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An ''invisible'' leadership style at the Ministry of Health has been slated in a high-level report card.
Released yesterday, the State Services Commission review graded ministry performance in numerous areas.
Its performance was graded ''weak'' in numerous areas, including leadership, internal behaviours, sector partnerships, engaging with staff, people management, and implementing the New Zealand Health Strategy.
Health Minister David Clark, who had asked questions about the report in Opposition, yesterday called it an ''indictment'' of the previous government.
''The performance improvement framework review... paints a picture of a ministry that needs support to provide stronger leadership and governance.
''The report echoes the concerns about a lack of ministry leadership that I have heard time and again in recent years from those working at the frontline of our health system,'' Dr Clark said.
The review said top tier managers were too focused on themselves, while middle managers, including some senior staff, had become disengaged and demotivated.
''Leadership is invisible in the ministry and across the system, as the executive leadership team has spent considerable time working on itself.
''The health and disability system and social sector see the consequence of this, and are becoming cynical about the ministry's commitment to working differently.''
The ministry had not done enough to reach ''vulnerable'' people to address their needs and needed to build alliances.
''For more vulnerable and disadvantaged communities and individuals this siloed service delivery is simply not working.''
Southern District Health Board was one of many contributors to the review, but the ministry's relationship with the board is not canvassed, despite a close working arrangement due to the presence of a commissioner.
Of the relationship with Canterbury DHB the review said there was ''underlying tension'' and an ''apparent lack of trust''.
An acceptance of certain ''negative behaviours'' in the ministry needed to change.
''An issue requiring attention in the ministry is an apparent tolerance for what is at best described as a lack of respect for colleagues in pockets of the ministry.
''At the time of writing the ministry does not appear to be addressing the non-alignment of values, despite this being a reasonably well-known and understood issue ... that has the potential to undermine any attempt to change the culture of the organisation.''
Outgoing director-general of health Chai Chuah responded in the review, saying desired improvements would be achieved through collaboration and lateral thinking.