Source: PSA
– Officials briefing to Health Minister spells out strategy to slow hiring
– Evidence of patient care being compromised laid bare by health workers
A briefing from Health NZ to the Health Minister in March 2025 lays out the Government’s deliberate strategy to delay hiring health workers to save money leaving patients and health workers to pay the price.
A new report by the Public Service Association, Vacant by design: how underfunding in health has left critical roles unfilled and patients worse off , spells out the consequences of the Government delaying recruitment, and ignoring the problems created by its underfunding of public health.
“The Minister of Health could have ordered every vacancy in our hospitals advertised and filled straight away. He never did, because letting health services struggle by while being understaffed was the plan all along,” said Fleur Fitzsimons, National Secretary for the Public Service Association Te Pūkenga Here Tikanga Mahi.
The report reveals that Health NZ Commissioner Prof Lester Levy and Interim CE Dr Dale Bramley told Health Minister Simeon Brown in March 2025 that its savings plan for the 2025/26 budget would be ‘underpinned by maintaining strong controls over recruitment.’ [1]
“There is only one way strong controls on hiring save money: by leaving hospitals short-staffed,” Fitzsimons said.
The report reveals a new approval process was put in place in 2024 so that decisions to fill vacancies were made by four regional recruitment panels, not at the hospital or service level, with strict limits on the number of FTEs they could approve (see attached).
Approvals to hire took months, before roles could even be advertised. In one case it took six months to replace three neonatal intensive care nurses. A Northland radiologist vacancy sat unapproved for 12 weeks. A Southern region sonologist vacancy took 28 weeks to approve.
“That same briefing to the Minister promised savings would be ‘undertaken with clinical leadership to ensure that safety and patient care is not compromised.’ Our evidence from health workers shows that was pure fantasy.”
For example: an oncology service had to stop chemotherapy in one area because there weren't enough nurses. Clinicians faced delays in getting patient results because lab workers are short staffed. Admin staff said clinicians now must do routine tasks impacting time they spend with patients.
“Health workers have spent the past two years, dreading every resignation, in labs, in mental health, in cancer care, in physiotherapy, in admin, all telling the same story in every corner of the system: not enough staff, more risk to patients, and workers left to absorb the pressure through stress and burnout,” said Fitzsimons.
“It’s become so bad, even short-term parental leave vacancies struggled to get filled in time.”
The report includes the annual survey of health workers who are members of the PSA. 1800 workers responded. In summary:
– 76% said their team waited more than a month for approval to fill a vacancy
– 85% said unfilled roles were driving colleagues to stress and burnout
“Every delayed hire is a patient waiting longer for a scan, a diagnosis, a midwife. And it's not as though the money wasn't there to be found. The Government found room for billions of dollars of tax cuts for landlords, for higher income earners, and for big tobacco.
“That’s the real choice this Government has made: tax relief for landlords over a properly staffed and funded health system for everyone.
“The pain the Government has inflicted on the public health system has been relentless from day one; axing Te Aka Whai Ora, the Māori Health Authority, more than 30 restructures, 2,800 roles scrapped, including more than 1000 IT jobs, with $58 million spent on redundancy payments alone.
“Our report provides stark evidence of the high price the Government’s deliberate choice to underfund the health system has inflicted on patients and health workers.
“That is why, come 7 November, we must change the Government to one that makes it a priority to meet New Zealanders’ health needs by properly funding the public health system. The PSA will be campaigning hard for that.”
Background
The report Vacant by design: how underfunding in health has left critical roles unfilled and patients worse uses the testimony of health workers, public documents, documents provided under the OIA, and information Health New Zealand | Te Whatu Ora provided to the PSA to expose the impact hiring restrictions have had on patient care.
Attached: Recruitment process guidance Health NZ 13 June 2024 (released under the Official Information Act)
Patient care impacts – health worker testimony examples
‘We had to shut down a service to provide chemotherapy in an area as there were not enough nurses to provide treatment.’ Oncology
‘Stroke patients should be seen at least Monday to Friday, and they are commonly only seen three times a week at the moment, this impacts on their ability to make meaningful gains.’ Physiotherapy
‘We now see very unwell clients with issues that could have been solved earlier, now the health of people has deteriorated.’ Mental health
‘Unfilled vacancies have caused a significant impact on turnaround times which results in delayed patient care. Doctors are having to phone requesting results for their patients which are not available due to staff shortages and work overload.’ Labs
‘Medical staff are forced to perform administrative tasks when there is no administrative support. This negatively impacts patient care.’ Administration
Recruitment delay examples
Selected examples of recruitment delays identified in the report:
– Registered nurse, Emergency Department, Southern region: not approved five weeks after application
– Consultant radiologist, Northland: not approved after 12 weeks
– Midwife, Birthing and Assessment, Counties Manukau: not approved after 7 weeks
– Sonologist, Ultrasound, Southern: approved after 28 weeks
– Registered nurse, ICU, Capital, Coast and Hutt Valley: approved after 19 weeks
– Administration clerk, Cardiology Services, Waitematā: not approved 10 weeks later
Previous statements
5 January 2026 New data shows Government axed thousands of critical health roles in middle of crisis
27 November 2025 OIA data reveals Health NZ delaying recruiting for vacant roles
[1] P2 Prof Lester Levy and Dr Dale Bramley, Briefing to Hon Simeon Brown, Minister of Health, ‘Update on HNZ Internal Budget 2025/2026’, 21 March 2025, Briefing – Update on HNZ Internal Budget 2025/26 (HNZ00082800) – Health New Zealand | Te Whatu Ora
The Public Service Association Te Pūkenga Here Tikanga Mahi is Aotearoa New Zealand's largest trade union, representing and supporting more than 95,000 workers across central government, state-owned enterprises, local councils, health boards and community groups.