The resignation of the director general of health is the latest departure in what Labour is calling a ‘purge’ of health leadership, writes Catherine McGregor in today’s extract from The Bulletin.

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Another day, another health resignation

It’s a dangerous time to be a top health executive. On Friday, Dr Diana Sarfati announced her resignation as director general of health and chief executive of the Ministry of Health, just two years into her five-year term (her predecessor, Sir Ashley Bloomfield, lasted four years). Sarfati’s is the latest in a spate of high profile health resignations and firings, starting with the sacking of the entire Health NZ board in July 2024. Earlier this month Health New Zealand’s embattled chief executive Fepulea’i Margie Apa resigned, four months ahead of her scheduled contract end date, followed by Dr Nicholas Jones stepping down as director of public health three days later.

While all three departures were presented to the public as resignations, that’s not the whole picture. Apa stepped down in “mutual agreement” with health commissioner Lester Levy, while Sarfati’s resignation came after health minister Simeon Brown refused to express confidence in her abilities.

Who will be the next domino to fall?

Prior to her departure, Sarfati had been “the only health system leader left standing since the coalition Government began”, according to The Post. However the government’s “purge” of health leadership may have yet another victim: Lester Levy himself. Levy was brought in to lead Health NZ following the sacking of its board in July, with a mandate to rein in its overspending and “bloat”. His reputation took a hit when The Post’s Rachel Thomas reported that he was continuing to work two days a week as an AUT lecturer, and again when Labour’s Ayesha Verrall accused him of “cooking the books” to make Health NZ’s deficits look better under his leadership.

Labour accused Levy of treating Apa as a scapegoat for Health NZ’s failings, both publicly and privately. Now it seems it’s Levy’s turn in the firing line. Asked repeatedly whether Levy had his full confidence, Brown was noncommittal. He’d “work with whoever’s there to make sure that they’re focused on delivering”, he said, and the government would “be making decisions around next steps in the coming weeks and months”.

Health sector pays tribute to Sarfati

The director general’s resignation has provided more grist for Labour’s attacks on the government’s health reforms. Acting health spokesman Peeni Henare said it seemed “as if Christopher Luxon is getting rid of everyone who disagrees with him” but was “fast running out of other people to blame for his Government’s failures”. Brown countered that Labour needed to “look in the mirror”, having “[torn] apart the entire health infrastructure by restructuring the health system during a pandemic”.

Sarfati was widely respected within the health community, especially around her work on cancer prevention. A “senior leader in the health sector” told The Post that New Zealand had lost a “world class leader” who would be “snapped up by some place somewhere in the international health system”. Her stepping aside “sent a very unsettling message” about the state of NZ’s health system, the anonymous source said.