Health New Zealand/Te Whatu Ora's boss says it's looking at ways to balance both its budget and patient care after a controversial letter put the sector under the spotlight.
Just over a week ago, Health NZ sent a letter to staff telling them not to cover sick staff, to ban double shifts, to close some vacant roles and make staff take annual leave in a bid to save money.
The controversial document stated public hospitals had been tasked with saving a total of $105 million by July.
Health NZ chief executive Margie Apa told AM on Thursday the letter, which was sent to managers and leaders, was guidance to encourage them to look at if positions were really needed now.
"We are testing whether roles that are not in budget or aren't replacing core services, the roles that don't fit that criteria, we are going back to managers to check whether they really need them," she said.
However, Apa wouldn't confirm on AM if any vacant positions had been dropped in the past week since that letter.
She added that recruiting was still taking place, noting that in the last week Health NZ had approved over 300 additional staff.
"We still have shortages, like ED (emergency departments), mental health, critical units," she said.
When asked about sick cover in the past week, Apa couldn't confirm if any of those positions had been filled.
"But I know that managers are taking a good look at where they do have services that are staffed up, that if they need sick leave, and again it's dependent which is why we need to trust our leaders and managers to make some of those decisions based on the day, how the ward or service is operating on that day, and make those judgements carefully."
A nurse told AM that there were no departments that were "staffed up", adding that if sick leave wasn't covered some wards would have one or two nurses covering a whole ward with up to 35 beds. That's a ward which would normally have six or seven nurses on a morning shift and three or four at night.
The nurse said shortages were impacting health outcomes for patients and wait times.
"If these cuts are implemented it will make these issues so much worse, they really need to look at patient care and health outcomes rather than a budget book."
In response, Apa said about 2000 nurses had been recruited in the past year. Labour said the nurses were hired in the year to September while it was in Government, but that "it hasn't taken long for National to undo that progress".
Apa added: "If she's [the nurse] working in an area where there are shortages it's really important that those leaders are making judgements about ensuring that they are able to provide safe staffing.
"We are delivering more care than we have in the previous calendar year, more surgeries, we're seeing 10 percent more people in the ED departments, the whole primary care sector is seeing more people. So we are actually providing more care.
"This situation we are in is really about trying to get back to a budget where we can't go into deficit like the previous DHBs were able to in this financial year, and ensure we are able to preserve ongoing investment in prevention and primary care and community.
"But certainly, within hospitals we have continued to deliver more and we have put more funding into hospitals in this financial year."
Apa also said she was working with unions to ensure life-preserving services will continue during a planned doctors' strike on May 7 and 8.
"We are hoping that we can get back to the table to continue negotiating on an arrangement that can support safe staffing."
