Health NZ CEO Margie Apa announced her resignation Friday. Photo: RNZ / Samuel Rillstone
- Health NZ CEO's resignation won't fix problems at Te Whatu Ora - unions
- Doctors say underfunding and political interference to blame
- Labour says Margie Apa's leadership was "undermined"
Health NZ has launched a global search for a new chief executive with the sudden resignation today of founding CEO Fepulea'i Margie Apa.
However, frontline healthworkers are sceptical that installing new leadership will make any difference to a system grappling with workforce shortages, spiralling deficits and industrial unrest - as well as suffering patients struggling to get help.
Apa's $900,000 a year contract was due to finish in June, so her departure was not unexpected, although the timing took some by surprise.
Resident Doctors' Association national secretary Dr Deborah Powell said Apa's relationship with Health Commissioner Lester Levy was undeniably fraught, given he had been brought in by former Health Minister Shane Reti to "cut the bloated health bureaucracy" after sacking the board for alleged financial incompetence.
Yet, as an experienced public servant with nearly three decades in the health system, Apa kept her counsel and never purposely said anything that could embarrass a minister.
Powell said the catalyst for her early exit may have been Dr Levy's "candid" interview with The Post newspaper last month.
He was quoted as saying he wanted a chief executive who could "build a team and lead a team that has got serious implementation capacity, that can, instead of writing about what they're going to do, can actually do it".
"[That] would have made it, I would imagine, intolerable for Margie to remain in that role," Powell said.
"She has worked bloody hard, we've seen that. And in that sense I'm sad to see her go."
However, it was difficult to see what had been achieved overall.
"Things aren't getting any better, despite the loss of a board and the imposition of a commissioner. So someone has to wake up to the fact this isn't the problem.
"The problem is funding."
In Health NZ's media release announcing Apa's departure, Dr Levy paid tribute to her work ethic, but described it as "a mutual decision" for her to step down.
Both have declined further interviews.
Apa survived three years in the top job, starting as interim head of the brand new agency in February 2022 before her fixed-term appointment in July of that year to oversee the mashing together of 20 district health boards into a single organisation.
During her tenure, she has served two governments, four health ministers, seen the board fired, the commissioner installed, and has had to make several of her senior leadership team redundant in the great "reset" to cut costs.
Government "running out of people to blame" - Labour
Labour's acting health spokesperson Peeni Henare said Apa's departure was "another symptom" of the government's mismanagement of the health system.
"And I suspect a result of her leadership being undermined over the last year and half with Lester Levy being appointed to a role, change of ministers and just the huge upheaval of the health sector in crisis at the moment.
"So while I'm saddened, I'm not surprised."
Prime Minister Christopher Luxon would soon "run out of people to blame" for the state of health, Henare said.
When asked for his response to Apa's resignation today, Luxon declined to be drawn on whether his government had lost confidence in her.
"Look, her contract came to an end, obviously she decided not to reapply. We don't make employment decisions. Those are up to individuals and the organisations they work with.
"All I can say to Margie Apa is thank you very much for the great service she's given leading Health NZ over the last wee while."
Apa's interim replacement is Dr Dale Bramley, a public health clinician and former head of Waitematā DHB, who is currently Health NZ's head of planning and funding.
'Thankless task'
Association of Salaried Medical Specialists executive director Sarah Dalton, who represents senior doctors and dentists, said Bramley was liked and respected - but would face the same problems as his predecessor.
"Until we sort out what kind of health system we are prepared to resource, it would be an utterly thankless and impossible task to lead Te Whatu Ora."
Dalton said while Dr Levy and successive health ministers talked repeatedly about the need to focus on patient need and clinical decision-making, they continued to put up "road blocks".
"Almost any decision with a financial tag goes almost all the way to the commissioner at his decree. It will be difficult to make real change of any significance because it usually comes with a bit of a price-tag, including staffing."
Dalton said major parts of Apa's work to realise the original vision of Health NZ had already been undone with the change of government.
"The disestablishment of Te Aka Whai Ora [independent Māori health authority] was a real loss... the Localities too could have been a chance to drive change, but they have been stripped back as well.
"But irrespective of her legacy, she's worked incredibly hard for the health system, and we wish her well. I hope she takes a decent break."
Apa's departure comes at a time when both senior doctors and nurses are in pay talks, lab workers are on strike, Health NZ's projected deficit for the 2024/25 year is $1.1b, hundreds more jobs are set to go and the "reset to return to budget" is likely to continue until mid-2027.
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