Chief executive Carole Heatly will leave the Southern District Health Board at the end of next month, and there is a call for an acting chief executive to be brought in from outside the embattled organisation pending a permanent appointment.
Ms Heatly's resignation for "personal and family reasons'' was announced yesterday in a media release, and shortly afterwards, Ms Heatly and commissioner Kathy Grant gave a joint interview at the Otago Daily Times office.
Ms Heatly said it had been a difficult decision. She was unable to commit for the next three to five years, and felt that "morally'' the chief executive needed to stay for that kind of period.
That was crucial because of the Dunedin Hospital rebuild, and to see out the commissioner regime, which would be in place until late 2019.
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Last year there had been "turmoil'' when the board members were sacked, but things had settled and it felt like the right time to go.
But she admitted she had anticipated staying longer in the job, for which she was paid $500,000 to $510,000 in 2014-15.
"I always thought this would probably be my last job. I'm relatively young, at 58,'' she said.
Mrs Grant admitted the news shocked senior managers who report to Ms Heatly, and they had received an "assurance'' that the commissioner team would provide "leadership''.
"I think perhaps it took a number of your team by surprise,'' Mrs Grant said.
Ms Heatly said: "I didn't want to unsettle my team until I had made up by mind.''
Ms Heatly recently took a month's leave, during which she considered her future.
Asked if she felt pressured to resign, she said: "Absolutely not. This has been my choice.''
Her role "certainly changed'' after the board members were sacked but she had enjoyed working closely with the commissioner team.
"It was really hard to lose a board that had appointed me, and I had an awful lot of loyalty to that board, particularly to the chairman [Joe Butterfield].''
In an email after the interview, Mrs Grant declined to say whether Ms Heatly's resignation involved a financial settlement, saying she did not comment on individual employment matters.
She declined to say whether an external acting chief executive would be brought in, and declined to confirm the hunt for a permanent chief executive would be international.
Mrs Grant said she appreciated Ms Heatly's personable manner and praised the rapport she enjoyed with staff and community groups. The role had involved public criticism.
"Carole has had to withstand a significant level of scrutiny.''
Ms Heatly, who has held the job for four years and four months, is originally from Motherwell, near Glasgow, and has previously held senior roles in the National Health Service in Britain.
Ms Heatly said her biggest mistake was underestimating the public feeling over the food service outsourcing. In hindsight, she would have handled the public attention differently.
"Just the sheer emotion of it, and how it became very politicised. I was quite surprised by that,'' Ms Heatly said.
She said the food was much better after the initial problems, but whether it was an improvement on what was served before the controversial outsourcing was a matter of opinion.
"It's down to personal choice whether you think one hamburger's better than another.''
The job was different from comparable roles in Britain because it was more political.
"The politics in New Zealand are a lot closer to where the action is.''
But she had enjoyed "every minute'', including "interacting with politicians''.
She did not regret the food decision, and stood by other unpopular moves, such as dumping Presbyterian Support Otago from a $5.5 million home support contract in 2013.
That decision, as well as outsourcing breast-screening and fertility services, were the right calls.
"People expect an awful lot from their public health services and we want to give them what they want, and sometimes you need to [consider] affordability and volume and locality and that's hard.''
Ms Heatly plans to stay in Dunedin permanently. She was unsure what to do next in her career, and would take a holiday.
"The New Zealand people have been very generous to me. They have really made me feel welcome.''
Association of Salaried Medical Specialists executive director Ian Powell said Ms Heatly was a "nice person'' and he wished her well.
Recruiting a new chief executive would take time, and the senior doctors' union was pushing for an acting CEO to be brought in from the outside.
"It is very important, if this DHB is to move ahead, that the interim chief executive is someone with good relevant experience, given where Southern is at, and, as a result, from outside the DHB.
"There isn't such a person inside the DHB at this particular time.''
Health Minister Dr Jonathan Coleman, who said last year when he sacked the board members that Ms Heatly was "staying on'' as a valuable member of the team, released a statement.
"Carole Heatly has been an important part of the team. I'd like to thank her for her service to the people of [Otago-Southland] and I wish her all the very best.
"She is leaving Southern in a much better shape with the vital rebuild of Dunedin Hospital in its early stage and, importantly, the rising deficit turned around and on a clear downward path.''
Dunedin North MP David Clark said six weeks' notice was short for a DHB chief executive, and that was concerning when the organisation faced challenges. It would be difficult for it to attract a suitable candidate because its difficulties were so well known, he believed.
Dunedin South MP Clare Curran said the resignation was "sudden'' and would leave a "void''. She was concerned the board appeared to lack stability and a coherent plan.
