What tops Health NZ Commissioner Lester Levy's to-do list heading into 2025

Saturday, 11 January 2025

Commissioner Lester Levy says current health boss Margie Apa,left, is “welcome to apply” as a global search starts for the next chief executive.

An international hunt is about to begin for Health New Zealand’s next chief executive, and Commissioner Lester Levy says current boss Margie Apa is “welcome to apply”.

Levy is almost six months into his 12-month Government appointment to fix the health system, with a mandate to save up to $2 billion, axe thousands of jobs and improve patient waiting times.

Here are the main things on his in-tray as we enter 2025.

Leadership

The $900,000 job of chief executive is officially up for grabs, Levy has confirmed, telling staff a “global executive search” is under way.

Chief executive of Health New Zealand - Te Whatu Ora, Margie Apa at health select committee in 2024.

Levy has remained coy on questions over Apa’s future since he began the role, but is believed to have kept Apa around to help him navigate the 80,000-strong “team of teams” he has been tasked with overhauling.

Apa’s three-year contract ends on June 25 and the role will be taken to market “in the coming weeks”, Levy said in a statement.

“I expect the process to be completed within the next three to four months.

“This appointment will be through an open competitive process and Margie, along with any other Health NZ managers or clinicians with the appropriate background, experience and expertise, are all welcome to apply for the role as are any interested candidates from around the globe.”

Questions continue to swirl over how the CEO who has led the organisation since its inception has survived until now when the board and multiple senior managers have been rolled.

Sharon Murdoch’s September 20, 2024, cartoon on Lester Levy and emergency departments.

In 2023/24 Apa was the highest paid public sector chief executive who still had a job. Her pay went from $864,000 in 2022/23 to $895,000 in 2023/24 – a $31,000 boost.

Waiting times

Levy’s mantra has become “the safest wait is the shortest wait” but since he was appointed waiting times have either flat-lined or worsened compared with quarterly results from a year ago.

“The year ahead is shaping up as an exciting opportunity to deliver for patients,” Levy told staff on Thursday, “as we move as many of our resources as possible closer to communities where they live and to reduce waiting times for essential clinical services.

“We will make every effort to reverse the more recent multi-year trend of increasing waiting times.”

In December Levy gave the agency a two-year deadline to make a “serious dent” in patient waiting times.

However he is reporting to an extremely results-driven Government which will be expecting to see progress on the $320,000 it’s paying him each year.

Dame Karen Poutasi was the final chairperson of the Health NZ Te Whatu Ora board before they were sacked and replaced by the commissioner.

Appointing a board

Health Minster Dr Shane Reti sacked the board in July with Prime Minister Christopher Luxon sending them off with accusations they were “financially illiterate”.

But the idea was always to re-appoint a board - the question will be who, besides Levy, will decide who’s on it and who would want the job.

Finances

Levy is clawing the agency back from what’s now a projected $1.1 billion deficit by June 2025.

Professor Lester Levy says he and the chief executive of Health NZ have made a commitment to protect the front line, but there may be some 'marginal changes' to front line work.

Health NZ - Te Whatu Ora has said it is making major progress on savings, but is not expecting to be back to budget until June 2027.

This target has been pushed out by a year from the originally planned two-year reset, but in the meantime each department is working through savings plans - which largely involve reducing head count.

Levy and his deputy commissioners will be turning their minds to Budget 2025 bids, including how much is needed for cost pressures.

Apa has said making cost reductions over a longer timeframe allows the agency to implement “change without compromising on delivery of health targets and mental health and addictions targets”.

Restructuring

The lion’s share of restructuring is understood to have at least been announced last year, with more than 2000 roles either cut, proposed to be disestablished, or left via voluntary redundancy.

But the agency has warned financial cuts will continue until 2027, with the human resources team expected to be last up after they have helped to implement all the other restructures.

Levy's draft turnaround reset plan dated Sept 1. The 97-page powerpoint was written by Levy intended to inform the final Health Reset Plan, the agency said.

The new Planning Funding and Outcomes unit is the latest to face a proposal to cut 200 jobs, with their consultation period ending on January 31.

The biggest day so far was November 27, when Te Whatu Ora released proposals to axe close to 1500 roles across the national public health services, data and digital, hauora Māori and Pacific health teams. Of these roles, about 700 were vacant.

Separately, more than 500 staff also took voluntary redundancy last year.

Reset plans

This is more likely to be on the out-tray, given Levy wrote plans underpinning a new operating model for Te Whatu Ora last year.

The plans include enabling patients to access care closer to home, greater clinical involvement, shorter waiting times, better workplace safety and clearer accountabilities for management and staff - but the agency has so far refused to release the details of the plan.

This barrier is expected to fall though, given Levy promised MPs at a health select committee grilling in December that he would release the plan soon.