitlists. So it's
a concern when you look at all that the biggest
health provider in the country is in poor shape. You know,
Health New Zealand was broad in after a big review
and it was meant to be a new way of
doing things, tackling and equity and providing consistent healthcare around
the country. It's now just over two years old, it's
(16:44):
already been drastically altered, and now some of its reforms
are being reversed. Our health authority scraped, the board's gone.
So Levy really needs to get Health end Zed working
quickly if we're going to fulfill some of the promise
on which it was built and tackle some of these
really big picture issues. He said in a speach a
couple of things that's worth pointing out. He said, I'm
not a religious person, but please pray for me, so
(17:04):
I don't think he's got any illusions about the task ahead.
He also said one thing that sort of came as
a bit of a warning that in terms of the
changes he's making, they're going to be fast and painful.
I certainly don't know that some of the issues that
are changed. I'm not sure about the fast part, but
I'd certainly agree that there's probably quite a bit more
pain to come.
Speaker 1 (17:21):
Thanks so much for joining us, Isaac. That's it for
this episode of the Front Page. You can read more
about today's stories and extensive news coverage at zidherld dot
co dot nzed. The Front Page is produced by Ethan
Sills and sound engineer Patti Fox. I'm Georgina Campbell. Subscribe
(17:46):
to the Front Page on iHeartRadio or wherever you get
your podcasts, and tune in tomorrow for another look behind
the headlines.
Kilda. I'm Georgina Campbell in for Chelsea Daniels and this
is the Front Page, a daily podcast presented by the
New Zealand Herald. Several weeks ago, the government dramatically move
to take control of House New Zealand by appointing Professor
(00:24):
Lester Levy as a commissioner. He has the unenviable task
of finding one point four billion dollars in savings while
also improving services and meeting the government's national health targets.
In the weeks that have followed, the dire state of
our healthcare has become clearer, with patient wait times dragging midwinter,
(00:49):
back office staff facing voluntary redundancy, and new mums struggling
to get post birth toast. It begs the question will
this cost cut inevitably be put ahead of healthcare? Today?
On the Front Page, I'm joined by New Zealand Herald
senior health reporter Isaac Davidson to find out what the
(01:11):
troubled state of tafata Aura means for the future of
healthcare in New Zealand. Isaac, why did the government appoint
a commissioner at House New Zealand?
Speaker 2 (01:28):
Yeah?
Speaker 3 (01:28):
So really from day one, government started expressing concerns about
Health and Z or Tafuta Aura's performance. It had already
talked about being skeptical about the reforms, and so it
began to act in December broad on this Crown Observer.
And this was just because of concern about the amount
of time people waiting and workforce gaps, and these concerns
then really intensified around March, and this is when it
(01:49):
became evident how much Health then Z was overspending by
so said at the time it was around one hundred
and thirty million dollars a month that it was overspending.
And it put in place some of these initial responses
en Z, did you know, hiring freeze around non frontline workers,
cracking down on overtime and taking leave, but all those restrictions,
so it weren't enough. And then at the same time
(02:10):
you had unrest on the board. Three board members didn't
seek reappointment, another couple resigned before their term is up.
All these issues just came to a head in July
and Shane Retty stepped in, brought in the commissioner, Lester Levy,
who had already been appointed chair at Health end Z.
Two remaining board members were effectively sacked and the rationale
that was given at the time, Retti said it was
(02:31):
basically financial mismanagement that was going to lead to a
deficit of about one point four billion. They didn't have
enough oversight and also these reforms that were coming through
were being mismanaged too.
Speaker 1 (02:41):
So that's pretty serious intervention, right, like a commissioner. Can
you just put that into context for me?
Speaker 3 (02:48):
Yeah, it's the most serious thing Retti can do in
terms of the legislation which governs health end zed. He
has a few options which escalate. One of them was interim,
one was the Crown Observer. The most serious is bringing
in a commissioner, which he's now done.
Speaker 1 (03:00):
And Lester Levy was already the chair previously. What else
can you tell us about who he is a little
bit about his background?
Speaker 3 (03:08):
Yeah, so he has a long record in these sorts
of roles in health and academia and local government. So
he's a trained doctor, that's his background. It's originally from
South Africa and he's had sort of over twenty five years.
He's headed up the Blood Service, the old Mercy Ascott Hospital,
Auckland Transport.
Speaker 2 (03:23):
He also cheered three of the DHBs.
