Ian Powell: health commentator on the implications of this week's high-profile health sector resignations

There's concerns over the future of New Zealand's health sector, off the back of three high-profile resignations that took place this week.

Director General of Health Diana Sarfati confirmed on Friday that she was stepping down from the role - seven days after Health NZ chief executive Margie Apa resigned before the end of her term.

Earlier this week, director of public health Dr Nicholas Jones also said he would be concluding his secondment as planned in February and resuming his previous role in Hawke’s Bay.

Health commentator Ian Powell says these resignations share a point of commonality following a turbulent period for the health system.

"We have a Government that kind of side-lines complexity considerations, it goes for the simpler options. And the simpler options are usually the ones that are wrong." 

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Episode Transcript

Speaker 1 (00:06):
You're listening to the Sunday Session podcast with Francesca Rudgin
from News Talks EDB.

Speaker 2 (00:12):
It's been a dramatic week for Health New Zealand with
the resignations from three top health bosses. On Friday, Director
General of Health Diana so Farti announced she was leaving
the role. That came to seven days after the sudden
resignation of Chief Executive Margie Apper, and earlier this week,
Director of Public Health Nicholas Jones also announced that he
was stepping down. So where to now for Health New

(00:33):
Zealand to discuss I'm joined by health commentator n pal
Thanks for your time this morning in.

Speaker 3 (00:39):
Oh, that's a pleasure.

Speaker 2 (00:40):
Three pretty big resignations. Has this come as a shock.

Speaker 3 (00:45):
Well, not real Well it is a shock, but it's
not a surprising shock. You said dramatic. I think that's
an understatement. And also it's a good reminder that a
week is a very long time in politics. But it
has to be seen in a bit or wider context
because it's just not those three resignations. There's also within

(01:09):
the last twelve months or less than that, actually about
eight months or so, we have had a board sacked
that helping gent on board sacked. We've had a health
minister demoted, taking that take removed from the portfolio, and
we've had these three as well. And in my view
what sits behind it there is a common theme. Each

(01:32):
of these has their own particular specifics and one is
not identical to the other. However, there's a point of commonality,
and it's more than the individuals. What we have is
poorly constructed and implemented health restructuring by the previous government
and very poor short sighted leadership by the current government.

(01:56):
Take those two things together and you have a recipe
for the instability, the uncertainty and the chaos that is
now occurring.

Speaker 2 (02:06):
He's not such a great shock if we take a
look at just this last week, though, are these three
a big loss for our health system? Doctor Dinah Setharti
in particular, was very highly regarded.

Speaker 3 (02:19):
Well, yes, that's right. She's got a very strong reputation
and it's well deserved. Her role in establishing the Cancer
Control Authority, for example, agency that took a lot of
grunt to do and a good understanding of health system
complexity to achieve it. I think in her case, I

(02:40):
think the reality was that she is the kind of
director general of health that the health system needs, but
not the kind of director general that fits in with
the current direction of this government, which is the wrong direction.

Speaker 2 (02:58):
What direction is that then?

Speaker 3 (03:01):
The wrong direction? Sorry?

Speaker 2 (03:04):
Which is yeahs? And why is it the wrong direction?

Speaker 3 (03:09):
Well, the wrong direction is I guess it goes back
to a comment that Christopher lux Luxan is known to
have made to the Circles, and that is that the
problem with health is that it is led by health.
Now that's a nonsense because you need experience in the

(03:29):
health system in order to understand its complexity. Arguably, health
is the most complex part of the economy of society
because of what it has to deal with with both
health care in the community and health care and highly
complex hospitals. But we have a government that doesn't. It

(03:55):
kind of sidelines complexity considerations. It goes to the simple options,
and the simple options are usually the ones that are wrong.

Speaker 2 (04:04):
So in I think to replace these three positions, will
people want to step in, as you say, this very
difficult time, as you know, in the sort of getting
New Zealand health back on track.

Speaker 3 (04:19):
Well, I think I think the pool of quality applicants
will be smaller much smaller than what it deserves to be.
There will be, I'm sure some quality applicants, but the
volume of them, the number of them, will be considerably
reduced because if you're seeking to recruit internationally, people who

(04:46):
might make good appointments are not fools, and they will
search the internet if they don't already know about the
state of the health system and what they might be
walking into. So why come to another part from another
part of the world to hear to such an unstable environment.
Within the country there is a lot of expertise around,

(05:06):
but a lot of that is actually left the health
system as a consequence of this restructurings. So there are
many people who could be considered but wouldn't touch any
of these positions with a barge pole.

Speaker 2 (05:17):
So can Health New Zealand handle these three big resignations
all at once? What impact could it have?

Speaker 3 (05:24):
Well? The impact is two fold. I suppose One is
its impact within the leadership itself. It destabilizes, it's uncertain
its own head office workforce and managerial workforce. Non clinical
is continually being restructured and this just reinforces that, and

(05:47):
so they don't know really what their future is from
day to day, So how can you have a functioning system.
The other point is that function is undertaken by Health
New Zealand and by the Health Ministry on a sort
of a higher level management level. Are often unseen. They
are important but often unseen functions that the wider health

(06:07):
system depends on. So I would describe it this way
is that we have a health system leadership that has
become a headless chalk. It's desperately trying to find a
GPS to navigate through the system's complexity. I can't find it.

Speaker 2 (06:20):
Yeah. So in all of this are there questions about
Lester Levy as the Health New Zealand Commissioner.

Speaker 3 (06:27):
Well impounding this is the report in the media and
newsprint mainly, but in the print media that the Minister
has declined to express confidence in the commissioner. Now Simming

(06:50):
and Brown has not refuted that and said no, that's wrong,
but so it has to be taken that his view. Now,
in normal circumstances, you would think that the person you
could almost be counting the week ace maybe weeks, but
not too many and even days before that person departs.

(07:15):
This is a bit different because the commissioner was the
solution to the rather manufactured crisis that the government used
as justification to sack the board and put him in
place as the replacement. To recognize that after five months
that's a fiesco and you need to get rid of

(07:35):
him is a bit of would only make the situation
worse in terms of the optics at the very least.
And so I think probably what will happen is that
he will stay on until his term, which is the
thirteenth of June. The government is looking to appoint a
new board to come in effect on the first of July,

(07:56):
and this suggests that Lester Levy will not be the
chair of that new board. That's what I would take
out of it.

Speaker 2 (08:04):
Oh and thank you very much for your time in
your thought this morning. Appreciated. That was IMpower via Health Commentator.

Speaker 1 (08:11):
For more from the Sunday session with Francesca Rudkin, listen
live to News Talks it' B from nine am Sunday,
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