1 00:00:00,160 --> 00:00:02,639 Speaker 1: Health New Zealand has today announced the appointment of four 2 00:00:02,880 --> 00:00:07,160 Speaker 1: new regional Deputy chief executives. Now we knew these appointments 3 00:00:07,160 --> 00:00:09,840 Speaker 1: were coming, The Health Minister, Shane Retti says he wants 4 00:00:09,920 --> 00:00:13,280 Speaker 1: more health decision making to happen at a local level. 5 00:00:13,520 --> 00:00:15,760 Speaker 1: Both the Health Minister and the new Health New Zealand 6 00:00:15,800 --> 00:00:19,040 Speaker 1: Commissioner Lester Levy have been outspoken about wanting to cut 7 00:00:19,079 --> 00:00:21,960 Speaker 1: down the organization's bloat of bureaucracy, and we've heard a 8 00:00:22,000 --> 00:00:24,720 Speaker 1: lot of that. The fourteen layers, the fourteen layers. Rob 9 00:00:24,760 --> 00:00:26,640 Speaker 1: Campbell is a former Health New Zealand chair and he 10 00:00:26,720 --> 00:00:27,680 Speaker 1: joins me, now, hello. 11 00:00:27,560 --> 00:00:30,440 Speaker 2: Rob, Hi, right, Andrew, how are you going? 12 00:00:30,560 --> 00:00:36,440 Speaker 1: Very good sir? So the four regional Deputy chief executives. 13 00:00:36,440 --> 00:00:39,199 Speaker 1: Are we returning to the model suggested by Heather Simpson 14 00:00:39,240 --> 00:00:39,839 Speaker 1: and the report. 15 00:00:41,159 --> 00:00:43,239 Speaker 2: It does seem a little bit that way, doesn't it. 16 00:00:43,280 --> 00:00:46,400 Speaker 2: And it's a bit counterinturdives to wander him these layers 17 00:00:46,400 --> 00:00:50,600 Speaker 2: of management and then put another regional layer in. It's 18 00:00:50,640 --> 00:00:53,199 Speaker 2: not all entirely clear yet, but it certainly as far 19 00:00:53,240 --> 00:00:57,280 Speaker 2: as the hospital side of the thing is concerned, the 20 00:00:57,360 --> 00:01:02,560 Speaker 2: regional directors are introducing a new form of bureaucracy into 21 00:01:02,600 --> 00:01:03,200 Speaker 2: the system. 22 00:01:03,280 --> 00:01:05,880 Speaker 1: As criticism of the current Health New Zealand structure the 23 00:01:06,000 --> 00:01:09,520 Speaker 1: one big bureaucracy that there was empire building and there 24 00:01:09,600 --> 00:01:12,640 Speaker 1: was a bloated bureaucracy. But surely if you're creating for 25 00:01:13,080 --> 00:01:17,000 Speaker 1: regional bureaucracies, there's a chance for empire building there as well. 26 00:01:18,000 --> 00:01:20,720 Speaker 2: Well. I think that was almost a concern when I 27 00:01:20,800 --> 00:01:24,600 Speaker 2: was in the role, and the previous board had this view, 28 00:01:24,680 --> 00:01:29,440 Speaker 2: but the new direction is obviously to insert this. I 29 00:01:29,440 --> 00:01:33,399 Speaker 2: do want to make the point that getting more decision 30 00:01:33,440 --> 00:01:37,240 Speaker 2: making made at the local level is critically important, but 31 00:01:37,319 --> 00:01:40,240 Speaker 2: of course the local level is not for regions. The 32 00:01:40,319 --> 00:01:44,600 Speaker 2: local level is very local, particularly so Tara's primary health 33 00:01:44,880 --> 00:01:47,760 Speaker 2: care is concerned. You've got to remember about half of 34 00:01:47,880 --> 00:01:51,120 Speaker 2: the Detata war of budget is not hospitals. It's funding 35 00:01:51,160 --> 00:01:54,279 Speaker 2: the other activities that take place right through the health sector. 36 00:01:54,360 --> 00:01:58,960 Speaker 2: And of course this is now another layer of bureaucracy 37 00:01:59,040 --> 00:02:00,960 Speaker 2: which is being inserted than to that process. 38 00:02:01,000 --> 00:02:02,720 Speaker 1: Well, was it that Stephen Joyce in the weekend who 39 00:02:02,800 --> 00:02:05,720 Speaker 1: actually said that the problem was we're always funding hospitals, 40 00:02:05,720 --> 00:02:07,240 Speaker 1: we're not funding primary care. 41 00:02:08,280 --> 00:02:11,080 Speaker 2: Yeah. I don't often enjoy agree with Stephen, but I 42 00:02:11,120 --> 00:02:14,680 Speaker 2: think he was quite right about this. It's the solutions 43 00:02:14,720 --> 00:02:18,280 Speaker 2: to our overall health crisis are not really to be 44 00:02:18,280 --> 00:02:21,160 Speaker 2: found in hospitals. Hospitals are important, but they're the end 45 00:02:21,280 --> 00:02:24,000 Speaker 2: stage of these things. We need to be getting far 46 00:02:24,080 --> 00:02:29,360 Speaker 2: more attention to both preventative health public health measures for example, 47 00:02:29,760 --> 00:02:32,639 Speaker 2: and to primary care. Again, the GPS and the other 48 00:02:32,680 --> 00:02:36,160 Speaker 2: local services that provided the various cope coformality services that 49 00:02:36,280 --> 00:02:39,680 Speaker 2: provide and they don't operate at a regional level. 