Overview
I have 30 years of policy experience in the NZ public sector, primarily in Health, but also in Treasury and a Minister’s Office, which gave me an excellent understanding of how the wider system works. New Zealand’s public health system continues to be my main area of interest.
I held second-tier policy roles in both the Ministry of Health and ACC and have an in-depth knowledge of both. My health sector knowledge is complemented by a thorough understanding of the tax system and the Budget process, gained over nine years working in Treasury.
Finally, my role as a Senior Advisor to a Minister of Health gave me another perspective on how the public sector works, the accountability arrangements, and the tensions between the numerous agencies involved.
Policy related to health funding was a particular focus of mine, including: how to determine funding for Vote Health; a formula to adjust Vote Health funding from year to year; how the system should be financed (taxes/social insurance/co-payments); population-based funding of District Health Boards; the introduction of capitation funding for Primary Health Organisations (PHOs); and the joint funding of acute hospital care by Health and ACC.
I have strong quantitative skills and academic qualifications in Maths and Economics.
A highlight of my time in Health was leading the implementation of NZ’s Primary Health Care Strategy for the first 18 months. We developed all of the operational policy, liaised with DHBs, and conducted a roadshow around the country. At the end of my time in the role, over 1 million people were enrolled in 34 PHOs – well ahead of projections.
After resigning from ACC at the end of March 2012, I undertook a number of short-term assignments and contracts. These included a 3-month appointment at the Tertiary Education Commission where I encountered Treasury’s process for capital projects, and a 5-month contract on population-based funding for Queensland Health in Australia. I completed 3 pieces of research for the Productivity Commission and several focus group exercises that form part of the Commission's inquiry evaluation process. (More detail below.)
Over the last few years I have written opinion pieces on various public policy issues that have been published in the Post and the Herald.
Work experience
Up to March 2012
ACC
July 2009 – March 2012
General Manager, Strategic Policy and Research: My Group of around 70 staff provided policy advice, strategic planning, legal services, research, and ministerial services, as well as supporting the Board. The most significant policy issue during this time was the Government’s intention to introduce choice/competition for work-related injury cover. I represented ACC in the lengthy and contentious policy process.
February – June 2009
Acting General Manager, Strategic Policy and Research: as above
ACC and Ministry of Health (joint appointment)
July 2007 – January 2009
Strategic Policy Director, ACC-Health Interface: This new role aimed to work more collaboratively across the ACC-Health interface to improve outcomes in both systems. My focus was on acute hospital services, home and community support, primary care, and elective surgery.
Ministry of Health
October 2005 – June 2007
Deputy Director-General, Sector Policy: I managed a directorate of 70+ staff with a budget of $14m per annum. The directorate covered: system performance, sector funding, workforce, health of older people, ethics and innovation, international, and therapeutics. A highlight was the development of performance indicators and targets for the health sector.
February 2000 – September 2005
Principal Advisor, Sector Policy:
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I led the first 18 months of the implementation of the Primary Health Care Strategy. This phase included the development of operational policy on the organisational form and size of PHOs, the minimum requirements to become a PHO, an enrolment system, a capitation formula, and extra funding to improve access for high need groups.
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I prepared Cabinet papers for the Minister to gain agreement to the changes and very significant new funding. There was considerable opposition from the sector and vigorous debate with GP groups about the approach to the roll-out and control over patient fees. We conducted a roadshow around the country and I gave several presentations at conferences in NZ and overseas. At the end of my time in the role, over 1 million New Zealanders were enrolled in 34 PHOs – well ahead of projections.
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I led an inter-departmental strategic review of the financing of the health system which considered the most appropriate mix of taxation, social insurance, health taxes and user charges.
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as Acting Deputy Director-General, Sector Funding and Performance, I managed a directorate of 35 people, with 6 direct reports. During my 5 months in this role, the directorate led the establishment of District Health Boards.
