Health NZ boss signing off every paper to ministers, adding to 17-step process, staff say

Wednesday, 29 January 2025

Health NZ - Te Whatu Ora chief executive Margie Apa is signing off every paper to health ministers, adding days to what’s now a 17-step process for some departments.

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The change in health minister has prompted Health New Zealand’s chief executive to insist on signing off every paper the agency sends to ministers, which staff say will add days to what’s now a 17-step process for some departments.

Chief executive Margie Apa says the process is a commitment to ensuring new Health Minister Simeon Brown gets the best advice, but Brown appears to have already told the agency to speed things up.

In an email last week, staff were told: “Effective now and until further notice, all papers to all of our Ministers need to be signed off by Margie before being sent to their offices.

“Margie has advised each paper will take 48 hours to review and approve. This means each paper must be received by the Briefings team no later than midday three working days before due date.”

In the email, commissioning business services group manager Matt McLay warned staff the process was already “often longer than the time we get to write the papers”.

A staff member tasked with writing some of these papers says the change was “on top of peer review, proofread, manager, group manager, director, [commissioning] director, national director …”

They provided a process now totalling 17 steps ‒ which separate sources have verified ‒ which includes up to eight layers of sign-off from various managers and directors.

“Lester and the [former health] minister were harping on about bureaucracy - I don’t know how you get more ridiculous than that,“ the staffer said.

Commissioner Lester Levy has promised to make the embattled agency more efficient and eliminate unnecessary bureaucracy.

“How are we expected to get anything out the door on time?” the staff member said.

“But also, what a phenomenal waste of Margie’s time and almost $1m salary.“

Apa is the highest paid public sector CEO, with a salary of $895,000 in the 2023/24 financial year.

Apa defended her move to review everything. “As chief executive I have asked for extra scrutiny on advice to make sure Health New Zealand - Te Whatu Ora is aligned to the priorities of the day.

The average sign-out time was already between 12 and 21 working days, depending on the nature of the request, the staff member said.

This was not unusual when there were “governance or strategy changes” such as a new minister.

“The purpose is to ensure advice is aligned, is sufficiently data driven or evidence based and fits the brief as requested. It is not unusual to seek assurance that teams have adjusted to new ways of working and are responsive.”

While the chief executive sign-off applies to everything, Apa said the lengthy process The Post outlined was ”not the reality for all advice“.

The 17-step process includes the Commissioning Business Services and is understood to include the National Public Health Service. These teams deal with advice on the likes of infectious diseases, rheumatic fever, vaping, maternity care and children’s health.

It appears Brown may have stepped in to instruct the agency to speed things up.

New Health Minister Simeon Brown says he has made his expectations clear that the health agency must be efficient.

He wasn’t aware of the process when asked on Friday but later in a written response said: “I have made clear my expectations that Health New Zealand needs to be an efficient organisation.

“I have been advised that the organisation is implementing more efficient processes.”

The staff member who revealed the process said most papers for ministers had an expected turn-around time of between three and 14 working days, but the average sign-out time was already between 12 and 21 working days, depending on the nature of the request.

The same people also deal with Official Information Act requests and information for politicians to answer oral questions, which must be turned around in a matter of hours, or written questions which are expected within three days.

The staffer added that changing the health minister added a “phenomenal amount of work” having to get Brown up to speed on the health system.

“If they could stop changing the Minister of Health, that would be great.”

The staff member The Post spoke to is from the same non-clinical team which has warned the restructure proposal to axe 200 positions as part of Commissioner Lester Levy’s cost-cutting work is “unworkable”.

They said the proposed changes in the restructure would make the process impossible, because the number of staff would be much smaller.