Speaker 3 (03:25):
Under the old system, in Auckland, including counties Minico where
he met he first met Marjori Uppo, who's now head
of Health end Z. Just one thing just worth plucking
out of his background as biography is that when you
grow up in South Africa, he lived in Sharpville and
this is where this sort of infamous massacre was when
police open fire and black protesters. The reason I mentioned
that is because he said it was only six at
(03:46):
the time, but it really shaped the rest of his life,
both his personal life and professional life. Just to pluck
out a couple of things, he said, I developed a
mindset of not necessarily it's accepting the status quo, never
to fall victim to complacency and different rance. Never had
a great desire to fit in. And he also said
they don't need to be popular or part of the establishment.
Speaker 2 (04:06):
Yeah.
Speaker 3 (04:06):
I mentioned that because it gives you a bit of
a clue about why he's taken on this hard roll
and my government might bring him in. And also just
when he's facing so much resistance from the health system,
that's sort of the background that he's bringing in.
Speaker 1 (04:17):
Yeah. Absolutely, And look you've mentioned Marjie Arper. How is
Lester Levy getting on in terms of working alongside the
chief executive and management at health en Z to funt Aura.
Speaker 3 (04:30):
Yeah, yeah, he knows her well, so he was chair
or while she was chief executive at Counties. I think
they got off to a pretty bad start. In that
very first press conference when he was brought in commissioner,
he was asked directly did he have confidence in his
chief executive? And his first response was fair question, Professor Levy.
Speaker 4 (04:47):
I know this is a kind of brutal question to
ask in this context, but then don't you've moved of
them as a County's actually said three years to get
speeding with him, two years just to cret years to
get to spend with in constraints. Do you have confidence
in her long term? So yeah, to answer that and
fair questions, so I've just been appointed.
Speaker 2 (05:09):
What I can and will say is that.
Speaker 4 (05:11):
I've been impressed by Margie's willingness to readjust to a
new direction and the effort that she's making to do that.
I'm not fixed on outcomes about any of these things,
open on outcomes, so we see how it goes. Right
at the moment, Do I have confidence in Marjorie to
do what we need to do? Yes, I do, because
(05:32):
she's already doing it.
Speaker 3 (05:35):
It went on to say that it being impressed by
a willingness to sort of take how things had in
a new direction. But that's not exactly a ringing endorsement,
and since then it has got worse in some senses.
There was this moment last month when health Ing ZIR
bosses gave a presentation internal presentation which Margie was part of,
and they outlined how thousands of jobs were being reviewed,
including specialists and nurses, and this led to Leicester Lee
(05:58):
by giving a pretty extraordinary public critic of the leadership,
including Marjorie Arpa. It used words like unacceptable, deeply disappointing.
It's a direct conflict with commitments he had made around
not cutting the front line, so that relationship already had
a few wobbles.
Speaker 1 (06:13):
Yeah, it was pretty public criticism. Is there any indications
to what their relationships like now or have we seen
anything else play out in public since then?
Speaker 2 (06:23):
We haven't.
Speaker 3 (06:23):
That has sort of really been the last we've heard
on it. I guess one thing to add was that
Upper might have reason to be concerned if you look
at the way that government has acted in other sort
of underperforming or what it sees as underperforming areas. If
you look at Kaiing Aura put out a big review,
came back with damning results, and then rarely was quite
ruthless and rolled the entire boards. So she would surely
(06:44):
have one eye on that sort of thing.
Speaker 1 (06:46):
And you have mentioned some of the financial difficulty. Can
we just dig into that a little bit more? What
do we know about the state of House New Zealand's books.
Speaker 3 (06:57):
Yeah, so when the commissioner was brought in there was
sort of two distinct arguments. Government said this is financial
mismanagement and the opposition or labour said, well, actually it's
underfunding how things. He is underfunded. So if we look
back we can see that how things he had ran
a deficit in its first year, so this is twenty
twenty two to twenty three, but these were one off problems,
mostly costs related to COVID, so nothing too major. It
(07:19):
was then projected to make savings in its second year.
This is partly because of it was all streamlining and
reducing duplication and services and so forth. But this is
as I mentioned earlier, it became apparent this wasn't going
to happen. It was by March this year, it was
clear that it was spending sort of one hundred and
thirty million too much a month. It's really important to
look at what's driving this overspend. Its two key factors.
(07:40):
One is the pay equity settlement for nurses, and the second,
which they talked about quite a lot publicly, is overspending
on nurse recruitment. So New Zealand had a massive shortage
of nurses aggressively recruited under the previous government and this government,
and that's now overcorrected. There's still vacancies, but that there's
got a long way to addressing that. I guess the
reason it's important to drive those factors is that no
(08:00):
politician would say we've got too much nurses. So it
doesn't quite fit as easily with that argument of financial
mismanagement and wasteful spending when you know that's what's driving it.
