Lester Levy: “Significant, Not Painless” Changes Needed

Written By: - Date published: 10:08 am, August 16th, 2024 - 14 comments
Categories: Christopher Luxon, Dirty Politics, health, privatisation, Shane Reti - Tags: , , , , ,

This an edited excerpt from Mountain Tui: “Lester Levy asks audience to pray for him as he says Health NZ needs painful, significant changes”

Two days ago, at an Atlas Network New Zealand Initiative Health Conference, Lester Levy gave a keynote speech.

In his capacity as Health NZ Commissioner i.e. the sole and primary decision maker of a $26bn government organisation – Levy argued that “significant changes” were needed, most which “will not be painless“.

I’ll provide a few more Levy quotes for you to read for yourself:

This is primarily a taxpayer funded health system, but there should be value for that. And right at the moment, I don’t believe that that can be evidenced.

We have got significant changes to make .. not all of which will be painless..

I have said that as long as it’s legal and ethical, I will do whatever I have to do..

Lester also repeated the questionable assertion from Luxon and Reti that Health NZ had an unforeseen deficit. Lester said of it:

This loss materialized in one month. I don’t actually believe that, looking into how this actually happened. But if you extrapolate that out for the year, we’ll be in a $1.4 billion deficit.

Yet many have pointed out that the ‘deficit’ was caused by Willis and Reti intentionally under-funding the health system in the May 2024 budget. The primary reason for the money gap was Health NZ had successfully hired more nurses, and pay equity, holiday backpay etc.

On NZME, Luxon even admitted he knew of the ‘deficit’ in October 2023.

Yet he and his team have persisted in claiming they didn’t know about it.

Levy indicated that the health system wasn’t providing the right value for taxpayers and significant and painful changes are now needed.

“The marrow has been sucked out of the (front) line into the supporting functions..”

“(Health NZ) has got so many priorities, it’s got no priorities at all”.

It’s alarming to hear that anyone in his position thinks the arbitrary line between front and back is meaningful when in reality, they operate as one unit to deliver outcomes.

Or to not acknowledge the health workers who tirelessly labour every day to serve – and deliver – positive health outcomes for Kiwis.

And under Luxon, Reti and Levy’s vision, we may see more of doctors doing cleaning duties and making beds, scheduling their own appointments, or planning budgets and upgrading IT systems.

Is that why ‘back office‘ is a convenient, political punching bag under this government?

However, Levy did assert that he wanted more “compassion” in our system and believed “more health services can be delivered within their existing resources.”

But in short, it was a lot of fanciful, theoretical, jargon laden talk – the type you might hear in Board rooms when you are trying to impress someone – but it perhaps also equated to an alarming mis-comprehension of what is at stake, and what is wrong.

Sarah Dalton, executive director of the Association of Salaried Medical Specialists, called his speech “hollow words”.

And the government persists in freezing frontline hires, not paying for healthcare workers, and effectively asking sick Kiwis to fund their own healthcare, even as doctors reach breaking point and nurses and doctors continue to warn “someone will die”.

Yesterday, Te Whatu Ora laid off a few hundred more staff, effectively halving its workforce – and Levy in effect admitted that a leaked proposal to cut ~4500 staff, was an attempt to demonstrate the cost savings he wanted.

Sir Ashley Bloomfield told the Tova Podcast that the politicization of our health system is unhelpful. And he offered what felt like a measured, caring assessment:

“To constantly talk about it as failing, or as a set of crises, or as a cock-up, as one commentator said, doesn’t do justice to the fact that the system does deliver for many people, on the back of great work by many, many people every day.”

“When I say I don’t think the health system is failing, it doesn’t mean I’m not worried. I’m very worried. I’m particularly worried about the wellbeing of some of the staff.”

“If they are over-tired and close to burnout, then yeah, that’s a risk to their wellbeing, and potentially the wellbeing of others, if it compromises their ability to make good decisions.”

On the other hand, Levy mainly warns that “heartbreaking,” “not painless,” “strong medicine” is needed for Health NZ and its staff.

But is his approach even correct?


