The announcement of the departure of three senior health officials this week served as a reminder of the broader malaise facing health professionals in this country.
With the Omicron wave still sweeping over the nation, director general of health Dr Ashley Bloomfield, director of public health Dr Caroline McElnay and public health deputy director Dr Niki Stefanogiannis have all resigned.
Senior Herald writer Derek Cheng tells The Front Page podcast the trio faced enormous pressure over the last two years as they were making decisions that literally determined whether people lived or died – pressure that was certainly a contributing factor in their decisions to leave.
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"I was told there were a number of factors involved, including just general burnout and Covid fatigue – simply being exhausted from working non-stop to try and keep people as safe as possible in the pandemic," he says.
But the problem of overwork doesn't stop at the executive ranks. Doctors, nurses, midwives and other healthcare professionals have all expressed concern about the amount of pressure they face on a daily basis.
"Burnout is a key issue," says Cheng.
"It was identified by Sir Brian Roche in one of his independent reports. We saw it in the Auckland health unit when people resigned in the middle of the Delta outbreak.
"Health workers have been our frontline heroes, but there really is no respite for them. As soon as one wave eases, restrictions are lifted and the pressure goes on the system once again. It's a real issue and there's no real solution or quick fix here either."
Efforts to bring in extra hands to ease that load carried by staff haven't been as effective as hoped over the last two years.
"We've had border exemptions for critical health staff for years and those places haven't been taken up. It's evident in the lack of ICU nurses that we have despite efforts to recruit [these specialists].
"There's such a global demand on healthcare workers – and New Zealand, frankly, has a low wage economy and isn't as appealing as some other places."
With the borders opening up and recruiters abroad actively recruiting health staff in this market, the pressure on hospital staff doesn't show any signs of abating. The incentive to leave New Zealand is even greater because the pay offered abroad is often significantly higher than that offered in the local market.
"The risk of losing key healthcare staff to higher wages over the Tasman is very real – especially now that MIQ has gone," Cheng says.
"There's no easy fix here. You can't just bump wages up overnight."
Even though restrictions are lifting around the country, the pandemic is not yet over – and if anything, the pressure on healthcare staff will only grow as the country shifts to a system reliant on personal responsibility.
"Covid is far from over, despite what people are saying. There could be a resurgence and there will be new variants."
These developments will again heap pressure on the already-stretched healthcare staff on the verge of burnout.
The leaders who take the reins from Bloomfield, McElnay and Stefanogiannis will have to navigate through the complexity of the ongoing pandemic while simultaneously ensuring staff aren't worked to the bone. And all this needs to happen within the context of a new organisational structure that will see all District Health Boards abolished by July 1.
So what type of leader will it take to lead the health sector through this change? And who are some of the leading contenders?
Listen to the full podcast to hear Cheng's insights on these and other pressing questions.
• The Front Page is a daily news podcast from the New Zealand Herald, available to listen to every weekday from 5am.