Women's health advocates say they had heard enough from the frontline to conclude the national health screening unit would likely be disbanded. Photo: 123rf
Te Whatu Ora is delaying its decisions on a mass restructure involving about 1600 hundred jobs, the national health agency says.
Te Whatu Ora had styled 2 June as "final decision" day, with the axe believed to be hovering over the national health screening unit.
It told RNZ on Wednesday it would be "postponing" making any announcements about what it would do next.
The agency later said it was the decisions themselves it was postponing, as reopened consultation with staff about specific areas.
The Public Service Association said it had been advocating for all workers, as many were not covered by a collective, and was pleased Te Whatu Ora had been listening.
"This is too important to be rushed," national secretary Kerry Davies said in a statement on Thursday.
That portends uncertainty persisting as the agency attempts to crunch together thousands of management and back office staff inherited under the health centralisation reforms of 11 months ago.
About 1600 jobs have widely been reported as being on the chopping block, though Te Whatu Ora told RNZ on Wednesday some jobs would merely have their "reporting lines" changed.
It failed to provide an estimate of the job losses when asked by RNZ.
The huge agency has done zero external consultation over the changes aimed to concretise - under the banner "Simplify to Unify" - the long-running health sector sea-change that is very far from proving itself to the public.
Women's health advocates say making such big changes entirely internally makes a mockery of public engagement.
Especially, they said, when they had heard enough from the frontline to conclude the national health screening unit would likely be disbanded.
They expect cancer and other screening to instead transfer into an immunisation and prevention unit.
They fear that will erode clinical leadership and a big focus on cancer will eclipse other screening, such as for newborns.
Te Whatu Ora refused to rule out disbanding the unit when RNZ asked it to on Wednesday, and confirmed it was under review.
"The organisation structure for the delivery of our national screening services is currently being consulted on," it responded.
It added it would reopen consultation on "specific areas", due to staff feedback.
Te Whatu Ora's number one message was that "no patient-facing positions will be affected by these changes."
It said the The restructure would not not impact on the delivery of the screening service received by the public.
'Really disappointing'
The Federation of Women's Health Councils has no confidence in that assurance.
Auckland Women's Health Council Sue Claridge said the changes were happening behind closed doors, when their impacts would be felt beyond them, such as in how screening was delivered.
"It is really disappointing ... they have so easily dispensed with any pretence of a consumer-centred health system in which consumers get to have a say about everything from policy through to health services delivery," she said.
This came less than a year after the passing of the Pae Ora (Healthy Futures) Act 2022, Claridge noted.
The four units on the threshold of "decision day" on Friday were the national public health service (including screening), finance, commissioning, and service improvement and innovation. Another four were scheduled for decision-day on 15 June, and two others in August.
Te Whatu Ora chief executive Margie Apa said in March 1600 jobs would be affected in all, and they were moving ahead to be as ready for winter as possible.
The agency inherited 270 executive leaders at a second-tier level, and the aim was to get these, and the tier-three numbers, down to about 110.
Consultation with staff began at the end of March.
The 20 district health boards that merged in mid-2022 had some duplicate functions. For instance, they all had their own comms staff - and now Te Whatu Ora has almost 200 of these, provoking attack from the National Party in March.
There have recently been three reviews of cancer screening - two on breast screening, one on cervical - that were in part critical of the national screening unit, and Te Whatu Ora is also intent on improving outcomes for Māori and Pacific people.
The women's health advocates said they had spent alot of time having input to a series of important health moves recently, leaving little left to take on Te Whatu Ora over its restructuring.
For instance, with the recent national breast screening review, "consumers need ongoing reassurance that recommendations would be acted on", the Federation of Women's Health Councils told RNZ.
"The cervical screening programme (NCSP) is also about to roll out new primary HPV testing activity. This must be monitored closely," co-convenor Barbara Holland said.
"Our consumer expectations are that all external stakeholders are kept engaged and will be consulted should any proposal to revise the clinical leadership and/or governance arrangements be considered for all our national screening programmes."