In this May 2024 article before he was appointed as the all powerful NZ Health Commissioner, Levy was described as a “top down, controlling and destructive” figure who consistently went into health organisations

“with an embellished assertion that he had inherited a financial mess and was the right person to fix it.

Ironically, following his appointment as their chairs, the three Auckland DHBs went from financial surpluses to deficits.”


Last but not least, it’s important to note that while the government wants to sound alarm bells over health system costs, our best and brightest continue to leave our shores, and their pro-tobacco policies continue to kill and add to health system costs.


Nicola Willis’s tax cuts – which have been offset for many with increased car registration, upcoming fuel levies, prescription fees, increased emissions flowing into insurance models, reduced beneficiary and disability funding etc – cost us $3.7bn a year.



That means the tax cuts cost $37bn + over 10 years.
 And Simeon Brown’s road plan costs $70bn over 10 years. Meanwhile, Luxon, Willis and Reti complain that our health system needs $1bn plus more, even as they fund the health system to the lowest per capita rate in a decade.

Is this all worth it, and is Lester Levy, a man who once championed privatising health, the right man to fix Health NZ – or perhaps, like the Atlas Network motto* hints at – break it down?

“Only a crisis – actual or perceived – produces real change. When that crisis occurs, the actions that are taken depend on the ideas that are lying around.
That, I believe, is our basic function: to develop alternatives to existing policies, to keep them alive and available until the politically impossible becomes the politically inevitable.”
– A Milton Friedman quote Atlas Network lauds

14 comments on “Lester Levy: “Significant, Not Painless” Changes Needed ”

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  1. Anne 1
    16 August 2024 at 10:51 am

    Lester Levy comes across to me as an updated male version of Christine Rankin. Remember her? Full of noise and hellbent on tearing WINZ apart. The outcome for the clients was soul destroying.

    This fellow appears to be intent on doing the same thing to the Health Service and on spurious grounds. He has the look of a thug and in my experience if they look like a thug they are a thug – fancy titles and suits not withstanding.

    As far as the deficit goes, I am a fiscal dummy but I love the way they never mention that word "Covid". Nah, we don't care how many lives and livelihoods were saved and how much it cost the previous govt.to save them. Its a good stick to hit them with and we're gonna hit em real hard because that is what we love doing right?

    • Tiger Mountain 1.1
      16 August 2024 at 12:03 pm

      Your instincts are correct Anne going by his track record! He is a career helicopter bureaucrat and “change manager” which means shafting ordinary people for top dogs of whatever stripe.

  2. Patricia Bremner 2
    16 August 2024 at 11:32 am

    A chosen lackey will say what is required.

  3. adam 3
    16 August 2024 at 12:35 pm

    Is this the same Lester Levy who when CEO of Middlemore had shit running down the walls Levy?

  4. TeWhareWhero 4
    16 August 2024 at 12:58 pm

    The NZ health service is a mixed system; most primary health care is privately owned, sucking up huge state subsidies and patient payments.

    Most diagnostic services outside of the DHB-run hospitals are privately owned, again sucking up vast state subsidies and patient payments.

    All elder-care, including a lot of palliative care, is privately owned, sucking up vast state subsidies plus patient payments.

    There are too many layers of unnecessary bureaucracy which draw funds away from essential service provision.

    As an example: mental health services in NZ are parlous because Neo-lib or Neo-lib compliant politicians and apparatchiks cynically used the anti-psychiatry movement's model of "care in the community" to justify closing down many state run facilities. In line with Neo-liberal contract culture, the resulting service gap was filled by a number of small scale providers, all in receipt of state funding. As these small providers can't provide their own support services in the way that larger organisations can, another contractor popped up to provide them, on a huge government contract.

    In relation to primary health, which logically should be of the highest quality, NZ's GPs refused to engage with the establishment of a national health service, as did consultants in the UK.

    As an example of how all this has worked to the detriment of NZers, the medical professionals who developed Pacific Radiology and made a mint for themselves out of state subsidies, then made a bigger mint by selling it in 2021 to Infratil, an investment company established by a Kiwi merchant banker.

