About 60 health and administration staff face redundancy as the country's biggest health board considers more cost-saving cuts.
Staff of the Auckland District Health Board, which employs more than 7500, said colleagues emerged in tears from meetings about the changes, announced yesterday.
About 1000 people, including 650 managers, areaffected in varying degrees. They range from the tier just below general managers, to administrative and support staff.
Many of the managerial jobs, such as charge-nurse-managers, contain a clinical component.
The board chief executive, Graeme Edmond, said last night that if a targeted job had a significant clinical component then that part of the position would be preserved, wherever possible. But that might be at a lower level.
Advice the board had received so far was that the changes would not affect safety.
"We are consulting on this structure through until the 1st of February," he said.
"There's the possibility that some feedback may say that this could result in that - in which case we would have to take that on board."
The proposed changes follow cuts at the general-manager level last week which prompted outrage from many staff, including 65 senior doctors at National Women's Hospital who said in a letter that they had no confidence that the board was interested in women's health.
New Zealand Nurses Organisation spokesman James Ritchie said it was too early to say what effect the proposed changes would have on nurses or patient safety.
"There has been some concern about the restructuring to date, but in terms of our members it's a matter of waiting to see the big picture and getting some feedback," he said.
The changes are designed to help the board save $40 million a year following its $423 million hospital rebuilding plan, which will concentrate inpatient services at Grafton and outpatient clinics and day-surgery at Green Lane.
Mr Edmond said other aims were to standardise management across the board's four major hospitals and other services and "to bring greater accountability and responsibility closer to the point of clinical care delivery".
Next year, the board will look at systems such as how patients are admitted and transferred. Mr Edmond said he could not exclude the possibility that this would lead to further redundancies.
