Nick Saville-Wood was announced as the new chief executive of the Lakes District Health Board this month. He'd been acting chief after Ron Dunham retired at the end of 2018. Saville-Wood was a "popular choice" according to colleagues in managerial roles, but the year to date has been a baptism of fire with back-to-back strikes. Unlike his predecessor, who entered the health sector as a nurse, Saville-Wood joined the DHB as a management accountant. He was later promoted to corporate general manager and was chief operating officer from 2016 to 2019.
Nick Saville-Wood is rolling up his sleeves.
He enjoyed the challenges in his former role as Lakes DHB chief operating officer, alongside former chief executive Ron Dunham, but that job had a narrower focus on the Rotorua and Taupō Hospitals specifically.
"The chief executive role is much more focused on the broader health continuum."
Central government, and the Lakes DHB's "big drive" is currently illness prevention.
"Certainly from our perspective, the current growth levels that are happening in the treatment area, the hospitals, is just unsustainable. I mean we'll be building hospitals left, right and centre if we continue on this pathway."
Consecutive strikes from junior doctors, anaesthetic technicians and midwives have had a massive impact on Saville-Wood's year to date.
He told the Rotorua Daily Post they had been unprecedented, and unfortunate, after a few years of very limited industrial action.
"You're just trying to do all your contingency planning and making sure that patient safety is maintained, as well as trying to resolve the issues with the unions. So that's been difficult and it's been the subject of all the national chief executives actually."
His biggest worry was the resulting burden on other staff, and the damage that could do.
"Medical teams, when they co-ordinate and work well together, you get really good outcomes, and strike action tends to polarise people... There's got to be a compromise somewhere in there that both of us [the unions and DHBs] can agree to."
The Lakes DHB area is the third most deprived in New Zealand.
Saville-Wood said this had big effects on Māori health outcomes, particularly mental health and children's health, and he would do a lot of work in this area.
"Health can't help with it all, you know this is multi-agency. So it's being able to influence those other agencies and get in there, and try and get income levels up."
Saville-Wood said the DHB's responses to cancer referrals had improved significantly in recent years.
"We were at 48 per cent of our cancer treatment target times in 2016 and now we are proud regularly achieve 100 per cent target levels, which is really great for our cancer patients."
He acknowledged that bullying and harassment were a problem for staff in many organisations, and the Lakes DHB was no different.
"It comes in a lot of forms and what we've noticed is there has been an increasing prevalence of patients and their families actually being party to that whole scenario of putting pressure on staff."
He said that didn't mean there wasn't bullying between staff too, and in a recent staff survey it came through as a major item, but it was unclear whether difficulties from staff or outsiders interacting with the DHB were the biggest contributor.
"So the process we are going to go through is actually getting in front of staff and finding out what are those things that we need to address."
The DHB is also running programmes, including one focused on "standing up for patient safety" and it is developing a code of conduct.
He said the DHB's size was one of its biggest advantages, as an employer.
"We are not too small that the people coming here, particularly clinicians, don't get the experience levels that they need. But we are not too big on the other side where you are just a number. You know each other by name.
"And there's a lot of support. For junior doctors coming here, there's a lot of support from senior doctors... Work and life balance in a small DHB like ours, particularly in the region we are in, is fantastic."