Medical jobs are going unfilled as part of a crackdown on hospital recruitment, despite Te Whatu Ora Health NZ saying otherwise.

RNZ has heard from multiple hospital workers throughout the country who say clinical jobs in their departments are being left vacant — and a senior hospital leader has written to staff about the “overly complex and bureaucratic” recruitment process.

In June, Te Whatu Ora instigated a hiring freeze on all roles that were “not patient facing” to try to rein in its budget, but its language around whether that applied to any medical jobs was murky.

It said all clinical roles that “needed” to be filled would be, but did not answer questions about what that meant in practice and whether any were being turned down.

But the senior doctors’ union, and other health workers who contacted RNZ, say in many cases clinical recruitment has ground to a halt — even the straightforward replacement of a departing doctor or nurse.

There's now a quota on how many jobs can be filled for each region and every appointment has to be approved by a regional committee.

Association of Salaried Medical Specialists executive director Sarah Dalton says frustrated doctors from many specialities have told her they are unable to fill desperately needed roles.

Even hospital bosses, like Middlemore’s chief medical officer of health, Andrew Connolly, have expressed worry about the lag.

In an email to his senior staff in June seen by RNZ, he tells them he's well aware of the frustration and challenges around hiring.

“The recent ‘confusion’ following Head Office comms has not helped, to put it mildly, but whilst there is apparently no freeze on clinical recruitment the process remains overly bureaucratic and unnecessarily complex and it is very slow,” he says.

A Te Whatu Ora spokesperson says the Connolly email refers to the earlier version of the recruitment change where every role in the country had to be approved by one person in the head office, and not the updated regional committee process.

However, Dalton says hospital doctors and dentists tell her little has changed and there are multiple examples of hiring still grinding to a halt.

“It is incredibly difficult to get approval to recruit, to go through a recruitment process, to do all of that machinery of getting someone into a role,” she says.

“It has absolutely slowed things down where the point from our perspective is it is a freeze.”

A nurse at Southern DHB tells RNZ a role in their department has been empty for about 10 weeks after a colleague left, even though a manager requested they be replaced almost immediately.

Normally, approval would take about a week — two at the most.

She wants Te Whatu Ora to be honest about what is happening.

An internal Te Whatu Ora recruiter, who asked not to be named, says many of her colleagues have been in tears as they speal to angry clinical managers wondering why nothing is happening about roles that need to be filled.

The managers have been initially said the freeze didn't apply to clinical roles, but recruiters have been told to pause everything, she says.

That's backed up by an internal FAQ document seen by RNZ that says the “pause” covers all roles.

In a statement, Te Whatu Ora says clinical recruitment is continuing. It quotes the number of clinical hires from before the freeze was put in place, but says it doesn't have figures for June.

Staff spoken to by RNZ says while some clinical jobs may be being filled, it's clear many are not, even if it's just because of a long delay.

The new process

A Te Whatu Ora document seen by RNZ has outlined the new hiring process.

Department managers must make their request for a vacancy they want filled by Wednesday each week. A human resources person then collates all the requests and they compare those with that fortnight’s recruitment quota.

They give that information to their regional recruitment forum, a committee made up of hospital managers — both clinical and finance/operational.

The forum makes a decision then sends it to the national recruitment team and the cost-saving programme team.

The following Wednesday, the department managers can begin recruiting for any approved jobs.

The regional recruitment forum has to prioritise approving roles that address a shortage on the critical workforce list and must consider the hospitals with the greatest frontline need.

Some roles are exempt from the committee approval process, including internal appointments to existing roles and those where there is extreme need.

Health NZ responds

Health NZ chief executive Margie Apa says more than 600 staff, including 124 doctors, 240 nurses and 140 allied health professionals, accepted a job offer in June.

“As is routine with recruitment, we recognise there may be delays at times between when staff leave and new staff come into roles.”

The new process meant recruitment had been “brought closer to the front line”, she says.

“Clinical recruitment continues, led by regional leaders working within region and district budget parameters. This means decisions are made where local needs are best understood and prioritised.”

Health NZ was pleased with its progress around recruitment and was “determined to maintain momentum”, Apa says.

“Overall, we have exceeded expectations in recruitment across different professions, and are realigning budgets to prioritise ongoing funding for frontline services.”

-RNZ.