Rob Campbell: Former Health NZ chair on the Government's changes to reduce cost blow-outs in the health system

A former chair of Health New Zealand says health crisis solutions won't be found in hospitals.

The health agency's appointed four deputy chief executives to be accountable for regional hospital services and budgets.

The Government last week appointed a Commissioner to take over its board, citing cost blow-outs.

Former chair Rob Campbell says hospitals are important - but they are the end stage of the healthcare.

"We need to be getting far more attention to both preventative health - public health measures for example - and to primary care, again the GPs and the other local services."

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Episode Transcript

Speaker 1 (00:00):
Health New Zealand has today announced the appointment of four
new regional Deputy chief executives. Now we knew these appointments
were coming, The Health Minister, Shane Retti says he wants
more health decision making to happen at a local level.
Both the Health Minister and the new Health New Zealand
Commissioner Lester Levy have been outspoken about wanting to cut
down the organization's bloat of bureaucracy, and we've heard a

(00:22):
lot of that. The fourteen layers, the fourteen layers. Rob
Campbell is a former Health New Zealand chair and he
joins me, now, hello.

Speaker 2 (00:27):
Rob, Hi, right, Andrew, how are you going?

Speaker 1 (00:30):
Very good sir? So the four regional Deputy chief executives.
Are we returning to the model suggested by Heather Simpson
and the report.

Speaker 2 (00:41):
It does seem a little bit that way, doesn't it.
And it's a bit counterinturdives to wander him these layers
of management and then put another regional layer in. It's
not all entirely clear yet, but it certainly as far
as the hospital side of the thing is concerned, the
regional directors are introducing a new form of bureaucracy into

(01:02):
the system.

Speaker 1 (01:03):
As criticism of the current Health New Zealand structure the
one big bureaucracy that there was empire building and there
was a bloated bureaucracy. But surely if you're creating for
regional bureaucracies, there's a chance for empire building there as well.

Speaker 2 (01:18):
Well. I think that was almost a concern when I
was in the role, and the previous board had this view,
but the new direction is obviously to insert this. I
do want to make the point that getting more decision
making made at the local level is critically important, but
of course the local level is not for regions. The

(01:40):
local level is very local, particularly so Tara's primary health
care is concerned. You've got to remember about half of
the Detata war of budget is not hospitals. It's funding
the other activities that take place right through the health sector.
And of course this is now another layer of bureaucracy
which is being inserted than to that process.

Speaker 1 (02:01):
Well, was it that Stephen Joyce in the weekend who
actually said that the problem was we're always funding hospitals,
we're not funding primary care.

Speaker 2 (02:08):
Yeah. I don't often enjoy agree with Stephen, but I
think he was quite right about this. It's the solutions
to our overall health crisis are not really to be
found in hospitals. Hospitals are important, but they're the end
stage of these things. We need to be getting far
more attention to both preventative health public health measures for example,

(02:29):
and to primary care. Again, the GPS and the other
local services that provided the various cope coformality services that
provide and they don't operate at a regional level.

Speaker 1 (02:40):
Were you in charge of a blood of bureaucracy when
you were in charge of Health New Zealand.

Speaker 2 (02:44):
Oh, there's no question. It was a blood of bureaucracy
when we first took over, and we were making some
progress on that. Nowhere near fast enough from my point
of view or the board's point of view, but we
were making progress on that, and progress is still being made.
This is with all. I've got various criticisms of what
has gone on in what's going on, but we all

(03:06):
have to hope that less to leave in the team
do get on top of these issues. And if they're
choosing to do it by a regional structure, well I
wish them well. I don't think it's the right thing
to do, but I wish that they can succeed with it.

Speaker 1 (03:17):
What do you make of the fourteen layers debate?

Speaker 2 (03:21):
Well, the fourteen layers were invented, weren't they. There are
some parts of the health service system which I would
say even more layers than that. There are other parts
which don't have anything like that. But that was a
bit of a spurious argument put up by the Prime
Minister and doctor Rieti. But there is, nevertheless, and has
been a lot of bureaucracy there and part of the

(03:43):
making of CAFAA WURA was specifically designed to strip out
some of that bureaucracy at the district level in order
to place more attention at the local level. So it's
a transitional phase that they're going through.

Speaker 1 (03:55):
All right. And did you and the Health New Zealand
executive organize very poor financial management systems and did you
have no idea what was happening in terms of the money?

Speaker 2 (04:07):
No, Look, that's I think the polite terms of firfee. Frankly,
the systems that were inherited were in many instances outdated.
Some of the DHP systems were okay, some were absolutely
terrible and they didn't match. So it has been a
hell of a job for the team to try and
pull together a proper national system, but it certainly is
something that has been worked on and they are making

(04:29):
progress with so that idea that nothing's being done is
simply misleading and wrong.

Speaker 1 (04:34):
Rob Campbell I think you for your time today, the
former chair of TA FATA, Auto or Health New Zealand.

Speaker 2 (04:39):
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