Office of the Treasurer, Minister of Finance, Minister of Revenue
February – December 1999
Chief Advisor: I provided independent advice on tax and a range of finance issues, as well as helping the Minister to manage key issues in these portfolios.
Office of the Minister of Health
February 1997 – January 1999
Senior Advisor: I provided independent advice on policy issues and liaised with the Ministry of Health and Health Funding Authority. Issues that I advised on included:
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the funding path for Vote: Health
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the ‘deficit switch’ to put hospitals on a sound financial footing
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booking systems for elective surgery
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the change from four regional health authorities to one Health Funding Authority and the governance structure of the Authority
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the purchase agreements with the Ministry and Health Funding Authority.
Ministry of Health
November 1992 – January 1997
Manager, Forecasting and Modelling: I managed a section that provided quantitative and economic analysis and research to support the strategic policy function, including:
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adapting population-based funding to the newly established regional health authorities and expanding the formula to include disability support services
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developing a formula-based approach to adjusting total health funding from year to year.
The Treasury
March 1983 – November 1992
In the last two of my years at Treasury I was the Manager, Personal and Indirect Tax. Before becoming a manager, I worked on a range of significant policy changes such as the removal of tax concessions for superannuation and the major income tax and social welfare benefit changes that accompanied the introduction of GST in 1986.
Department of Health
1981 – 1982
I was a junior member of the team that developed and implemented population-based funding for NZ Hospital Boards.
Short Term Roles and Projects
After April 2012
Universities NZ and DPMC: I conducted four focus groups and prepared a report on ways to improve knowledge sharing between academic researchers and policy makers. The focus groups included policy analysts, senior policy managers, Chief Science Advisors, and academic researchers.
AUT/University of Queensland: At the start of the Covid-19 pandemic I contributed to the development of a Bluetooth app to assist with contact tracing. I used my health system knowledge to advise on how the app would present information to users as well as how it would interface with manual contact tracing. We worked towards implementing it with the Queensland Department of Health, however ultimately initiatives at the state level were overtaken by a federal decision to use one approach across Australia.
Productivity Commission: In 2019 I prepared two research reports for the Commission’s Future of Work Inquiry. The first considered whether a publicly-funded unemployment insurance scheme could offer better income-smoothing for people displaced from their jobs by technological changes.
The second report considered the impacts on the ACC scheme if significant numbers of employees were to become independent contractors, again as the result of changes in technology.
For the Commission’s Inquiry on Regulatory Institutions and Practices, I interviewed board chairs and government monitors of regulatory Crown entities and used the results to recommend changes to current governance and monitoring arrangements.
Data Futures Partnership: This was an independent group appointed and funded by government to maximise the benefits from the use of data in New Zealand. Working with Dr Rhema Vaithianathan of AUT, I developed a set of Guidelines for Trusted Data Use aimed at improving the levels of comfort and trust for people providing data and within the wider community. The guidelines apply equally to government agencies, NGOs, and companies collecting information about clients and customers.
Another project investigated barriers to government agencies sharing personally-identified data in order to target social services more effectively.
Queensland Health: I had a 5-month contract as the Subject Expert on Population-Based Funding. In this role I led the development of a population-based approach to funding Queensland’s 16 Hospital and Health Services. This work drew heavily on my knowledge of how population-based funding has been used in the NZ health system since the early 1980s.
Ministry of Justice: I developed a set of 6 measures to be used by senior management to assess court performance in the priority areas of timeliness, cost per case, and trial date certainty. I also recommended how the measures could be used to drive improvements by comparing results across the Ministry’s 14 service delivery areas. My recommendations were accepted by the Ministry.
Tertiary Education Commission: As Special Advisor to the Chief Executive for a 3-month period, I provided advice on the level and timing of government funding to help rebuild Canterbury tertiary institutions after the earthquake in February 2011.
Academic Qualifications
1984
Four Certificates of Proficiency in Economics (Stage 3 level papers), Victoria University of Wellington
1980
MA in Mathematics (awarded with distinction), Victoria University of Wellington