Published on the 03/12/2024 | Written by Heather Wright

Cuts to continue through to 2027…

Health New Zealand is slashing a net 1120 roles from its data and digital group, which plays a key role in integrating the IT systems managed by the previous District Health Boards and ensuring the antiquated systems continue functioning.

The cuts would equate to 47 percent of the data and digital team. FTE numbers for data and digital will be cut from the current 2400 to 1285, with nearly 500 roles already vacant and not planned to be filled. Staff will be invited to apply for 822 ‘new roles’, with four regional digital directors also being appointed as part of the changes.

“Numerous transformative IT projects designed to bring the health system into the 21st century have already been mothballed.”

Leigh Donoghue, who was Health New Zealand chief of data and digital, was shown the door in October with chief executive Margie Apa saying she was ‘reshaping’ the executive leadership team to help focus on empowering regions and delivering on health targets.

The new consultation also proposes 358 roles are cut from the National Public Health Service, which runs immunisations and monitors outbreaks.

The organisation this week confirmed in its annual plan that it ended the financial year with a deficit of $722 million, against a target surplus of $54 million, and will continue its cost cutting plans through to 2026/27 when it expects to get back on budget.

Data and digital’s budget for the 2024/25 financial year will drop from $816 million to $658 million.

The annual report heralded Health New Zealand’s use of data and digital services to improve health, saying significant progress had been made on modernising and digitally transforming the health system in the 2023/24 financial year.

“We have implemented new digital technology and supported with data that has helped improve access to care, enhanced our people’s experience of work and supported the health reform goals through greater use of digital services to provide more care in homes and local communities,” the annual report says.

It says 338 projects and initiatives, ranging from minor enhancements to significant IT programmes and valued at $103.6 million, were completed by the end of June.

RNZ reports Health NZ spent $72 million on contractors and consultants for one IT project, with recruitment company Robert Walters paid $17 million in the last two years on the project.

HSAAP Programme documents show $36.9 million went to contractors and $35.4 million to contractors over three years, with Deloitte taking home nearly $10 million and Infosys garnering more than $7 million.

Among the ‘delivery highlights’ called out in the annual report are the replacement of immunisation and Covid-19 trackers with the Aotearoa Immunisation Register and the completion of tranche 1 of the Hira Programme, which aimed to transform access, use and secure sharing of health data. Tranche 1 finished in June, with no further money allocated for future tranches. Tranches 2 and 3 of the flagship health information sharing programme were intended to be funded from Budget 2022 but the Budget earlier this year recalled more than $330 million earmarked for data and digital initiatives over the next five years, including funding for tranche 2.

A cyber security uplift program is continuing, and a new national CRM, launched in December 2023 has been extended beyond Covid to support some other services.

A new patient information system for the South Island is replacing eight aging and disconnected systems, enabling more efficient and connected healthcare, with improved analytics and a view of a single waitlist for the region.

Other work has included new public health websites, a national disease management system, tap-on, tap-off for staff in emergency departments across Waitematā and a rollout of a new clinical tasking and collaboration tool across the Northern region.

Work is also underway on replacing legacy systems for health sector payments and agreements.

“Despite efforts to improve our systems, the inherited patchwork of IT and data systems can still impede rather than enable better patient care, frustrate our employees and impact health system productivity,” Health New Zealand says.

Long term underinvestment has resulted in a large amount of technical debt: 50 percent of critical hardware in the system is now beyond intended lifecycle, 25 percent of the databases are out of support, with 54 percent on extended support, while 43 percent of virtual servers are out of support.

“We have aged applications and infrastructure that is end-of-life, out of support or not fit for purpose. This means there is a high degree of vulnerability to incidents and outages, including cyber breaches and a risk of irrecoverable data loss.”

Ryl Jensen, chief executive of the Digital Health Association, says the cuts to the data and digital services funding and workforce could have ‘catastrophic consequences’ for New Zealand’s health system.

“Many of these people are responsible for keeping the health system’s aging IT systems operational,” Jensen says.

“These systems need regular maintenance and updates to function effectively. Without this critical support, the health system could face significant disruptions and frontline clinicians may struggle to deliver timely and efficient patient care without the necessary digital tools.”

A Health New Zealand report early this year showed it inherited a patchwork of about 4,000 systems that  are not integrated and are often out-of-date with no effective backups, from the 20 District Health Boards.

That was leading to more frequent and more serious service outages, with risks of unsafe data sharing and breaches.

Jensen says the data and digital team had made good progress over the past two years on systems poised to transform how the health system was connected.

“However, the legacy of 20 different DHB systems has created significant challenges, perpetuating a postcode lottery for healthcare delivery and outcomes.

She says the cuts risk undoing that progress and not just impacting the present, but stalling the future.

“Numerous transformative IT projects designed to bring the health system into the 21st century have already been mothballed following over $380 million cuts to data and digital programmes in Budget 2024,” she says.

The PSA has also slammed the moves, dubbed ‘a shameful attack on an already stretched public health sector’ by Ashok Shankar, Public Service Association national health sector lead.

“We already spend far less than other countries on public health IT systems,” Shankar says.

“These cuts mean Te Whatu Ora will only do the bare minimum, putting band-aids on an already failing system and not proceeding with planned upgrades.

“The promise of the health reforms, including a modern fit for purpose IT system that delivers accurate data on patients to clinicians no matter where in the country, is being scuttled by these short-sighted cuts,” he says.