Health New Zealand is asking for voluntary redundancies from admin and advisory staff ahead of yet more looming job cuts at the cash-strapped agency.
In an email to staff on Wednesday, that has since been published on Te Whatu Ora's website, chief executive Margie Apa said to be "sustainable", the public health system needed to live within its budgets.
"That means we need to move towards being a more efficient organisation, focusing our resources on the delivery of frontline healthcare," Apa said.
"It is now clear the initiatives already in place will not, by themselves, resolve the financial issue or ensure we have the right people in the right place."
As staff costs accounted for the biggest chunk of expenditure, Te Whatu Ora needed to further review its size and structure as part of its "reset", Apa wrote.
"We are therefore providing the opportunity for eligible staff to consider voluntary redundancy, ahead of more formal change consultation processes likely over the coming months."
Voluntary redundancy was being offered to a limited number of staff working in administration, policy advisory and specialist services.
Expressions of interest open from Thursday and close on 13 September, with outcomes to be decided by mid to late September.
Applications would be considered on "a case-by-case basis", she said.
"We are not opening up voluntary redundancy more widely at this stage. However, we will enable any staff to pre-register their interest if they were to become eligible to apply in the future."
Apa urged staff to respect each other's privacy and any decisions made by those involved.
"I know situations like this can be difficult. Please continue to support each other - talk to your manager or a colleague if you have concerns."
An all-staff hui will take place tomorrow.
The move comes as Te Whatu Ora continues to work through the previously announced restructuring to its commissioning team, which involved axing 268 roles.
The total number of staff in commissioning has shrunk from 1004 to 756 in the first round of restructuring to now 482.
The Public Service Association labelled the offer of voluntary redundancies as "rash and reckless", "unfocused and wide-ranging".
According to the union, teams impacted included administrators, procurement and supply chain, information, analytics and research, policy and programmes, as well as communications, finance, and HR.
National secretary Kerry Davies said losing hundreds of specialist staff to meet government imposed spending cuts would further "destabilise" the public health system.
"Just as they did for other public services, the politicians target people working behind-the-scenes because they think they can get away with it," she said.
"But clinicians are well aware patient care depends on administrators, IT support, and logistics workers."
This workforce was under huge pressure due to the hiring freeze in health, Davies said.
"We're already hearing horrifying stories of 72-hour wait times and worse for mental health care. Gouging at the foundations of an already stretched-to-breaking system will mean people won't get the care they need."
The New Zealand Nurses Organisation said the offer to take voluntary redundancy was "in breach of the established consultation processes".
Chief executive Paul Goulter said the union did not agree with the "perfunctory" way in which the proposal was presented.
Furthermore, it disputed the "economic rationale" for a reduction of staff.
"This approach does not allow for all the options to be considered when a genuine staff surplus is identified.
"We also hold the view that taking this approach is disrespectful of the values that underpin the relationship process as set out in Te Mauri o Rongo."
Any reduction of staff would affect those who remained and cutting supporting roles would mean other staff had to pick up that work, he said.
Health New Zealand declined to comment on the issues raised by the NZNO.
It also declined to comment further while the process was underway, out of respect for individuals considering taking voluntary redundancy.
