Various schools have had Crown monitors appointed to steer them back in the right direction, as have several city and regional councils: in recent years there has been speculation that either the Gore District Council or the Otago Regional Council might need some extra outside assistance.
While the inference most will draw from a monitor being appointed is that something has gone wrong, there could be many reasons why external expertise is needed and it is not always a bad thing to call for help.
Last week, however, the country entered new and unusual territory when a Crown Observer was appointed to help out Health New Zealand – Te Whatu Ora.
But bringing in the cavalry, in the form of experienced health administrator Ken Whelan, to try to rescue Te Whatu Ora brings monitoring to a whole new level of the state service.
Since HNZ Te Whatu Ora was created by the former Labour government it has been beset by dissension and trouble.
Most spectacularly, its former chairman Rob Campbell was fired in February by then Health Minister Ayesha Verrall.
But from accusations of lacking transparency, to being inadvertently far too transparent by the recent alleged theft of vaccination data, peril has dogged HNZ wherever it has gone.
Much of this is business as usual: health is a huge, expensive and emotionally-laden sector, dealing as it does with people’s lives and wellbeing.
But much of it is not. Labour fundamentally reformed the way health was to be administered in this country and many of the building blocks it intended to be in place by now — such as the much-vaunted health localities, which were meant to provide local input to the new centralised health system — remain unfinished.
New Health Minister Shane Reti has seen something he does not like and brought in Mr Whelan to sort whatever it is out.
Dr Reti’s announcement was not overly specific, saying that HNZ had "significant ongoing challenges" and that the organisation had to overcome a range of issues, including health workforce numbers and hospital wait times.
Again, this is same old, same old: hospitals have always struggled for specialist staff — although possibly not with such great difficulty as during this Covid-19 era — and for anyone waiting for an operation a waiting time of any length is too long.
Coincidentally, earlier that morning Te Whatu Ora had released its latest quarterly Clinical Performance Metrics, which revealed the ongoing struggle the organiusation has.
Waiting times for under 25-year-olds to access specialist mental health services were up, acute bed days were up, avoidable hospital admissions were up people waiting more than four months for a First Specialist Assessment was markedly up, and a further 3000 or so people were added to the 26,610 who had spent more than four months waiting for planned care during the previous quarter.
A key statistic, Emergency Department Admissions, remains unreported due to "ongoing challenges with validating the data used to produce this metric."
On the plus side, the number waiting more than a year for treatment had dropped by 12,300 — although the fact that that many people, and counting, were waiting that long for treatment is a whole story in itself.
Dr Reti has called for a reset of HNZ, with a "clear focus on health outcomes".
His clearest hint at what he, at least, feels is rotten in the state of Denmark was that under the previous regime there had been "a lack of oversight" of the reform process.
By which we suspect he means that a lot of loose threads remain lying around while health staff are distracted putting out fires elsewhere.
Assuming that is so, we tend to agree. Adminstration systems are vital, and need to be sorted out as soon as possible: clinicians must be free to treat the ill, not worry about governance structures and reporting processes. The sooner Mr Whelan can refocus Te Whatu Ora the better, but it will be no small task.
