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Departing HWNZ boss says independence needed to fix ‘unworkable’ agency

7 February 2019 Cliff Taylor - New Zealand Doctor

The departing head of Health Workforce New Zealand says the organisation’s structure has been “completely unwork­able” for years and starved of resources.

Executive chair Des Gorman, who has resigned after nearly 10 years in the job, is also not convinced the shake-up of the agency announced by health minister David Clark will be ef­fective, saying HWNZ needs to be more independent from the Ministry of Health.

But Professor Gorman is con­fident the relationship between HWNZ, which funds most GP training, and the RNZCGP will remain strong.

“It’s so important that it has to be afforded the highest pos­sible priority.”

HWNZ to undergo long-awaited changes

Dr Clark announced just be­fore Christmas that HWNZ will undergo long-awaited changes in the next couple of months, in­cluding becoming a stand-alone directorate, after previously be­ing part of the ministry’s people and transformation directorate.

More details of the changes, including to the board, and up­dated terms of reference will be announced in April.

In a media release, Dr Clark says strengthening the health workforce is an ongoing priority.

“It has been clear for some time that we’re facing workforce constraints, and in recent years we have not invested sufficiently in planning for a growing and ageing population.”

He says the new health work­force directorate will have great­er capability and capacity on workforce issues.

“This provides an opportunity to refresh the approach to workforce strategy and planning by clarifying the respective roles and functions of HWNZ, DHBs and the ministry.”

He has asked the health and disability sector review team to consider future health work­force options as part of its work.

Responsibility but no authority

Professor Gorman says the HWNZ board “signalled a year ago the current structure isn’t working”.

“The simple reality was while the board had responsibility for a whole range of things, it had no authority. The authority sat within the ministry.”

He says things became “com­pletely unworkable” during his time in the role. “The reality is, in the first period, the ministry was more than happy to imple­ment the work plan. In the last few years, it hasn’t been. Over the last five years, there was low productivity.”

He says the agency came up with some world-leading ap­proaches “but there were no re­sources to do them in the last few years”.

Still “subservient to the day’s industrial dispute”

Professor Gorman says he is not hopeful the reformed HWNZ will be effective because it is still too embedded within the minis­try, which makes it “subservient to the day’s industrial dispute”. His preference would be to see something with more independ­ence, like a Crown entity.

But he is positive about the ongoing relationship with the RNZCGP.

A ministry review of the col­lege’s GP training programme is about to start. College presi­dent Sam Murton did not want to comment on the changes until more is known.

Professor Gorman says that as an informal adviser to HWNZ, he will continue to advocate for the importance of general prac­tice. “I can’t imagine under any circumstances would they coun­tenance any discounting of the relationship with the college and general practice.”

He says it was always his in­tention to resign this year as 10 years in the role was more than enough.

A small interim, external ad­visory group has been set up to support HWNZ changes and ad­vise on new terms of reference.

Former Careerforce chief ex­ecutive Ray Lind is expected to chair the group, which will also include the chairs of the current advisory groups to the HWNZ board, Jenny Carryer, Helen Pocknall and Ken Clark. There will also potentially be some other members.