One union claims as many as 20,000 roles could be eligible for voluntary redundancy, writes Stewart Sowman-Lund in today’s extract from The Bulletin.

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Voluntary redundancies at Health NZ

Some staff working at Te Whatu Ora Health NZ have been asked to apply for voluntary redundancy, an email leaked to media and subsequently shared by the health agency revealed. The Bulletin and other media outlets have seen the letter from Health NZ chief executive Margie Apa which said that staff working in health administration, advisory and knowledge roles could apply for a voluntary payout. “It is now clear the initiatives already in place will not, by themselves, resolve the financial issue or ensure we have the right people in the right place,” Apa wrote to staff. Though redundancy is, at this point, only available to certain staff members, a spokesperson for the health agency wouldn’t comment on whether it could potentially impact those working on the frontline. However, as Stuff’s Bridie Witton reported, the letter noted that staff working in other areas could register their interest for redundancy should they become eligible in the future.

Unions and opposition respond

The move prompted backlash from the key unions representing health workers, reported the Herald’s Azaria Howell, with the national secretary of the Public Service Association saying Te Whatu Ora had been forced into this situation due to the “unhinged and unplanned defunding of healthcare” by the government. “This government is deliberately destabilising the foundations of the overall health system that make every operation, diagnosis, vaccine, scan, or other public and community health service possible,” Kerry Davies said. The PSA said it believed 20,000 roles could be eligible for redundancy. Paul Goulter from the Nurses Organisation told Newstalk ZB’s Heather du Plessis-Allan there was a worry among health workers about whether there could be a knock-on effect from any job losses. “Nurses [have been] saying – who’s going to do that work? And if it’s us, who’s going to do the rest of the work we have to leave behind?”

Labour’s health spokesperson Ayesha Verrall, in a statement shared by NZ Doctor, said the staff in the firing line were the “backbone of our health system” and patient care could be affected by the loss of roles.

A health system under pressure

The news of potential job losses at the agency just adds to what has been a shaky few weeks for the health sector. Here is just a small selection of recent headlines:

• Six-day wait for doc after admission at Waikato Hospital
• West Coast practices quit loss-making weekend clinics (paywalled)
• Workforce woes prod rise in virtual services for Whanganui Regional Health clinic (paywalled)

While these are all distinct and unfortunate circumstances, they all stem from the same root problem: the health system is under intense pressure. It’s been little over a month since the government dumped the remaining board members at Health NZ and brought in a commissioner, Lester Levy, to oversee a structural overhaul. It was in the face of what the government labelled “overspending” to the tune of $130m a month. But some, such as a group of university experts in this piece for The Conversation, have argued such “overspending” was simply a response to systemic underfunding. According to that report, New Zealand has historically underspent on health when compared with other countries.

The government and the health agency’s new commissioner have maintained that frontline roles will be safe throughout any restructure. In a recent opinion piece for the Herald, Lester pushed back at claims published in the Medical Health Journal that critical roles within the agency were at risk of being cut due to financial issues at the agency. However, he also rejected the narrative that more funding on top of what was made available in the latest budget would help resolve ongoing problems, writing “[recent] health funding increases have not led to anywhere near commensurate value in terms of public benefit”.

The GP squeeze

A lot of the focus in recent weeks has been on emergency rooms and hospitals, for understandable reasons. However, the health squeeze is also impacting general practices – GPs – and rural areas are particularly facing the consequences. The Press has been covering this angle exceptionally in recent weeks through the “Fractures on the Frontline” series. In a recent report, Mariné Lourens noted that New Zealand is short close to 500 GPs as workers leave the sector due to burn out. It’s expected the GP shortfall will increase in the coming years, which will likely mean more practices turn to “telehealth” services in place of actual, face-to-face consultation. This has been particularly prominent in more isolated parts of the country where access to services can be limited. This report from Leanne Warr at the Bush Telegraph looks at the struggle to secure staff for rural healthcare, and the longer term impacts it can have on patients – limited access to health can mean worse health outcomes for those in rural New Zealand. With further job losses in the pipeline, will things get worse before they get better?