“If I still have a job tomorrow, thank you for inviting me,” were some of the last words from Leigh Donoghue as he addressed New Zealand and Australian digital health industry leaders at the Beehive in July.

Less than three months later, Mr Donoghue, Health New Zealand | Te Whatu Ora’s chief of data and digital, has been shown the door by chief executive Margie Apa, in what she said was a “difficult decision.”

“As the reset of Health NZ progresses, I have looked at how I need to reshape the Executive Leadership Team (ELT) to help our focus on empowering the regions and delivering on health targets.”

Ms Apa said she was now moving to the next phase of the reset, which focused on enabling services to better support regions.

“This means a change to roles in the ELT. I am disestablishing the positions of chief people officer and chief of data and digital.”

The chief people officer is Andrew Slater, who has held the role since April 2023 and was previously CEO of Homecare Medical/Whakarongorau Aotearoa, while Mr Donoghue has been with Health NZ since May 2023.

“The people in those roles have made enormous contributions to Health NZ, and these have been difficult decisions,” Ms Apa said.

“These changes are all part of the wider HNZ reset to ensure we get back on budget, live within our means and deliver faster and easier access to healthcare for New Zealanders.”

Ms Apa said the first phase of the reset involved establishing regional deputy CEOs “to enable the devolution of responsibilities for integrated care delivery to communities with regional leadership,” with those roles having now been in place since August.

Mr Donoghue’s role included leading implementation of digital technology and data to improve access to care, enhance employee work experience, and support Health NZ’s strategic aims and “key system shifts.”

Health NZ’s website states that the chief data and digital role is “critically important in bringing about the system shifts required to achieve the aims of the health reforms, in particular developing a greater use of digital services to provide more care in homes and communities.”

Mr Donoghue joined Health NZ from Accenture Australia, where he was health industry Lead for Australia and New Zealand and the wider Asia Pacific region. 

“Leigh brings significant experience in digital health leadership, including leading complex, multi-year change programmes across diverse teams and delivery challenges,” Mr Donoghue’s profile states.

He also brought a sense of wit and dry observation to the role, having variously called data and digital Health NZ’s “ugly baby” and an “old banger.”

That last comment came at the Digital Health Association’s Parliamentary reception in July, when Mr Donoghue said New Zealand had “barely scratched the surface in terms of the digital health revolution,” and that healthcare needed “a new chassis.”

“A digital chassis that takes cost and friction out of the system. Freeing up clinicians to be more productive and deliver better care. The banger we’ve assembled over many years is not going to get us there.”

It was a continuation of how Mr Donoghue had started his speech, when he said it was “nearly a pleasure to be here.”

“When I accepted to become a speaker tonight, I didn’t realise it would have quite the timing it did, with health quite so topical,” Mr Donoghue said, referring to that week’s replacement of Health NZ’s board with a commissioner by Health Minister Shane Reti, who left the reception early.

“I want to acknowledge Minister Reti, who’s left so I can breathe a little easier,” Mr Donoghue told the digital health audience in July.

Unions dismayed at $100m savings target

The disestablishment of the two roles comes as a letter to Ms Apa was released last week expressing concern from a group of health unions about proposed savings in the health sector.

The letter referred to a briefing the unions had received on “six elements of a savings programme which is in the process of being implemented across Te Whatu Ora,” and included a $100 million savings target in data and digital.

The unions said it was unclear how the decision to allocate cost savings had been made.

“However, any decision to allocate cost savings, including what will be significant redundancies in some has been made. 

“Confirming the expected savings targets, without allowing us to comment on these is a significant breach of good faith.”

The unions said they were informed that “within each directorate, leadership teams are drawing up lists of projects, programmes and positions which will be disestablished.”

The letter said disestablishment of any one of these projects, programmes or positions “may well have significant risks or costs elsewhere in the organisation.” 

The letter gave the example of the data and digital team, which “cannot assure us the scale of cuts being asked for will not increase the risk of another cyber-security attack similar to Waikato Hospital.”

The letter from the unions – which include APEX & NZRDA, MERAS, STONZ, ASMS, PSA, Kahui Kōkiri and NZNO – was in response to a briefing they received from Health NZ’s commissioner Lester Levy and Ms Apa in September, which outlined that Health NZ was running over budget by $147 million per month. 

“We were also told that because of this overspend, the organisation intended to undertake a programme of cuts and savings, including programmes and projects and making positions redundant.”

The unions said they had received no detailed financial information from the Health NZ “to understand how or why there is a budget overspend,” and until that was clear, any cuts should be shelved.

“Until such time as we have been provided the information on the $147 million overspend, and the opportunity to make comment on this information, any subsequent decisions about the allocations of redundancies, cuts and cost savings should be paused.”

In response to an inquiry from Pulse+IT about the unions’ letter, Ms Apa said Health NZ was “undergoing a reset to ensure we get back on budget and live within our means”.

“Part of this process is putting more authority back into the regions, closer to the frontline,” she said. “We are working closely with our people, and the relevant unions.

“We have important processes to complete which involve talking our people about budgets and then consulting on changes. 

“We won’t comment on any changes until they’re communicated to our people and affected teams and staff have the opportunity to provide input.”

Digital Health Association chief executive Ryl Jensen said the latest reported cuts came on top of the $380 million of funding ‘re-prioritised’ away from data and digital in Budget 2024. 

“That’s nearly half a billion dollars slashed from a fund that’s supposed to leverage New Zealand’s innovative digital technology sector and take our health sector into the 21st century,” Ms Jensen said.

She said the data and digital cuts go against the global direction of digital health investment, with New Zealand “already well behind in digital health technology investment compared to other countries.”

“New Zealand spends between 2.5 and 3 percent of the total health budget on these technologies compared to international averages of between 5 and 8 percent and over 10 percent by countries at the forefront of this transformation.  

“Cuts like this just exacerbate the problem, pushing us further and further behind as a country. This could really undermine healthcare delivery in New Zealand for years to come.”