Mr Fix-It: The man taking on troubled Waikato DHB

Derek Wright has a reputation as a fix-it man.

The interim chief executive at Waikato District Health Board has spent most of his career in health managing broken situations back to repair.

As the replacement for Dr Nigel Murray, who resigned in October amid an expenses scandal, Wright is arguably tasked with his biggest challenge yet.

That is; change the culture, create a workplace people are proud of, get Waikato Hospital to the top of its game, and turnaround the DHB's financial problems.

The 63-year-old has set himself a one year deadline to achieve the transformation.

He doesn't want to commit for too much longer than that for two reasons - he gets bored easily which turns to "mischief", and he wants the next chief to hunker down for five years and lead the embattled DHB into a period of stability, security and ultimately, growth.

And it should be noted, Wright - previously the health board's mental health and addictions executive director - was given the seal of approval for the important interim job by the senior doctors at Waikato Hospital.

This is no mean feat, particularly given the dysfunctional relationship Murray created with clinicians during his three year tenure, and the loss or partial loss of training accreditation in different units at the tertiary hospital.

Wright says there's no secret to being a good leader.

"It's not rocket science. I think it's about having that focus, having that visibility. I'm really clear that I make decisions everyday that impact on the work that staff do and unless I'm informed then I might be making the wrong decisions."

Relating to people from all walks of life comes naturally to Wright.

Born in Scotland and raised in Fife, north of Edinburgh, Wright fell into health at 19 when his neighbour offered him a job at the local hospital as an orderly.

"I started at the bottom basically."

The football-mad teenager earned just 10 pounds per week, about $200 by today's standards, graduating to 15 pounds a week after he trained to be a nurse.

That was 1978. He specialised in surgery and crossed into mental health, working his way up from a staff nurse to a charge nurse.

He moved to Newcastle in 1984 at the time when major health reforms were underway with an emphasis on turning clinicians into managers.

Wright was offered a spot at Birmingham University to study health management and moved into general management shortly after.

By then he was married to Elizabeth - who he met in the nurses' home of a psychiatric hospital - and together with their two children in 1992 the couple upped-sticks and moved to New Zealand on a health industry exchange for one year.

Wright swapped jobs with the manager at Auckland mental health services based at Waitemata.

"During that year I also got asked if I would take on the role of project manager for the closure of Kingseat [Hospital] and Carrington [Hospital].

"I think it was because, 'new guy, if it doesn't work then he's out of here and if it does then he's out of here anyway and we can take the credit'."

Wright closed the two former mental hospitals - Kingseat took longer than a year - and back in the UK he and Elizabeth decided, thanks to a bitterly cold winter, they would make New Zealand home permanently.

He managed mental health and drug and alcohol services at Waitemata from late 1993 before becoming general manager of North Shore Hospital for four years.

That was followed by a stint as the first mental health regional director for the northern region before Wright was headhunted in 2007 to be director of operations in South Australia.

"The day I arrived, they had 74 psychiatrists and 40 of them resigned. Nothing to do with me. It was all to do with pay negotiations they were having with the state but that was my introduction to South Australia."

Five years later Wright returned to New Zealand. He worked for a non-government organisation and was made redundant.

He set up a consultancy, doing strategic planning, restructures and service reviews, including a mental health review for Northland.

Wright initially turned down the opportunity to apply for the mental health director role at Waikato, but eventually succumbed to a persistent recruitment agent.

He joined the DHB in February 2016, during the middle of a Ministry of Health Section 99 review of its mental health unit, following the death of patient Nicky Stevens.

Among other things, the review identified the need for an experienced senior executive in the DHB's mental health team, a position left vacant during a restructure of the executive leadership by Murray.

The DHB had also been in the spotlight for allowing fake psychiatrist Mohamed Siddiqui to work there for six months in 2015 on a salary of $165,000.

"There was lots to do but there was a really good team and me never having worked in Waikato before, I came in with fresh eyes. We made lots of changes. There was already lots happening - I just hopefully provided some leadership to the team."

Wright has already been outspoken on some issues. He previously said he believed New Zealand had too many district health boards.

Twenty for a population of 4.5 million is out of kilter he reckons, and he believes there should be one linked IT system for all DHBs so that health records follow patients.

He also wants to see real change come from the ministerial mental health inquiry launched last month, not just "a tinker and throwing money" at the problem because as it stands our mental health system is unsustainable, Wright says.

Plus there's room for better training, Wright suggests. Much of his training was on the wards compared to today's student nurses, some of whom get all the way through a nursing degree only to find the profession is not for them once they get properly into a hospital.

"I think the pendulum has gone too far. I think probably when we trained in the '70s we were a cheap workforce. I think here there's too much of the academic side of it and not enough of how do you deal with people."

Nowadays Wright says there are lots of expectations from health that didn't exist 40 years ago.

"In the early '70s, if you were a patient and you needed a hip replacement and you were 65, you didn't get it done.

"Whereas we operate on 90 year olds now because the expectation is you get it done."

For now though Wright will concentrate on the job at hand - restoring public confidence in Waikato DHB.

He has set about doing this with a number of initiatives including recently proposing to trim his executive leadership team, to dismantle the 18-strong group Murray put in place and re-assemble it so only 11 executives report directly to him.

Wright also returned the executives to Waikato Hospital after Murray moved them to an ivory tower in the city, away from the coalface clinicians felt.

There's a 10-year plan being developed focusing on prevention and working smarter, and staff at the $1.4 billion organisation have rallied behind it.

He's confident of regaining the lost training accreditation in obstetrics and gynaecology and is working on creating a workplace free of bullying and where targets feel they can speak out.

Wright will continue visiting the DHB's 7000 staff including those at hospitals in Taumarunui, Tokoroa, Te Kuiti and Thames, and he is tackling the way the DHB communicates, both internally and externally.

It's undoubtedly damage control after the DHB was accused of keeping information secret during the Murray affair, but making himself available to the media and sending out fortnightly intranet updates to staff, complete with jokes, is a good start.

"I've hopefully brought some consistency to the organisation. I do a lot of management by walkabout. It's a slightly different culture I'm trying to bring to the organisation. I guess I'm just trying to humanise management."