Health NZ commissioner Lester Levy reveals priority to tackle patient waiting times

Health NZ commissioner Professor Lester Levy. Photo / Dean Purcell

New health boss Lester Levy has identified shorter wait times for treatment as his top priority – and claims it can be done with existing health funding.

Professor Levy also expressed confidence today in Health NZ chief executive Margie Apa, saying he had been impressed at her willingness to take the organisation in a new direction.

The former district health board chief was appointed commissioner yesterday after the Government sacked the remaining members of the Health NZ board.

He has been tasked with finding $1.4 billion in savings while also improving services and meeting the Government’s national health targets.

That will require the disestablishment of between 2500 to 3000 “back office” roles at Health NZ, which Levy described as “bloated and bureaucratic”. It is not yet clear whether that figure includes 1600 roles already slated for disestablishment as part of the merger of district health boards into a single entity.

Speaking to reporters at North Shore Hospital today, Levy outlined his reasons for taking on the job.

He said New Zealanders should not be waiting so long for essential health services.

“I … want to stress that, from my point of view, the absolute and most urgent priority over the next few years is actually to get waiting times down, because New Zealanders need and deserve a lot better in this regard.”

Levy also said Health NZ could deliver more healthcare with existing resources. He also underlined the importance of a “compassionate” health system, saying at one point that it should be “infused with the milk of human kindness”.

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In appointing Levy as commissioner, Health Minister Shane Reti blamed the previous government’s “mismanaged health reforms, which resulted in an overly centralised operating model, limited oversight of financial and non-financial performance, and fragmented administrative data systems which were unable to identify risks until it was too late”.

Labour’s health spokeswoman, Dr Ayesha Verrall, the former Health Minister, said the previous government was not to blame for Health NZ’s deficits.

Verrall said the Government did not put enough money into health in this year’s Budget. The Government’s $1.4b top-up did not take into account updated figures on demographic changes, she said.

Health NZ reported a deficit of $1b in its first full year of operation (2022/23) but this was put down to one-off events including the pay equity agreement for nurses and Covid-19 costs.

It was expected to have no deficit in the 2023/24 year and deliver half a billion dollars worth of savings by streamlining systems after the merger of the DHBs.

Reti said he became aware of Health NZ’s deteriorating financial position for the 2023/24 year and beyond in March.

The half-billion dollars in savings were “in doubt” by the middle of the financial year and other solutions needed to be found to bridge the gap, a Cabinet paper released by Reti showed.

Levy said today that Health NZ did not need more money but needed to spend it more wisely: “It can be done but it does require a different paradigm and a different approach.”

Asked what Health NZ was spending $130m above its budget on each month, he said Health NZ may not have been the correct size when it was set up.

Apa said in its early years Health NZ had focused on recruiting nurses, especially from overseas, and had “overcorrected much quick than … expected”. Vacancy rates have been cut from 12% to 6% since 2022.

Since April, Health NZ has placed significant restrictions on recruitment. While it has denied a hiring freeze on front-line workers, many parts of the sector have said the restrictions were effectively a freeze and were preventing key roles from being filled.

Levy said he would not make cuts to the clinical workforce in finding the $130m in savings each month.

“We’re not looking to make our savings out of that area but we are looking to get more productivity.”

Levy and Apa promised to “bring decision-making closer to communities” by devolving the provision of services into four regions. Levy rejected the suggestion that this was a reversal of the centralised model set up by the previous government.

While it was described as a “reset” today, the original plan for Health NZ included four geographic regions – Te Waipounamu, Central, Te Manawa Taki and Northern.

Isaac Davison is an Auckland-based reporter who covers health issues. He joined the Herald in 2008 and has previously covered the environment, politics and social issues.