Speaker 1 (08:09):
Yeah, So what does labor have to say in response
to those accusations because this government is blaming the previous
government for what they say is mismanagement.
Speaker 2 (08:22):
Yeah, that's right.
Speaker 3 (08:22):
So it's opposition in particular. So former Health Minister A
Cheverel says the problem stem from inadequate levels of funding
provided by the new government, especially in this year's budget.
She particularly points to health officials saying earlier this year
they'd need a bigger top up than forecasts. So before
the election there was an estimate of what it would
need that has now changed, and that's because of things
(08:43):
like demographic changes and inflation. They didn't get this in
the budget. They got the lower estimate. So to quote
Verril on this to summon it, the government's trying to
pretend this is something to do with health and zed governance.
Speaker 2 (08:54):
It is to do with their budget, she said. And
we saw some backing for this and.
Speaker 3 (08:59):
Editorial and New Zealand Medical Journal a few weeks ago
and where researchers looked and drilled down into this and
said cost overruns were unlikely to be solely caused by
port management and really successive governments had underfunded health.
Speaker 1 (09:22):
So plenty of problems are pretty big mountain to climb.
How does Levy plan to turn all of this around?
Speaker 3 (09:31):
Yeah, so he outlined a few priorities, getting spending under control,
reducing bureaucracy. We had this slightly notorious comic now that
Christopher Luxe and the Prime Minister made around there being
fourteen layers of bureaucracy between the top of tafutor and
the patient has now been shown to be slightly false,
but les Leeves certainly said it's a bloated organization. That's
what he wants to crack down on. Also talking about
(09:52):
better value for spending, so improving performance. That's really around productivity,
and he singled out surgical weightlist or weightlists, which blown
out as really one of his top priorities. He's also
wanting healthcare to become more localized again, so under Health
n Z it feels it's become too centralized.
Speaker 2 (10:09):
In Wellington.
Speaker 3 (10:09):
He's talked about a hard reset and he's made some
moves already in that direction by appointing for regional deputy
chief executives and rationale for that is what he calls
bringing decision making closer to communities. So there's a bit
of devolvement going on there, but 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 and reducing non frontline roles to meet this budgets.
Speaker 1 (10:32):
And one of the things that has been put on
the table is a voluntary redundancy scheme. Can you tell
us more about that.
Speaker 3 (10:39):
Yeah, So last week care was put out by Tafatura
for voluntary redundancies to people working in health administration, advisory
and knowledge roles.
Speaker 2 (10:50):
This is what they would call back office roles. The
union says.
Speaker 3 (10:54):
The jobs like are people that schedule operations, keeping on
top of supply chains HR communications. So people can now
put their names forward. That's the limit of it so far,
but it may be extended further if they do want
to cut more jobs.
Speaker 1 (11:08):
The PSA, in response to that redundancy scheme said, this
looks like and I quote, to be part of the
government's agenda to strip back public services as a prelude
to privatization. Is there any truth to that, any response
from the government to those suggestions.
Speaker 3 (11:27):
It's a big claim and I haven't seen government respond
to it. I guess at the heart of that is
the concern that while politicians would call these back office
roles that by removing them, you desabilize the foundations of
the health system. That's what the union said, So it's
cutting the staff which make diagnosis and treatment possible. The
people to underline that, and also that it's unfocused and
(11:48):
broad it's cost cutting without considering how it to.
Speaker 2 (11:50):
Affect people's health.
Speaker 3 (11:52):
I think psare probably thinking a little bit as well
about the UK, where under a conservative government the NHS
was ground down and underfunded and then services were privatized.
One more thing to mention is that in this underfunded
health system there's already been sort of a quiet creep
of private ownership in some areas. I'm thinking of the
diversion of elective surgeries into private practice of private doctor
(12:14):
has been helping out with backlogs, and also the purchase
of GP clinics by private companies.
Speaker 1 (12:21):
And just on cost cutting. I wrote a story at
the weekend about Wellington Regional Hospital no longer offering to
host with spreads to mums who have just given birth.
They said that they were doing this following advice from
dietitians that toast is nutritionally suboptimal. Labor said it believes
(12:43):
this is cost cutting, and a father whose partner had
given birth that weekend was also told by hospital staff
that it was cost cutting.
