Open article. Note the video of the Health Select Committee excerpts starts at 1:22
In watching the Health Select Committee yesterday, it became clear to me why Margie Apa remains Health NZ CEO.
During Levy’s testimony, Apa sat like a rock next to her boss. She nodded supportively, scribbled notes to him, jumped in when he faltered, and helped him to answer questions.
When Labour’s Dr Verrall asked why Health NZ started implementing “a surge” of NDAs, Levy said he didn’t know anything about that.
Apa explained -
Apa:
“I did ask for NDAs for senior managers who were involved in budgets. And, that’s not unusual…”
Verrall:
“Well, I can advise members of the Health NZ delegation that this is a highly unusual practice in a public sector organisation.”
“And I put to you, Commissioner Levy, that you have the power to ask for these to be removed.”
“The Public Service Commissioner has asked that I [ask you] whether you think this is appropriate for a public service organisation.
I have seen some of these NDAs.
They ask officials not to discuss their ideas.
This is North Korean, get rid of it.”
Levy acknowledged that he had received a letter from the Public Service Commissioner.
And he said they would respond soon.
Verrall later expands:
“Every government department in New Zealand writes a budget and none of them have this level of non-disclosure agreements.”
[They are being used to] “hide the scale of the cuts they are planning”.
This is consistent because the NDAs appeared after the leak of one of Health NZ’s latest proposals - 4492 cut to meet Dr Levy’s budget request.
[470 doctors, 1491 nurses, 338 allied staff and more than 2000 managers and admin workers.]
Newsroom cited sources as saying the model was not a drill when the press caught wind of it. “At least one region” was already consulting on its rollout.
But they all knew it was “politically unpalatable”.
[Wait - what about the health and well-being impacts to Kiwis?]
The issue with NDAs is this is a public sector organisation and transparency and accountability should be foremost.
But Apa received a public bollocking from Levy the last time a budget leaked. So I can perhaps understand why she conceived of the idea. Still it’s inappropriate - this is the public service, not her fiefdom.
At the time, Levy claimed he didn’t know anything about the budget proposal. He had just asked for his target numbers to be met. i.e. Luxon’s target numbers.
[What does he know? And what does he actually do? The 3 days a week actually makes sense.]
Apa also backs Levy up outside the Committee when the waiting media throng ask Levy how many hours he works for Health NZ. Why did he ask for $320,000 on a part time job? Was it justified for what amounts to one of two part time gigs?
Levy said he worked 10-12 hours a day, 7 days a week:
“Ask Margie.”
Margie affirms.
Later, Levy says -
“The job is never put as a full-time job,
but I would propose to you if you're working 10 to 12 hours a day on a particular job, that’s quite a lot.”
[Wait, so 10-12 hours a day for Health NZ? Or 10-12 hours on whatever job you’re working at? And if you’re doing your full teaching schedule 2 days a week, how do you fit in 24 hours a day and still sleep and eat?]
The role of the Chair was always to work a 2.5 - 3 day job, Levy continues, even though he isn’t the Chair anymore.
Luxon was on hand to defend Levy, saying it was “quite normal” for Kiwis to have more than one job and such people work “incredibly hard” i.e. more than 8 hours a week, he meant…. ah, 8 hours a day.
[Freudian slips can be hard to overcome. But also, is Luxon inferring it’s common for Kiwis to find $320,000 part time Czar gigs? If so, please re-direct Prime Minister. I work long hours for very little. So do the majority of Kiwis.]
And yes, Jan. It seems to be too important a role to have a part time IT Professor on it, Mr Luxon.
[Hipkins is also interviewed here and it strikes me at this point that Hipkin’s popularity is falling because he hardly gets any media time, unlike folks like Seymour and Luxon when in opposition. In fact, hardly any Opposition members get air time anymore]
What was clear to me in watching the Health Select Committee is Levy is similar to Luxon in at least three ways.
One, he likes to promote himself. He boasted about his time at Waitematā district health board. Except the results show he has a playbook that is inconsistent with genuine transformation - ultimately leaving health districts in worse shape after he leaves. Glory is easy to take, but doing the right thing is always going to be more important - but not for everyone.