    Along with loads of other investments in energy, Infratil has a controlling stake in RHCNZ Medical Imaging Group which comprises Pacific Radiology, Auckland Radiology, Bay Radiology. It has 70 clinics nation-wide and without it, the NZ health system would collapse.

    It gets, what in effect is a vast tax-payer subsidy via DHBs out-sourcing imaging from their over-stretched hospitals, and most importantly, via ACC.

    The sheer absurdity of it is, most of us pay hefty tax via income tax and GST; when we go to a doctor in a privately owned practice which is subsidised heavily out of those taxes, we pay an additional amount out of our already taxed income. If it was just a nominal sum it would be less offensive, but it is high enough to put a lot of people off seeking medical advice in a timely manner.

    It's a complete rort, a scam and this Levy fellow looks to be about to finish what the Neo-libs started and turn the NZ health system into something like the US model -– or the one in Sth Korea in which it's commonplace for people to end up in crippling, medical-related debt either to a bank or to one of the country's huge network of indescribably vicious loan sharks.

    (Although it's illegal, loan sharking and selling organs to pay off escalating debt is disturbingly commonplace.)

    Add to this depressing scenario, the medical profession's over-reliance on a pharmaceutical and symptomatic paradigm, and the chemical soup in which we all now live – thanks to the medical-industrial complex's even more monstrous stablemate, the petro-chemical complex – and it is an issue which must have the early pioneers of national health services spinning in their graves.

    What to do? Hassle your MP; write to the media (cue hollow laugh); do not ask for or accept any unnecessary prescriptions; research your own health issues and be ready and able to challenge the system; don't abuse ACC – it's too often a money pipeline to the private sector.

    Most important, don't vote for venal, opportunist arseholes.

    • Tiger Mountain 4.1
      16 August 2024 at 2:31 pm

      Good observations made. The dirty big secret (as in not widely addressed for the public) of NZ health is the penetration of what was public infrastructure by private capital.

      In the 90s National waded into provincial hospitals closing many down. I still recall whole towns turning out to surround their particular one in a protest effort to retain–but usually to little avail.

      Natzo ministers galore have been personally involved in second tier private health providers. One time Health Minister Coleman hightailed it straight out of Parliament to the private sector. These money grubbing bozos think it is all fine. Hips and knees get contracted out in job lots to private providers but the tricky stuff and research remains public. I have seen at several hospitals the Drs Porsches in the car park, gone after lunch to their “other gig”. I had a likely four month wait for a scan at DHB but the Doc said my mate Johnny can do it for you Monday at Kensington for a grand…

    • roblogic 4.2
      16 August 2024 at 8:06 pm

      Very insightful TWW, mind if I repost that comment on X/twitter?

  5. feijoa 5
    16 August 2024 at 8:52 pm

    There's another layer to this too.

    In days gone by, pharmacies, opticians, dentists, physiotherapists, etc, were all small businesses, owned and operated by the actual professionals themselves.

    Now they are being bought up by large foreign interests, and small owner operators are slowly being squeezed out by multiple factors- bulk purchasing, the onerous contract requirements and audits, etc.

    But hey, profits come first.

    • tc 5.1
      17 August 2024 at 9:17 am

      The amount of profit being made in health, electricity, etc is part of the grand design.

      Essential services and utilities are rivers of gold to the Investor. I would be confident that they will do ok out of Lester's levies.

      Minister brown has eyes on that water.

    • Mountain Tui 5.2
      17 August 2024 at 10:05 am

      This is an excellent point.

  6. Mike the Lefty 6
    17 August 2024 at 10:42 am

    So why is the Health Commissioner even TALKING to NZ Initiative?

    They are just the Business Roundtable renamed.

    So when your Health Commissioner, which is basically the generalissimo of public health, starts talking to an outfit that would gladly privatise the whole shebang you have to worry about what they have in store for us.

  7. georgecom 7
    17 August 2024 at 8:32 pm

    the change that is needed is a new government. the health system is showing Reti is getting out of his depth (nice man, no action) and it might be one of the significant issues to sink the COC govt. A developing and worsening health crisis under Reti's over sight

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