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Key points
Levy Lester delivered a speech this week at an Atlas Network partner NZ Initiative event. In it, he signalled that “significant”, “not painless” changes were needed for Health NZ
He said he believes that Health NZ can do more with existing resources, and emphasised concerns with finances, Health NZ productivity, and wait times.
In April, Luxon promised reduced wait times for elective surgeries and ED admissions/transfers. So far, the trend - as for Luxon’s jobseeker beneficiary KPI - is not positive
This week, Lester said “wait times” are the “critical issue” for Health NZ and “the number one reason why I took on this job”.
The National government intentionally underfunded Health NZ during the May 2024 budget to the tune of $1.4bn and Levy echoed Reti/Luxon by suggesting it’s unsustainable - but all at what cost to NZ and Kiwis?
Meanwhile, as Levy laments the projected $1.4bn “deficit” for the year for Health NZ, it’s important to note:
Nicola Willis’s tax cuts cost over $37bn over 10 years,
Simeon Brown is committing $70bn for roads over 10 years.
Levy delivers keynote speech at an Atlas Network Partner Event
This week, Lester Levy gave a talk1 at a NZ Initiative health conference - transcript in full above.
Levy was key note speaker.
The event was covered by NZME and The Post, although Levy refused to give Post reporters the time of day.
ANYONE with even a cursory interest in the health system should pay very careful attention to what Levy said - not necessarily his content, but the way he speaks, the flags he is waving, and the signals he’s revealing.
If I may be blunt - his words are weasel words to me - found in the hallways of senior government offices or bureaucratic old time cultures, when you’re trying to impress people who don’t know their own craft, but are keen for ‘results’.
Levy’s speech included phrases like this:
“In my humble view, Health New Zealand-Te Whatu Ora has so many priorities it has no priorities at all. We are going to have very clear priorities, we are going to bring focus into the organisation, we are going to bring discipline into the organisation, and we will change whatever needs to be changed to deliver these low waiting times to patients, families and communities”
“The whole organisation needs to become much more responsive, needs to speed up and it's not where the organisation has been but it's where the organisation needs to get to and that movement isn't going to be easy.”
“I believe very strongly that more health services can be delivered within their existing resources.”
“I have said that as long as it's legal and ethical, I will do whatever I have to do to deliver to patients, families and communities what they need and deserve.”
This at a time when frontline doctors and nurses have been coming out more and more strongly to say the government’s approach is just not working.
But the government persists in freezing frontline hires, not paying for healthcare workers, and effectively asking sick Kiwis to fund their own healthcare, even as doctors reach breaking point and nurses and doctors continue to warn “someone will die”.
Yesterday, Te Whatu Ora laid off a few hundred more staff, effectively halving its workforce - and Levy in effect admitted that a leaked proposal to cut ~4500 staff, was an attempt to demonstrate the cost savings he wanted.
Sarah Dalton, executive director of the Association of Salaried Medical Specialists, called Levy’s speech at NZ Institute “hollow words”.
But as the overseer of a $28bn budget and 90,000 health staff i.e. the NZ government’s largest department - Levy’s role is absolute in its authority and dangerous in its lack of checks and balances.
In a large organisation, there are checks and balances against authoritarianism. Boards typically contain 7-12 people because diverse skill sets and collective agreements make for better outcomes.
However, here, under a false pretext of “an unexpected deficit”, Reti was made King / Czar / Oversee / Lord / Baron and Chief of ALL in Health NZ - to do as he will.
It is in other words, a complete takeover by someone who has been described as “top-down, controlling and destructive”.
Further his track record appears poor for health organisations, as the Newsroom article from before his appointment revealed -
In each of the (health leadership) positions, he came in with an embellished assertion that he had inherited a financial mess and was the right person to fix it.
In each of the four DHBs (District Health Boards), the chief executives resigned … almost all the senior leadership team also resigned. Morale also plummeted … Ironically, following his appointment as their chairs, the three Auckland DHBs went from financial surpluses to deficits.
I would summarise his speeech as - it is clear the government is alarmed that Luxon and Reti’s health related KPIs - particlarly around wait times are not trending well.
And, as they have pushed themself against a wall with their tax cuts, and their operating allowance is now razor thin at ~$1 billion a year, Luxon is quite probably a little concerned about their numbers.
As some of you who follow Luxon might realise, he appears very focused on self-image and that includes being a ‘successful CEO’. I believe he needs his 9 KPIs to be realised, and will try to enforce it through, and that’s what Levy is there for - wait times and to stamp down on costs.
Levy on wait times:
“So for us, the key element is to get waiting times down.”
“We're going to bring discipline into the organisation and we will change whatever needs to be changed in order to deliver these low waiting times.”
“I strongly believe that the waiting times are a critical issue, an urgent issue and that is the number one reason why I took on this job.”
“We have waiting times that are designated and you know most of those now are not being met and there's a big delta between where we are and where we need to be.
So that's a massive challenge and an urgent challenge and that's the number one priority for the organisation.”
Yes, according to Levy, it’s his number one priority and why he took the job - because it is Luxon’s #1 health priority. Luxon’s self esteem around meeting his self-imposed, artificial and, in my view, unskilfully constructed KPIs quite possibly hangs on it.
BTW here are Luxon’s two health targets:
Emergency Departments: 95 percent of ED patients admitted, discharged or transferred within six hours
Elective treatment: 95 percent of people waiting less than four months
Last but not least, it’s important to note that while the government wants to sound alarm bells over health system costs, our best and brightest health care workers continue to leave our shores, and the government’s pro-tobacco policies continue to kill Kiwis, and add to health system costs.
Nicola Willis’s tax cuts – which have been offset for many with increased car registration, upcoming fuel levies, prescription fees, increased emissions flowing into insurance models, reduced beneficiary and disability funding, austerity budget job cuts etc – cost us $3.7bn a year.
That means the tax cuts cost $37bn + over 10 years.
And Simeon Brown’s road plan costs $70bn over 10 years.
Meanwhile, Luxon, Willis and Reti complain that our health system needs $1.4bn more, even as they fund the health system to the lowest per capita rate in a decade.
Is this all worth it, and is Lester Levy, a man who once championed privatising health, the right man to fix Health NZ – or perhaps, like the Atlas Network favoured motto2 hints at – break it down?
The full transcript and video is above.
“Only a crisis – actual or perceived – produces real change. When that crisis occurs, the actions that are taken depend on the ideas that are lying around. That, I believe, is our basic function: to develop alternatives to existing policies, to keep them alive and available until the politically impossible becomes the politically inevitable.”
– Milton Friedman
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