50 00:02:40,080 --> 00:02:42,280 Speaker 1: Were you in charge of a blood of bureaucracy when 51 00:02:42,320 --> 00:02:43,840 Speaker 1: you were in charge of Health New Zealand. 52 00:02:44,440 --> 00:02:46,600 Speaker 2: Oh, there's no question. It was a blood of bureaucracy 53 00:02:46,639 --> 00:02:49,040 Speaker 2: when we first took over, and we were making some 54 00:02:49,240 --> 00:02:52,680 Speaker 2: progress on that. Nowhere near fast enough from my point 55 00:02:52,680 --> 00:02:54,440 Speaker 2: of view or the board's point of view, but we 56 00:02:54,440 --> 00:02:57,800 Speaker 2: were making progress on that, and progress is still being made. 57 00:02:58,680 --> 00:03:02,799 Speaker 2: This is with all. I've got various criticisms of what 58 00:03:03,440 --> 00:03:06,080 Speaker 2: has gone on in what's going on, but we all 59 00:03:06,080 --> 00:03:07,960 Speaker 2: have to hope that less to leave in the team 60 00:03:08,040 --> 00:03:10,320 Speaker 2: do get on top of these issues. And if they're 61 00:03:10,400 --> 00:03:12,760 Speaker 2: choosing to do it by a regional structure, well I 62 00:03:12,800 --> 00:03:14,799 Speaker 2: wish them well. I don't think it's the right thing 63 00:03:14,840 --> 00:03:17,080 Speaker 2: to do, but I wish that they can succeed with it. 64 00:03:17,160 --> 00:03:19,560 Speaker 1: What do you make of the fourteen layers debate? 65 00:03:21,280 --> 00:03:24,120 Speaker 2: Well, the fourteen layers were invented, weren't they. There are 66 00:03:24,160 --> 00:03:27,880 Speaker 2: some parts of the health service system which I would 67 00:03:27,960 --> 00:03:31,480 Speaker 2: say even more layers than that. There are other parts 68 00:03:31,480 --> 00:03:33,640 Speaker 2: which don't have anything like that. But that was a 69 00:03:33,639 --> 00:03:36,560 Speaker 2: bit of a spurious argument put up by the Prime 70 00:03:36,560 --> 00:03:40,640 Speaker 2: Minister and doctor Rieti. But there is, nevertheless, and has 71 00:03:40,760 --> 00:03:42,920 Speaker 2: been a lot of bureaucracy there and part of the 72 00:03:43,040 --> 00:03:46,800 Speaker 2: making of CAFAA WURA was specifically designed to strip out 73 00:03:46,880 --> 00:03:50,120 Speaker 2: some of that bureaucracy at the district level in order 74 00:03:50,240 --> 00:03:53,120 Speaker 2: to place more attention at the local level. So it's 75 00:03:53,160 --> 00:03:55,360 Speaker 2: a transitional phase that they're going through. 76 00:03:55,480 --> 00:03:58,760 Speaker 1: All right. And did you and the Health New Zealand 77 00:03:58,880 --> 00:04:03,640 Speaker 1: executive organize very poor financial management systems and did you 78 00:04:03,720 --> 00:04:06,120 Speaker 1: have no idea what was happening in terms of the money? 79 00:04:07,040 --> 00:04:10,800 Speaker 2: No, Look, that's I think the polite terms of firfee. Frankly, 80 00:04:11,720 --> 00:04:15,680 Speaker 2: the systems that were inherited were in many instances outdated. 81 00:04:15,720 --> 00:04:18,440 Speaker 2: Some of the DHP systems were okay, some were absolutely 82 00:04:18,520 --> 00:04:20,960 Speaker 2: terrible and they didn't match. So it has been a 83 00:04:21,000 --> 00:04:22,800 Speaker 2: hell of a job for the team to try and 84 00:04:22,880 --> 00:04:26,960 Speaker 2: pull together a proper national system, but it certainly is 85 00:04:27,000 --> 00:04:29,159 Speaker 2: something that has been worked on and they are making 86 00:04:29,240 --> 00:04:32,560 Speaker 2: progress with so that idea that nothing's being done is 87 00:04:32,920 --> 00:04:34,240 Speaker 2: simply misleading and wrong. 88 00:04:34,680 --> 00:04:36,200 Speaker 1: Rob Campbell I think you for your time today, the 89 00:04:36,200 --> 00:04:38,680 Speaker 1: former chair of TA FATA, Auto or Health New Zealand. 90 00:04:39,360 --> 00:04:42,520 Speaker 2: For more from Hither Duplessy Allen Drive, listen live to 91 00:04:42,640 --> 00:04:45,679 Speaker 2: news talks it'd be from four pm weekdays, or follow 92 00:04:45,720 --> 00:04:47,480 Speaker 2: the podcast on iHeartRadio.