A proposed restructure of Waikato District Health Board's executive leadership team will trim the number of senior managers reporting directly to the chief executive by seven.
The DHB's leadership team of 18 is one of the highest in the country, second only to Auckland DHB with 20, and the same number as Capital and Coast DHB.
The move follows the Weekend Herald's revelation last week that executive leadership teams at the country's 20 district health boards are costing taxpayers $60 million a year.
Waikato DHB's executive team earned $4.6m of that figure.
Interim chief executive Derek Wright, who took the helm after Dr Nigel Murray resigned amid an expenses scandal in October last year, has now proposed a reshuffle that would trim the team by two executives, and reduce those reporting to him to 11.
Auckland District Health Board's leadership team is made up of 20 people but only the 11 members of the executive leadership team report to the chief executive.
In the Waikato proposal, posted on the DHB's intranet this week, Wright wants to create a deputy chief executive role to take responsibility for the board, virtual health, property and infrastructure, and human resources.
All four areas had a tumultuous year in 2017 under Murray's leadership.
The board was rocked by the expenses scandal after it was revealed Murray spent $218,000 of taxpayer money in three years and board chairman Bob Simcock resigned over the fiasco in late November.
That case is now being investigated by the State Services Commission.
The DHB's flagship virtual health app SmartHealth has failed to attract targeted numbers since its launch in May 2016 and the procurement of HealthTap, the American information technology company that powers SmartHealth, is under investigation by the Auditor-General's office.
In August the Herald revealed the cash-strapped DHB's $7.7 million refurbishment of Hamilton's KPMG building had blown out to $14.7m in one year.
The DHB had to seek permission from the Ministry of Health to continue the refurbishment, originally envisaged to hold 800 staff, but after Murray left Wright decided the executive team would return to the Waikato Hospital campus.
And in November the DHB was forced to apologise to a former health promoter who was unjustifiably dismissed.
Kathleen Archibald won an employment case against the DHB but with Murray's approval the Human Resources department appealed, lost the argument again and was ordered to pay her $10,000, a severance payout and legal fees.
In the restructure Neville Hablous' chief of staff position would be disestablished and he would become deputy chief executive, overseeing the four departments.
However the management of virtual health would be transferred to the office of the chief medical officer after the DHB's own review of HealthTap is complete, expected to be before the contract is due for renewal in May.
"I think one of the issues they had is they tried to run this (SmartHealth) as an IT project separately and I want it to sit clinically, because it's really about how we deliver clinical services," Wright said.
The position of executive director of virtual health and innovation, held by Darrin Hackett, will be reviewed and potentially replaced with a director of virtual health.
A fortnightly meeting of the 18-strong executive team would reduce to a one-hour, weekly meeting of 11 key managers, including the acting chief medical officer Rees Tapsell and the executive director of Te Puna Oranga Loraine Elliott.
Tapsell would also take over management of the junior doctors' office within Waikato Hospital.
Other notable changes are the stepping aside of Professor Ross Lawrenson as clinical director of strategy and funding to concentrate on research.
Under the proposal that role would merge with one currently held by Dr Damian Tomic, to become clinical director of primary care and strategy and funding.
That position, and that of Ian Wolstencroft's executive director of strategic projects, would drop to outside the executive leadership team and will no longer report directly to Wright.
Wright said the restructure was about separating out day-to-day work from strategy, aligning the executive structure with the future needs of the DHB, and reducing the number of people who directly report to him.
"The restructure is aimed at giving greater clarity to how and where decisions are made and ensuring enhanced clinical input/partnership."
Wright confirmed the demoted executives would not take a pay cut.
The proposal is open for consultation by staff and a decision is expected on February 26.
Current executive team and proposed changes
- interim CEO until Jan 2019
- chief of staff
(would become interim deputy chief executive)
Dr Grant Howard
- acting chief operating officer Waikato Hospital
- executive director community and clinical support
- acting executive director mental health and addictions
- executive director Maori health
(executive director Te Puna Oranga)
- executive director virtual care and innovation
(reports to deputy CE)
- executive director strategic projects
(reports to Maureen Chrystall)
- executive director strategy and funding
Prof Ross Lawrenson
- clinical director strategy and funding
- executive director corporate services
- executive director facilities and business
(reports to deputy CE)
- executive director public and organisational affairs
Marc Ter Beek
- executive director operations and performance
(reports to Dr Howard).
Professional advisory members
Dr Rees Tapsell
- acting chief medical officer
(takes over management of RMO office)
- chief nursing and midwifery officer
Dr Damian Tomic
- clinical director primary and integrated care
(reports to Julie Wilson)
- director quality and patient safety.
Currently outside executive team
- human resources general manager
(would report to deputy CE).