Health NZ chair’s next 12 months: ‘Culture change will underpin all else’

Friday, 15 August 2025

Culture change will underpin all else, Lester Levy, the former commissioner and current chairperson of Health NZ says of the critical next 12 months to turn the country’s creaking healthcare into a “high-performing health system”.

In the August issue of the New Zealand Medical Journal, Levy penned an editorial named, Reforming Health New Zealand: confronting crisis, sustaining recovery.

“By the early 2020s, New Zealand’s public health system faced deep-seated and widely acknowledged problems,” Levy wrote.

“These trends reflected structural fragmentation, variable local governance, outdated infrastructure and the absence of a coherent national delivery model.”

Levy said the 2022 health reforms sought to address that by replacing the 20 district health boards with Health NZ – Te Whatu Ora.

“Yet, as is often the case with health reform, the gap between structural change and improved outcomes proved difficult to bridge. The first two years of Health New Zealand were marked by deteriorating financial control, widening performance gaps and an erosion of local clinical governance.

“By mid-2024, the organisation was facing a cash crisis, growing deficits and mounting political and public concern that the reforms were failing to deliver.”

Levy was appointed as commissioner in July, 2024 to replace the board of Health NZ, and tasked with finding $1.4 billion in savings that financial year.

“The remit was explicit: arrest the financial decline, stabilise service performance and lay the groundwork for a sustainable turnaround,” Levy said.

Levy said, over the first year, “financial recovery was a central achievement”.

“Between July 2024 and May 2025, the monthly deficit fell by 85%, and by the end of the financial year the organisation was under budget.

“The organisation is now on a credible path to break even by 2026/2027.”

Levy said the next 12 months “must consolidate financial control, deepen performance improvements and - crucially - move towards the devolved, clinically led model that was envisaged in 2022 but never realised.”

Part of that was moving decision-making authority and budgets progressively from the national centre to regional, district and unit levels, and also “embedding clinicians at ever level of governance”.

But it was culture change that would “underpin all else”.

“Leadership can set direction and allocate resources, but sustainable improvement depends on the day-to-day decisions of clinicians, managers and support staff.”

Problems still plague the health system, such as RNZ on Thursday reporting acute mental health wards were at 140% capacity, high profile problems in Nelson Hospital earlier this year and women in lower North Island needing to travel to Christchurch for certain cancer surgeries for the next four to five years.

In January, Levy spoke to The Post on his progress as Health NZ Commissioner. “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,” he said at the time.

Malcolm Mulholland of advocacy group Patient Voice Aotearoa said at the time, “the situation has gotten worse for patients… they're struggling to deal with a health system that just seems to be failing every day”.

Last month, the Government re-established the Health New Zealand Board, taking over “from the commissioner and deputy commissioners appointed last year to stabilise the organisation and set a clear direction,” Health Minister Simeon Brown said.

Levy was appointed the head of Health New Zealand for a 12-month term. Brown also announced his intention to begin the process in late 2025 for a permanent chairperson from next July.

Levy did not respond to a request to comment.