Health workers are not a cost-saving measure

We already knew our public health system was underfunded and bursting at the seams.

We knew health workers were exhausted, patients were waiting too long for care, and unmet need was building.

Now we know that, against that backdrop, Health New Zealand was deliberately restricting recruitment as part of efforts to save money.

That is beyond disgusting.

The PSA’s new report, Vacant by Design: how underfunding in health has left critical roles unfilled and patients worse off, reveals Health NZ told Health Minister Simeon Brown in March 2025 that its savings plan would be “underpinned by maintaining strong controls over recruitment”.

The report details lengthy delays before critical vacancies could even be advertised, alongside evidence from health workers about what understaffing meant for patients.

Chemotherapy was stopped in one area because there were not enough nurses. Laboratory results were delayed. Stroke patients were not receiving physiotherapy as frequently as they should. Clinicians were doing administrative work because essential support roles were vacant.

RNZ reported on the findings this morning, including responses from Health NZ and the Minister.

Our spokesperson and former intensive care specialist Dr David Galler says restricting recruitment to save money while services were already under extraordinary pressure is indefensible.

“How did anyone look at the pressure our hospitals and health services were already under and decide restricting recruitment was an acceptable way to save money?

“The workload didn’t disappear because positions weren’t filled.

“Patients still needed scans, blood tests, chemotherapy, mental health support and other care. A vacant position might look like a saving on a spreadsheet, but in the health system the cost is simply transferred to the workers left carrying an impossible load and to patients waiting for the care they need.”

Work as imagined versus work as done

The revelations also raise serious questions about repeated assurances from Health Minister Simeon Brown that there was no hiring freeze.

In a post on LinkedIn today, Dr Galler goes further, accusing the Minister of playing “word games” rather than being upfront with New Zealanders about what was happening.

He describes the disconnect as “work as imagined versus work as done”: the difference between how a health system is described from a distance and what health workers and patients are actually experiencing on the ground.

Health workers have repeatedly described understaffing, rising workloads, delays and the distress of being unable to provide the care their patients need.

Now we have documentary evidence that recruitment was being tightly controlled as part of efforts to make savings.

As Dr Galler writes, the cost is borne by patients who wait, miss out on services or feel abandoned when they most need care, and by health workers carrying the additional workload and the moral distress that comes with being unable to meet growing patient need.

Read Dr David Galler’s full response on LinkedIn.

The consequences are not felt equally

Our Māori Co-Spokesperson Louisa Wall says Māori whānau are particularly exposed when an overstretched public health system cannot provide the care people need.

“When services are understaffed and access is delayed, Māori whānau do not have the luxury of simply going somewhere else. For many, the public system is the system.

“Healthcare must be based on need, not ability to pay. Te Tiriti must be honoured, Māori leadership protected, and our public health system properly funded.”

This matters because decisions about funding are not abstract.

They determine whether there are enough nurses on a ward, enough people in laboratories, enough mental health workers, enough allied health professionals and enough support staff to keep services functioning.

The workload does not disappear because you leave a position vacant. The patient does not disappear because there is nobody available to treat them.

And this is exactly why properly funding public health is one of our Three Asks ahead of the 7 November general election.

As Dr Galler says:

“Properly funding healthcare means funding the workforce needed to deliver it. We cannot decide how many health workers we can afford and then expect patient need to somehow fit inside that number.”

We are asking every political party to:

Fund public health properly.

Honour Te Tiriti o Waitangi.

Keep healthcare public.

Our public health system exists to care for people. Fund it to do the job.