As the squeeze on the health sector intensifies, the Government has brought in British managers responsible for slashing thousands of staff and hundreds of millions of pounds from the National Health Service budget - and in one instance putting finances above patient needs.
Director-General of Health Kevin Woods was head of Scotland's NHS for five years and took over here early last year. Under Dr Woods the Scottish NHS slashed £600 million in 2007-08 and a further £300 million in 2008-09.
Asked to find a further £100 million in his final year, he cut nurse numbers by 1500 and axed 1000 administration positions.
At the time, he said he believed services could be improved despite the cut in staff numbers.
"We see our pursuit of quality also linked to our policy to improve efficiency. We've invested considerable amounts in equipping the health service with the tools to do that and yes, we do believe we can continue to make progress."
He also reduced the number of A&E departments in west and central Scotland from 15 to eight, a policy that brought huge protests from local communities.
Dr Woods is one of NZ's highest-paid public servants - he's on about $550,000 a year.
Kevin Snee, former chief executive of Devon National Health Service in southern England, is now a key spokesman for the health sector in NZ as chairman of the District Health Board chief executives group.
Since becoming Hawkes Bay DHB chief executive two years ago, he is credited with turning the board's operating budget around, and has produced a surplus now earmarked for capital investment.
More recently, one of his senior managers circulated a memo to staff which was interpreted as a plan to cut 35 nurses.
Like Dr Woods, Dr Snee is confident the sector can maintain services despite smaller annual budget increases than seen previously.
However that's a trick he has not always been able to pull off. In Devon, he presided over a review which decided that about half of 300 people on a continuing healthcare programme were no longer eligible.
Families appealed against the review, and the resulting independent investigation found the NHS had made tackling financial overspend a higher priority than the needs of patients.
Dr Snee is paid between $410,000 and $420,000, according to figures made public last month.By Adam Bennett Email Adam