Speaker 5 (12:54):
Lead emails seen by One News shows the moves not
just about nutrition than king. A Health New Zealand general
manager wrote to Stuff saying the patient food budget blew
out by one and a half million dollars last year,
part of the reason being staff and members of the
public were eating the food. He said, in the fiscal environment,
these practices are untenable.
Speaker 6 (13:16):
This is such a small cost saving strategy on the
scale of the becasts that a hospital has, but a
massive cost for goodwill.
Speaker 1 (13:29):
So it's an interesting example of what's going on. And
a piece of toast is such a simple thing. A
loaf of bread doesn't cost a lot, but it clearly
meant so much and has meant so much to mums.
Lots of people posted on social media about a cup
of tea or a milo and a piece of toast
(13:50):
after giving birth was just the best toast that they'd
had in their life. Can you tell us a bit
more about that or what you make of it, or
if you have your own experience.
Speaker 3 (14:02):
Yeah, I do bring a little bit of personal experience
to this. When we had our second child at Auckland Hospital,
we went across the road to part our birth care
and it was late at night, about ten or eleven
at night, and we were supplied a brilliant cheese toasty
by the care there. And it's hard to overstate how
good that was. It was sort of this transcendent culinary experience.
(14:24):
And I'm not even the one that did all the
work with having our child, so I can see. It's
just one of those emotional issues of when funding affects
people on a human level, it just brings the mind
as well. When Lester Levy gave his first speech as Commissioner,
and one of the other things he said amongst his
priorities was so the health system needs to be more compassionate,
he gave this slightly extraordinary quote that the health system
needs to be infused with the milk of human kindness.
(14:47):
It's quite maternal image. I think denying mother's a piece
of toast after birth is probably not what he had
in mind, but it's one of those issues. It's sort
of the funding debate in microcosm rearly in one hand
saying it's been done for health reasons, you know, mutual reasons,
the other because there's.
Speaker 2 (15:01):
Not enough money.
Speaker 3 (15:02):
And we'll see more stories like this and more serious
ones as this sort of funding debate goes on. You know,
it reminds us as real people behind these decisions and
whose experience of health system might be suffering. We've seen
a few really serious examples just in the last week,
you know, people queuing from six am to see a
gp in Otara hospital eds without doctors overnight.
Speaker 1 (15:24):
Yeah.
Speaker 3 (15:24):
As I say, see a lot more stories like this
was the health system and transition or someone' say in crisis.
Speaker 1 (15:31):
The toast situation is certainly not what the House Minister
Shane Retti had in mind and he strongly urged the
hospital to reconsider its position and just to say that
it has. In fact you turned and toast will continue
to be offered for new muns. I mean, what does
the current state of House New Zealand mean for the
(15:53):
future of our housecare? Is it that we're just going
to see more and more of these stories as you say.
Speaker 3 (15:59):
Yeah, I mean the bigger picture is you've got these big,
long running problems that are beginning to stack up on
top of each other. You got growing aging population, people
with more complex conditions, iniquities and in terms of access
to health care depending on where you live or your ethnicity.
And at the same time you've got a shrinking, aging
workforce means exhausted and burnt out and laid over that
(16:22):
you've got the shock of COVID nineteen, which is still
reverberating and affecting things like shortages and waitlists. So it's
a concern when you look at all that the biggest
health provider in the country is in poor shape. You know,
Health New Zealand was broad in after a big review
and it was meant to be a new way of
doing things, tackling and equity and providing consistent healthcare around
the country. It's now just over two years old, it's
(16:44):
already been drastically altered, and now some of its reforms
are being reversed. Our health authority scraped, the board's gone.
So Levy really needs to get Health end Zed working
quickly if we're going to fulfill some of the promise
on which it was built and tackle some of these
really big picture issues. He said in a speach a
couple of things that's worth pointing out. He said, I'm
not a religious person, but please pray for me, so
(17:04):
I don't think he's got any illusions about the task ahead.
He also said one thing that sort of came as
a bit of a warning that in terms of the
changes he's making, they're going to be fast and painful.
I certainly don't know that some of the issues that
are changed. I'm not sure about the fast part, but
I'd certainly agree that there's probably quite a bit more
pain to come.
Speaker 1 (17:21):
Thanks so much for joining us, Isaac. That's it for
this episode of the Front Page. You can read more
about today's stories and extensive news coverage at zidherld dot
co dot nzed. The Front Page is produced by Ethan
Sills and sound engineer Patti Fox. I'm Georgina Campbell. Subscribe
(17:46):
to the Front Page on iHeartRadio or wherever you get
your podcasts, and tune in tomorrow for another look behind
the headlines.
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