Are we going to address the issues raised by Rob Campbell and his sacking last week, or will they be sent to purgatory, along with the man himself, never to be spoken of again? That would be a shame, because he’s thrown down some big challenges.
Campbell, chair of the board of the new health service Te Whatu Ora, broke the impartiality rules for senior public servants by publicly criticising National’s plans for water reform.
I’m not saying he should have been free to break the rules: You do that, there should be consequences. But I don’t believe for a second he was sacked because he took a partisan position on a political issue.
That’s a sin worthy of a telling-off, not banishment.
It’s also laughable. The public service is full of people whose personal views motivate their work, on the left and on the right, often despite the policies of the Government of the day. On the whole, though, they don’t talk about it openly.
Campbell did commit two big sins, although being partisan isn’t one of them. First, by attacking a National Party policy he gifted the Opposition with the chance to embarrass the Government all the way into the election. He allowed National and Act to argue that Labour has appointed public servants to undermine them.
It’s a political sin and no Government will stand for that. Campbell had turned himself into a cudgel for National Party leader Christopher Luxon to beat Prime Minister Chris Hipkins with, so somebody had to take the cudgel away.
Politically damaging and petty at the same time.
The second sin is more substantial and has been well explained by Ian Powell, the former executive director of the Association of Salaried Medical Specialists.
Powell says Campbell was chosen as the inaugural chair of Te Whatu Ora because he was a health outsider. He was expected to bring his business experience to the abolition of the district health boards and other structural reforms, without being captured by vested interests in the hospitals. The DHBs were mired in inefficiency and his independence would help him sort that out.
To begin with, working with staff drawn largely from the Ministry of Health, Campbell embraced the role.
But as Powell notes, as he learned how health providers work, he started to change his mind. And in December he started telling the world about it.
In an interview on RNZ on December 12, he talked about workforce shortages and the constraints placed on DHBs by the ministry. He was supposed to be a spokesperson for Government policy but he was off-message.
On December 19, in a comment on LinkedIn, he suggested that rather than blaming DHBs, “the leadership and monitoring and support from the ministry was a much greater problem” and that better funding would help too. That was definitely off-message.
Then on December 31, also on LinkedIn, he wrote, “My inbox stays busy from within the health system (please don’t stop). Tired, committed, skilled health workers of all kinds. Asking for help to help them help others. We do not do the things we know we should do, know how to do. Or at least not comprehensively or fairly. I got locked into the blame game this year. That was wrong.”
Te Whatu Ora is the country’s largest employer, with 80,000 staff and an operating budget of $20 billion. It also represents the Government’s flagship reform programme. Cabinet must have been horrified: its boss had gone rogue.
In addition, Campbell backed the Green Party bill on alcohol sales, complained about an over-reliance on consultants and argued for more nurses to be brought in from overseas.
And he promoted the value of co-governance, with the benefit of his own experience, at a time when Hipkins had signalled he wanted to shut down the debate and possibly the policy itself.
Campbell faux-enraged National by criticising them, although secretly they must have been thrilled. He enraged Labour much more by enraging National. Worst of all, he publicly questioned the wisdom of the very reforms he was supposed to champion.
By last week, when Health Minister Ayesha Verrall sacked him, Rob Campbell had run out of friends.
But he’s not a stupid man, nor is he politically inexperienced. It’s not credible that he was naive about what he could and couldn’t say.
If he had decided the health reforms were wrong, what was he going to do? Simply resign? Or go down fighting, perhaps in the hope that some of the larger issues might be addressed?
There are several that should be.
One is National’s water reform policy, which triggered his sacking.
Luxon says rates won’t rise, but his colleague Simon Watts says councils’ water agencies might raise their fees. In my view, that contradiction alone makes the policy laughably incoherent. And, frankly, dishonest.
Another is co-governance, whose salient feature rarely gets a mention: It’s consensus decision-making. The Waikato River Authority has been practising it for the past 12 years: Partners in an issue sit down together and everyone agrees on how to proceed.
Nobody, anywhere, has complained that because of this the authority’s decisions have been unfair or don’t work.
Compare that model of democracy with one in which antagonists line up to fight each other and the winner takes all. And remember how the winner is decided. Not by the superiority of their arguments, command of the facts, respect for the other side or the justice of their cause, but only by one thing: Whose team is bigger.
We should be fighting for co-governance, and hailing those prepared to do so.
Campbell has also called attention to health reform itself. The problems are acute and spread widely, and they are made worse by a miasma of low morale that has been allowed to sink over our hospitals and other parts of the health system.
What’s needed should be blindingly obvious to every politician. It’s not top-down structural reform. It’s doing everything possible to empower, enable and support frontline staff.
Funding. Pay. Immigration rules. The number of hospital beds. Training. Pastoral and clinical support. More funding. Taking the lead, not from officials, consultants, politicians and ideologues, but from the skilled, motivated and despairing professional healthcare workers holding everything together.
Making it work for doctors and nurses is the way to make it work for patients.
If you ask me, there’s a fair chance the political side that convinces us they understand this one big thing will win the election in October.
Come on, Chippy and Mr De Luxe, be as brave as Rob Campbell. Why don’t you?
In all of this, one theme links Campbell’s comments on health, co-governance, water reform and impartiality: The decision-making system is not fit for purpose.
Public service bosses serve on fixed-term contracts and the chairs of crown agency boards are political appointments, also on fixed terms. Why do we need impartiality from them, especially when it’s only pretended anyway?
If we appoint the Rob Campbells of this world on fixed terms and make them subject to recall, we should expect them to speak the truth to us, as they see it. We should respect them for it and criticise them when they fail to do it.
We need reform in this country, everywhere you look. The problems are deep-set and urgent. And we need all the talented people we can find to lead that reform, actively and transparently, fully engaged in the public debate.
We should not care when they put politicians’ noses out of joint. It’s probably a good sign.