A district health board has signalled its intent to offer voluntary redundancies to senior staff raising concerns about patient safety and leading a union representative to describe it as "bonkers".

A letter from Counties Manukau DHB acting chief executive Gloria Johnson was sent to senior managers on Monday suggesting voluntary redundancy be offered to a number of staff on individual employment agreements and those at the top of their pay band, including all clinicians.

Counties Manukau DHB runs Auckland's Middlemore Hospital.

Association of Salaried Medical Specialists executive director Ian Powell said it was "absurd" and "bonkers" to be encouraging staff to leave when the existing workforce was overworked.


In July, the hospital warned they were seeing record demand for services and advised people to see their family doctor first unless it was an emergency.

In August, under-pressure staff at Middlemore Hospital told accident and emergency patients to go elsewhere or face a wait of up to eight hours. They made a sign and put it up at the front of the Accident and Emergency Department warning people off because of extensive delays.

A Counties Manukau DHB spokeswoman confirmed a letter was drafted for senior managers for consultation around the "possibility that some senior staff may wish for family or other reasons to cease their employment voluntarily".

She said it was intended as "a good thing to offer staff".

The intent of the scheme was to enable more resources to be directed into frontline services, rather than reduce clinical staffing levels, she said. Any clinical staff approved for a cessation package would be matched by increased numbers of other clinical staff more closely involved in frontline services.

Johnson said the scheme was in the discussion stage only.

Powell said there was a 50 per cent burnout rate among medical specialists and 25 per cent of specialists employed by New Zealand DHBs intended to leave in the next five years.

"When you've got high understaffing, you've got high workloads, why on earth would you be doing this," he said. "This is one of the most stupid things I've ever seen."


Public Service Association national secretary Erin Polaczuk said nine years of underfunding in health has put DHBs like Counties Manukau in a "perilous state".

"The DHB should be offering incentives for experienced clinicians to keep working for the DHB, not offering them costly exit payments," she said.

"Our members are already struggling to deliver quality care when and where it's needed. Workloads are incredibly high and there are current vacancies in many professions. Removing senior experienced staff from any role in the organisation will have serious consequences for the remaining staff and patient safety.

"Our members will be concerned that this is just the beginning and that forced redundancies of other staff will follow."

Polaczuk said losing senior staff when there were already unfilled vacancies would have a flow-on effect and put more pressure on other doctors and could create an environment where mistakes were made, and leave patients facing further delays.

She acknowledge Counties Manukau DHB, like health boards around the country, was under increasing financial strain but said this was not the way to manage it.


On Tuesday the association received a guarantee the health board would not roll out the scheme and that a proper consultation process would begin with urgency, Polaczuk said.

New Zealand Nurses Organisation DHB industrial adviser Lesley Harry said they remained concerned that offering redundancy to senior nurses and midwives and replacing them with less experienced ones was not in the best interests of the workforce or patients.

"This idea of the voluntary cessation scheme, and the way it has come about, is unacceptable and inappropriate. It demonstrates that the DHB is under financial pressures due to underfunding. It is a desperate and peculiar way to attempt to make savings," she said.

"This DHB is short of senior experienced nursing staff as it is. It is mind-boggling how this scheme will ensure safe staffing levels and ensure the right skill mix for patient care."