'Unworkable': Inside a Health NZ meeting to gut specialised teams

Friday, 10 January 2025

Staff at Health New Zealand say a plan to axe non-clinical jobs in maternity care, children’s health and sexual health will slash crucial expertise and make health outcomes worse.

'They are putting the cart before the horse by sacking the people and then figuring out what programmes they are keeping,“ a staff member told The Post.

The Post was leaked an anonymised internal chat and audio from a meeting with staff in the Planning, Funding and Outcomes Community and Mental Health team in December.

It was intended as a “deep dive” into a proposal to axe 200 positions as part of Commissioner Lester Levy’s cost-cutting mandate, but saw staff grow increasingly frustrated when senior managers struggled to clearly answer their questions.

The Friday before the meeting, those same staff were mistakenly cc’d into an email inviting them to discuss job changes, inadvertently exposing which staff were disestablished and which were safe.

Staff were stunned to see the proposal to cut senior experts in women’s health, sexual health, oral health, rainbow health and youth health and recruit to more generic positions such as a new “Child & Youth” team, before Health NZ - Te Whatu Ora had decided which work to continue.

One staffer used the analogy that you would not employ five generic surgeons before discovering you needed a specialised cardiac surgeon and didn’t have one.

“Unfortunately, we're having to resize the team, and so we have to come up with a structure that works best,” replied a manager on the call, who The Post has chosen not to name.

A staffer who spoke directly to The Post said it appeared to be simply a numbers game. “I may as well walk around with my salary written on my T-shirt because that’s all they need to know about me.”

Starting Well - a team dedicated to maternity, pre-conception and early years - would lose 20 fulltime positions and see the team’s remaining staff merge with another focused on older people (Ageing Well) into a broad group called Age and Stage.

“The lack of SME [senior medical experience] in this Age and Stage is unworkable. This will have significant impact on the front line delivery of services,” one staffer wrote.

“The impact this is having on staff is difficult but the most affected people in this whole process is the whānau that we serve,” another later said.

Staff also raised the point that the proposal meant the HIV plan - a Budget 2022 initiative - “no longer has a team to implement it”.

“We have to deliver the work with less people… not mentioning specific things doesn't mean that we're not going to be doing them,” a manager replied.

The ministers responsible - Health Minister Shane Reti, Mental Health Minister Matt Doocey and Associate Health Minister Casey Costello - say they have been assured the proposed changes “will not impact Health New Zealand's ability to deliver on priority areas, such as delivering the HIV action plan and maternal and children’s health services”.

That was despite proposed roles for disestablishment including jobs in those areas, where the Government had specific strategies for improvement.

The proposed cuts included a team called Kahu Taurima, which was redesigning maternity and early years services as part of the Government’s Child and Youth Strategy and a new rheumatic fever team which regularly reports to Reti.

The agency’s “commitment to deliver on the HIV action plan remains unchanged by the consultation process”, Jason Power, Te Whatu Ora’s funding and investment co-director said in a statement.

The changes were proposals and feedback was encouraged and would be carefully considered before final decisions were made, Power said.

It’s understood one role up for disestablishment is a doctor working on HIV prevention whose appointment Doocey recently announced

A joint statement from Reti, Doocey and Costello did not address questions on whether they expected commissioners to make adjustments to the proposals if they believed cuts were happening in the wrong places.

They were aware the consultation was happening - though neither the minister nor Health NZ would say when they were made aware.

The plan also suggested “the abortion function shifting into the child & youth team” - which staff said was wildly inappropriate. Neither Health NZ nor the relevant ministers acknowledged The Post’s questions on this.

“That’s bananas,” Labour’s health spokesperson Dr Ayesha Verall said. “These are adult women who have an entitlement to a service.”

Verrall was sad to hear specialised rainbow roles, which she established as a Budget 2022 initiative, were up for disestablishment.

“It’s a small team that does important work for a group that’s often excluded.

“Slashing specialist roles means the ability of health service to serve particular situations is reduced.”