Health staff survey reveals ‘immeasurable pain’ of cost-cutting

Monday, 3 March 2025

One survey respondent said they did not have enough budget to buy new instruments for operations.

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Cancelled surgeries, exploding wait lists and psychologists working reception - a new survey of health staff outlines the “immeasurable pain” of restructuring and cost cutting at Health New Zealand - Te Whatu Ora.

In the survey of more than 1200 healthcare workers in both clinical and non-clinical roles, 81% of respondents said cuts and restructuring had damaged the services they delivered and 86% said the cuts would make healthcare harder to access.

Both Health NZ and the health minister maintain the ongoing “reset” at the agency will improve the system, but have refused to directly answer questions on whether they maintain the changes are not impacting frontline care - a claim that remains a major point of contention between staff and decision-makers.

Health NZ has forecast savings of $660 million this year with more the year after.

“These savings will not impact frontline clinical care, with a commitment to maintain, and grow in appropriate areas, clinical headcount,” the agency’s Statement of Performance Expectations for the 2024/25 financial year says.

Fleur Fitzsimons, national secretary of the Public Service Association union (PSA), says the claim is “blatantly false”.

“Workers are seeing, every day, the devastating impacts of cuts to health on patient safety and patient care. It is critical they are respected and listened to,” Fitzsimons said.

In the survey, staff said paediatric clinics were running at 50% capacity due to hiring restrictions and departments faced “significant and unjustified” delays of between six and eight months to replace clinical roles.

“We do not have budget to buy new instruments for operations … so some type of operations cannot go ahead,” one respondent said.

One person who worked in a community rehabilitation service with stroke patients said: “Due to a hiring freeze … our wait list has exploded”.

Several staff who worked with cancer patients said waits were longer due to hiring restrictions.

“This means cancer patients are not getting adequate diagnosis to help guide their drug regiment, families are not getting their prenatal diagnosis on time, which reduces their options and creates immeasurable pain, and family members may get cancer that is undetected and advancing without proper monitoring.”

Fleur Fitzsimons from the Public Service Association (PSA) says workers must be listened to.

One South Auckland staffer who worked in the community said they were now treating the effects of unmet need, with patients having hospital admissions instead of preventative medicine for falls or pressure sores.

“How can the government do this to the most vulnerable people in our society? It is inhumane.”

Health NZ acting chief executive Dr Nick Chamberlain said the agency valued the voice of staff, but argued there was no hiring freeze.

“We recognise that the reset has been unsettling for staff but we are resetting to strengthen our frontline, provide quality, compassionate, affordable healthcare at the right time and in the right place and, importantly, achieve the national health and mental health targets.

Nick Chamberlain, acting chief executive of Health NZ, says in response to the survey, “there is no hiring freeze”.

“As of this week there are 4240 FTE [full time equivalent] being recruited. There is no hiring freeze. For non-clinical roles we are recruiting where the role is essential to achieve our priorities including the health targets.”

He said no final decisions had been made on restructure proposals.

Health Minister Simeon Brown did not address the PSA’s call to stop the cuts but said his Government was “refocusing the health system on the Government’s health targets to deliver better services and outcomes for patients”.

“Our Government’s focus is also on frontline clinical roles, not bureaucracy.”

In the year to September 2024, the clinical workforce grew by more than 2700 staff, Brown said.

Health Minister Simeon Brown would not directly answer questions on whether the changes were impacting frontline care.

PSA delegate Jenna Osborne-Taylor said leadership seemed to be “very resigned” to the fact the agency had to live within its budget, but hoped the results were confronting for decision-makers.

“You can kind of dismiss a handful of people as maybe being dramatic, but 1200 people, no, it’s just too many, and they all have the same story.”

The union laid out a list of recommendations urging HNZ to stop the cuts, lift hiring restrictions and fill vacancies urgently, hire more administrators, lift funding for IT services, prioritise ending structural racism, address health worker burnout and take a long-term view of health resources.

The survey was conducted by the PSA over five days in January.

Respondents included mental health and public health nurses, therapists, social workers, pharmacists, technicians, home-based disability support workers, administrators and IT staff.

The PSA has filed legal proceedings with the Employment Relations Authority in an effort to stop the proposed cuts in IT, public health and Pacific health and appealed to the Privacy Commissioner to step in.

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