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Speaker 1: Now a bizarre thing has happened at Health New Zealand.

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Speaker 1: Yesterday management held a meeting which included the Chief Executive,

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Speaker 1: and in this meeting they proposed saving the money that

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Speaker 1: Health New Zealand needs to save by cutting staff, including

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Speaker 1: nearly five hundred doctors and fifteen hundred nurses. Now, immediately

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Speaker 1: the Commissioner has stepped in, stopped the plan and given

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Speaker 1: the Chief Executive a massive public bollocking over it. Health

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Speaker 1: New Zealand obviously doesn't want to speak about it today.

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Speaker 1: DearS Gorman is Auckland University emeritus professor who's with us.

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Speaker 1: Hey dez is on what planet would this be a

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Speaker 1: good idea?

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Speaker 2: Oh? No planet. I mean, the argument that this is

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Speaker 2: some sort of speculative comparison doesn't hold water. There's only

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Speaker 2: two explanations for this. Either one is that it's a

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Speaker 2: Washington Monument type of offering, or the others is that

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Speaker 2: they were serious about cutting frontline staff. Now they would

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Speaker 2: appear looking at it. It's probably more likely the latter,

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Speaker 2: and you'd have to argue that the timing and the

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Speaker 2: nature of this is just egregious and stupid.

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Speaker 1: Yeah, I mean, it seems it's the latter, which is

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Speaker 1: they were actually going to do it, because a source

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Speaker 1: has told the media outlet Newsroom it wasn't a mistake.

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Speaker 1: They were planning the cuts and at least one region

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Speaker 1: of the organization had already started making plans to consult

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Speaker 1: and implement the changes. Does that blow your mind?

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Speaker 2: Oh? Absolutely. Look one area where I disagree with Lester's

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Speaker 2: I think the health system is in crisis. I think

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Speaker 2: you look at health workforce numbers, that's a crisis. And

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Speaker 2: it's important to recognize it's a crisis either for several reasons.

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Speaker 2: And that is women and men each day go to

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Speaker 2: work and they don't provide the healthcare they think their

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Speaker 2: patients deserve, and they go home at night quite distressed. Now,

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Speaker 2: to tell them that this is not a crisis, this

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Speaker 2: is a business as usual, is not to validate their experiences,

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Speaker 2: and I think that's whattant we do that. The other

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Speaker 2: thing is when you call it a crisis, you don't

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Speaker 2: come up with business as usual solutions. Yeah, you come

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Speaker 2: up with crisis solutions, and.

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Speaker 1: That's basically what we need now. Now, Look, if we

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Speaker 1: take the source of their word, it means that the

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Speaker 1: cuts were planned. I can't see how that could happen

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Speaker 1: without the chief executive, Margie Upper signing off on that.

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Speaker 1: Am I right?

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Speaker 2: Oh, I can't see that either. But clearly the implication

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Speaker 2: is that there's a disconnect between the commissioner and his

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Speaker 2: senior officials. And I think we're seeing that across all

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Speaker 2: of the health portfolios, that the various health ministers are

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Speaker 2: struggling against officials headwinds, and so I think they're all

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Speaker 2: finding it much harder to implicate it, to introduce changes

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Speaker 2: than they thought they would because of those headwinds.

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Speaker 1: Now, if her idea of how you save the money

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Speaker 1: is to cut doctors and nurses, she's got to go right,

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Speaker 1: because she's not up to the job.

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Speaker 2: Oh look, that's her idea. Absolutely, look at a truism

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Speaker 2: that the best way to save money and health care

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Speaker 2: is not to have health workers, not to have patients.

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Speaker 2: But that's just an abject nonsense. And so I think

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Speaker 2: if you've got someone at a time like this proposing

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Speaker 2: a cut front line staff, then they're so out of

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Speaker 2: touch with the reality that don't belong in it.

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Speaker 1: Yeah. Now, it's obviously easy for us to sit here

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Speaker 1: and say they're doing the wrong thing. What's the right

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Speaker 1: thing to do, Dez, how do you save this amount

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Speaker 1: of money?

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Speaker 2: Oh, look, I think Leicester will do that. I think

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Speaker 2: Lester will say the one hundred to thy nine million

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Speaker 2: a month hemorrhage. The question will be, though, when that

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Speaker 2: hemorrhage has stopped, how do you then transition to a

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Speaker 2: new state where you can start offering more services of

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Speaker 2: higher value. That is the best possible outcome at the

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Speaker 2: last possible cost. And I think the focus has to

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Speaker 2: be on primary care either. The big savings will come

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Speaker 2: on primary care. Yeah, not in hospitals.

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Speaker 1: Well do you mean pump lots of money into primary

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Speaker 1: care in order to save later on down the line?

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Speaker 1: Is that what you're talking here?

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Speaker 2: No, I mean we're working with the GPS to develop

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Speaker 2: new business models. Because there's no point going to the

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Speaker 2: GP community and saying this is what you're going to do.

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Speaker 2: They will simply oppose that, as they have done for

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Speaker 2: oast century. You've got to go to them and say, look,

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Speaker 2: what would it take for us to do to get

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Speaker 2: you to do more? Do more after our care, do

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Speaker 2: home visits, do more critical care in the community. What

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Speaker 2: sort of ecosystem would encourage that sort of.

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Speaker 1: Yeah, it's always good to talk to you. It sound well.

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Speaker 1: Thank you very much for having a chat to us.

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Speaker 1: Dez Gorman, Auckland University Emeritus Professor. For more from Hither

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Speaker 1: Duplessy Allen Drive, listen live to news talks it'd be

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Speaker 1: from four pm weekdays, or follow the podcast on iHeartRadio