Lester Levy’s first six months - in his own words

Saturday, 18 January 2025

In his first interview of 2025 and halfway through the job, Professor Lester Levy spoke to The Post on his progress as Health NZ Commissioner. You can read what others have to say about his performance here.

Thousands of jobs are on the line amid a financial crisis that seemed to land overnight, and somehow spending less money will result in a better health system.

“We are having to fix a problem, and it is painful and it is difficult and it is heartbreaking, but that's our reality. It's not possible to continue to lose this level of money, $150 million every month,” says Health NZ Commissioner Lester Levy, who is promising to make it make sense.

Come end of February, deep dives on waiting times, an independent Deloitte report into the finances and his much anticipated Health Reset Plan will start to be released.

Health Minister Dr Shane Reti ordered this reset plan by August 30 last year and had it a day later, but very few have seen it. Levy says it will be focused on a patient-centred, clinically led, devolved organisation.

He says a “culture change” is the key to turning around patient wait times.

“It’s a mindset, It’s how people look at their roles.”

He used the example of, years ago, turning around North Shore Hospital’s emergency department performance, from 61% of people discharged within six hours, to 95% “with the exact same people”.

He says no, that isn’t code for making everyone work harder, but says the secret will be in more clinically led decision making which moves decisions and resources “close to the action”.

All very nice, but this was always the intention when Te Whatu Ora was established, so how will his approach be different, and cheaper?

“Implementation capacity, that's the number one issue.”

This means critical decisions about “trade-offs and model changes” will happen in the next six months, clinically led.

“Look, we are reducing the number of projects. Many of the projects that we have don't have positive outcomes. We spend a lot of money. We don't get a good outcome.

“We'll be putting the problems out to the clinicians. They'll make recommendations, we'll expect those recommendations to be objective. We'd expect them to be evidence based, and then it will be up to us to act.”

Reti has told The Post there has been occasions where he has stepped in to say cuts are too close to the clinical frontline, sometimes acting on the request of clinicians.

Levy says there is room in restructure proposals for changes but the savings goals are non-negotiable, so if one person stays, another has to go.

His commissioner role officially ends on July 21, 2025, but he warns things will be far from fixed by then.

“What we're really trying to do is overcome the crisis situation and get everything really well set up so that can be built on and that in three years time, when somebody writes a ‘look back’ report, it doesn't look like the reports you're going to see.”

Real progress on wait times won’t happen until 2026, he says. Does he want more time in the role?

“It was never envisaged that there would be a commissioner for like, four years.”

Two years?

“That’s really the Government’s decision to make.

“I think that if it's in a year, or if it's in 18 months, I don't think that makes too much difference, because we're not going to get everything done.”