It is curious Ms Apa should go now, mere months before her contract was due to expire.
We might have expected her to depart close to the time of the appointment of commissioner Prof Lester Levy in July last year.
Maybe it would have been too expensive to "encourage" her to go then — her salary for 2023-24 was $895,000.
Such resignations always prompt the "did she fall or was she pushed" question, but it matters little.
Her departure, along with that of former health minister Shane Reti, is not likely to produce the dramatic improvements to our public health services many would like to see.
Ms Apa, with decades of experience in the health sector, had the unenviable job of shepherding the fledgling HNZ organisation through the tumult of its establishment in the wake of the Covid-19 pandemic.
It was never going to be easy.
She came into the role with high hopes the new organisation would be an enabler of more flexibility which would work better for local communities rather than a central bureaucracy that held everything up.
Starting out, she described the most exciting part of the health reforms as the establishment of Te Aka Whai Ora the Māori Health Authority, so its abolition by the National-led coalition government must have been a huge disappointment.
Restructuring is never easy and there was much about this one which was unpopular and not well thought out from the outset.
These included short-staffing and overworked staff (exacerbated by the pandemic), a primary care sector in tatters, a frightening infrastructure deficit and no real plan to address it, demand for health services not matching supply, inequity in the system particularly for Māori and Pasifika, huge longstanding holiday pay debt inherited from the DHBs, and pay disparity.
As well as that, and more, Ms Apa had to cope with turmoil in the oversight of Health NZ including a change of government, the sacking of the governance board to be replaced by Prof Levy as commissioner, and this year’s change in the health minister.
Concerns about the lack of transparency around HNZ have never abated.
Ms Apa did not seem comfortable dealing directly with media and struggled to convince a sceptical public and, it would seem, many HNZ employees, her organisation was on the right track.
Prof Levy was appointed with a hiss and a roar, and much hyperbole about the dire financial state of the organisation, supposedly the result of a bloated bureaucracy, but we doubt the public is more positive about the direction now he is half-way through his year’s term.
We have yet to hear much of his grand re-set although he had to provide the health minister with a detailed turnaround plan by the end of last August showing how the organisation would break even while delivering on the minister’s expectations.
It is hard to see what has happened to talk of beefing up the role of the regions, and clinicians are not convinced much headway has been made on strengthening the clinical voice in decision making either.
(The Dunedin hospital rebuild controversy illustrates the disdain the government had for the expertise and time clinicians had put into coming up with a suitable design).
If there is a cohesive, comprehensive, and timely plan for improving primary care, it has not been spelled out. This cannot go on when the sector is expected to do more because of pressure on hospitals.
Ms Apa may be breathing a sigh of relief to be leaving such a problem-laden stressful job.
However, it is hard to see how anyone brave or foolhardy enough to take it on will be able to bring about the myriad improvements needed, in a financially constrained environment.
