Des Gorman: Auckland University Emeritus Professor on Health NZ Commissioner Lester Levy's planned overhaul for the health system

Health New Zealand's boss says his plan is to strengthen the clinical frontline - and it won't be cut or reduced.

Commissioner Lester Levy has emailed staff to address a presentation yesterday, that suggested significant frontline cuts.

He told them that directly conflicts with his thinking, and should be dismissed.

Auckland University Emeritus Professor Des Gorman says it implies a disconnect between the Commissioner and senior officials.

"And I think we're seeing that across all the health portfolios, that the various health ministers are struggling against officials' headwinds. And I think they're all finding it much harder to introduce changes than they thought they would."

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Episode Transcript

Speaker 1 (00:00):
Now a bizarre thing has happened at Health New Zealand.
Yesterday management held a meeting which included the Chief Executive,
and in this meeting they proposed saving the money that
Health New Zealand needs to save by cutting staff, including
nearly five hundred doctors and fifteen hundred nurses. Now, immediately
the Commissioner has stepped in, stopped the plan and given

(00:21):
the Chief Executive a massive public bollocking over it. Health
New Zealand obviously doesn't want to speak about it today.
DearS Gorman is Auckland University emeritus professor who's with us.
Hey dez is on what planet would this be a
good idea?

Speaker 2 (00:35):
Oh? No planet. I mean, the argument that this is
some sort of speculative comparison doesn't hold water. There's only
two explanations for this. Either one is that it's a
Washington Monument type of offering, or the others is that
they were serious about cutting frontline staff. Now they would
appear looking at it. It's probably more likely the latter,
and you'd have to argue that the timing and the

(00:57):
nature of this is just egregious and stupid.

Speaker 1 (01:00):
Yeah, I mean, it seems it's the latter, which is
they were actually going to do it, because a source
has told the media outlet Newsroom it wasn't a mistake.
They were planning the cuts and at least one region
of the organization had already started making plans to consult
and implement the changes. Does that blow your mind?

Speaker 2 (01:15):
Oh? Absolutely. Look one area where I disagree with Lester's
I think the health system is in crisis. I think
you look at health workforce numbers, that's a crisis. And
it's important to recognize it's a crisis either for several reasons.
And that is women and men each day go to
work and they don't provide the healthcare they think their
patients deserve, and they go home at night quite distressed. Now,

(01:36):
to tell them that this is not a crisis, this
is a business as usual, is not to validate their experiences,
and I think that's whattant we do that. The other
thing is when you call it a crisis, you don't
come up with business as usual solutions. Yeah, you come
up with crisis solutions, and.

Speaker 1 (01:52):
That's basically what we need now. Now, Look, if we
take the source of their word, it means that the
cuts were planned. I can't see how that could happen
without the chief executive, Margie Upper signing off on that.
Am I right?

Speaker 2 (02:04):
Oh, I can't see that either. But clearly the implication
is that there's a disconnect between the commissioner and his
senior officials. And I think we're seeing that across all
of the health portfolios, that the various health ministers are
struggling against officials headwinds, and so I think they're all
finding it much harder to implicate it, to introduce changes
than they thought they would because of those headwinds.

Speaker 1 (02:27):
Now, if her idea of how you save the money
is to cut doctors and nurses, she's got to go right,
because she's not up to the job.

Speaker 2 (02:36):
Oh look, that's her idea. Absolutely, look at a truism
that the best way to save money and health care
is not to have health workers, not to have patients.
But that's just an abject nonsense. And so I think
if you've got someone at a time like this proposing
a cut front line staff, then they're so out of
touch with the reality that don't belong in it.

Speaker 1 (02:54):
Yeah. Now, it's obviously easy for us to sit here
and say they're doing the wrong thing. What's the right
thing to do, Dez, how do you save this amount
of money?

Speaker 2 (03:01):
Oh, look, I think Leicester will do that. I think
Lester will say the one hundred to thy nine million
a month hemorrhage. The question will be, though, when that
hemorrhage has stopped, how do you then transition to a
new state where you can start offering more services of
higher value. That is the best possible outcome at the
last possible cost. And I think the focus has to

(03:22):
be on primary care either. The big savings will come
on primary care. Yeah, not in hospitals.

Speaker 1 (03:28):
Well do you mean pump lots of money into primary
care in order to save later on down the line?
Is that what you're talking here?

Speaker 2 (03:35):
No, I mean we're working with the GPS to develop
new business models. Because there's no point going to the
GP community and saying this is what you're going to do.
They will simply oppose that, as they have done for
oast century. You've got to go to them and say, look,
what would it take for us to do to get
you to do more? Do more after our care, do
home visits, do more critical care in the community. What

(03:57):
sort of ecosystem would encourage that sort of.

Speaker 1 (04:00):
Yeah, it's always good to talk to you. It sound well.
Thank you very much for having a chat to us.
Dez Gorman, Auckland University Emeritus Professor. For more from Hither
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