Bewildering bureaucracy has to go, says health boss

Lester Levy wants fewer managers at the Waitemata DHB and greater involvement by clinicians in leadership and governance. Photo / Martin Sykes

When Lester Levy took over public health services for 530,000 Aucklanders in June, he immediately visited the hot spot of North Shore Hospital's troubles.

Ongoing publicity about the misery of long waits in the emergency care centre for patients needing to be admitted to a ward had helped overcome his initial reluctance to return to the public sector.

"Half an hour after I was appointed, I was in the emergency department. I was speaking with somebody and I said, "What's the problem; why haven't these patients gone through?'

"They said, 'They won't let us put them in their ward.' I said, 'Who's they?' That language has to go."

While the Government has approved rebuilding and expansion plans expected to overcome North Shore's overcrowding, Dr Levy's visit illustrates what he considers needs to change at the Waitemata District Health Board, of which he was made chairman - the inertia, the acceptance of circumstances that can lead to inadequate care for patients.

His interview with the Herald is his first detailed public assessment of the board since he accepted Health Minister Tony Ryall's job offer, a return to the public sector after founding and running what has become the Mercy-Ascot private hospitals group.

He has given up those interests for his new job but retains his academic position in the business school at Auckland University, where he has honed his ideas on bureaucracy, change and innovation.

"It has surprised me, after being away from it for quite a period, how bewilderingly bureaucratic [the DHB] is," says Dr Levy, a former chief executive of Counties Manukau DHB's predecessor, South Auckland Health.

"The bureaucracy has created a sense of complacency, or even indifference ... [an attitude that] the status quo is the right way."

He wants to lead a sharp change of direction to prepare Waitemata for the increase in demand for health services as the population rapidly ages.

"We need a system that's much more thinking, much more creative, much more experimental even, if we are going to provide our population with the health service they need."

Dr Levy wants a slimmed-down management group and greater involvement by clinicians in leadership and governance.

Waitemata has begun a management restructuring that is expected to scrap 30 jobs by next month and merge divisions.

Dr Levy has won the respect of union leaders, although they reject his claim of general complacency.

"The problem is we've got a lack of quality leadership in health," says Deborah Powell of the Resident Doctors Association.

Ian Powell of the Association of Salaried Medical Specialists, says: "There has been a malaise at Waitemata, but the management more recently are working with us to turn that around."