Health NZ boss: System poorer than thought

The chairperson of newly minted Health New Zealand has warned the sector is ‘‘more dysfunctional’’ than he thought and cautioned that ‘‘defensive’’ attitudes risk slowing plans to overhaul the health sector.

The Government has consistently had to defend reforms to centralise health in an effort to salve poor access to quality healthcare, especially for Māori, through the new Health New Zealand and Māori Health Authority.

The legislation underpinning the reform passed its third reading in June and the new entities came into existence on July 1. But Health New Zealand chairperson Rob Campbell said abolishing district health boards is a bigger job than anyone anticipated.

‘‘A personal observation is that the system, the national system, was more dysfunctional than I had really appreciated, hence the need for reforms,’’ he said.

Clinicians supported the changes but raised concerns about the timing: during major workforce shortages, a blockbuster winter, and the pandemic.

Campbell said the reforms were going well, generally – ‘‘we haven’t dropped the ball on anything’’ – but it was slow work to change entrenched attitudes.

‘‘People are quite defensive of their current way of doing things, defensive of their positions within the structure, and breaking that down will take some time . . . we have to break it down by persuasion and encouragement.’’

Getting ‘‘basic information’’ from the health system was also a challenge.

‘‘The system and information within the system is poorer than I had thought, and so getting the basic information in a form that you can make decisions on is a major priority for us,’’ he said.

Hiring for senior management positions in the new organisation was happening almost daily. And once the new system was set up, those in charge would have to persuade clinicians what came next was better than the old approach, he said.

Health staff, already under pressure before the first community case of Covid-19, have faced relentless strain in the past two years, and doctors last month warned the sector was at risk of ‘‘catastrophic collapse’’.

Campbell said workforce shortages, pay disputes, and illnesses were out of the organisation’s control, but it had a good relationship with unions.

‘‘There are these tense negotiations going on about money, but on workforce issues we are united,’’ he said.

Health NZ would soon be releasing its health plan – a public guide to what it will be doing. ‘‘There are people both within and outside the health services who would’ve liked to see, or expected to see, more radical changes quickly.

‘‘We have opted to be very careful and measured in that so that will continue for quite a period of time while we get properly organised, so that is a bit of a tension.’’

‘‘The system and information within the system is poorer than I had thought.’’ Rob Campbell Health New Zealand chairperson