Two, he favours corporate talk and saying the right thing. Levy has a lot of ideas about IT, investment, and productivity. He says all the right things - what someone like Luxon would want to hear. Levy’s real job is about wait times, because we all know that’s what Luxon’s KPIs say. It’s the “actual real mission here” Levy admits.
All while ignoring the elephant in the room - funding and budget needed to hire “resources”. [Not to mention patient care, doctors and nurses and their well-being/retention, cost of healthcare, access to healthcare, preventative healthcare etc]
Instead, Levy claims Health NZ has more than enough resources - they just haven’t squeezed enough out of them:
”We've got a lot of resource and we're not actually getting the true value out of that resource and we need to do that and we're working to do that.”
The saying “drawing blood from a stone” emerges in my head.
Three, he is hands off but puts people into positions so they can be blamed take accountability instead. For example, at one point during the media questions, he is asked if the understaffing issues at Dargaville hospital have been fixed yet. Dargaville has no doctors overnight and telehealth was used. The cardiac patient died.
Levy draws an obvious blank here before saying “it’s not for me to fix everything, so we now have regional Deputy Chief Executives.“
It’s a certain type of leadership style that enjoys accolades but consistently positions accountability elsewhere. Hence his common refrain “I don’t know about that”. Luxon uses it commonly too - “I haven’t heard about that.”
Back to Apa.
It’s good she survived.
It’s not easy to.
By all accounts, Levy has always left a wake of organisation and leadership destruction where he works.
But she has clearly shown her utility to him and been willing to bend to the new direction.
I once thought it odd that if the “unexpected” health deficit was as Reti claimed [fact checked here by the Post as a fail], why she would retain her job.
[The deficit was actually caused by successful nursing recruitment numbers etc. as reported by Marc Daalder.]
Well it turns out they found another scapegoat:
2023 CFO of the Year: Rosie Percival.
Health commentator Ian Powell:
“It forms a pattern of Lester Levy when he comes into a new organisation. First of all, he diagnoses a crisis of financial mismanagement. And secondly, people get scapegoated. And I think that Rosalie is a casualty of that.”
In conclusion, it turns out Health NZ is paying ~$1 million more in senior executive salaries after Dr Levy started. No money for Health, Luxon had said despite underfunding Health, but anything we need to imprison more Kiwis.
Some profit from such models.
Way to go, talkers.
EXTRA STUFF:
Talking about CEOs:
Other public sector leaders didn’t survive the change in government like Apa has.
For example, Kāinga Ora CEO Andrew McKenzie fell on his sword after the government ran an apparent pre-conceived “independent review” on Kāinga Ora.
And after McKenzie left, National appointed a much more business friendly individual: Matt Crockett - former Telecommunications and Fletcher Building executive.
Scribbly Notes:
Yesterday’s Health Select Committee provided a number of insights.
Lester Levy confirms that his primary focus is to achieve lower wait times and child immunisation targets. i.e. Luxon and Reti’s specific health KPIs.
He calls reduced waiting times the “real mission here” i.e. Luxon’s KPIs
Lester Levy previews cuts in all areas of healthcare - from technology to people to infrastructure - but promises that the front-line will be fortified.
Levy says that Health NZ has plenty of “resources” but they are not getting the required productivity from those resources - he boasts of his record at other health districts of doing the same.
Apa says there are over 4000 more clinical appointments. The bulk of those are nurses (backing up the report by Marc Daalder, that the Health NZ “deficit” was due to factors including an unexpected nursing hiring success)
Levy previews multi-disciplinary models of health for primary care. There is a hint that capitation (funding) for GPs will be used to incentivize GPs to adopt the new model.
Levy confirms his commitment to ensure that Health NZ does not run over its allocated budget. [Contrast this to Luxon on Monday intimating that money is no object when it comes to prisons]
Verrall to Levy: "Health NZ NDAs are North Korean - Get rid of it."