Immunisation Advisory Centre staff cut by nearly 40%, leaked document reveals

A public health specialist has warned against cuts to the organisation that provides education, support and clinical advice to the country's immunisation workforce.

A leaked internal document from the Immunisation Advisory Centre (IMAC) described staff numbers being slashed by almost 40 percent and significant reductions to some services after Health New Zealand more than halved its funding.

Neither Health NZ nor UniServices - the University of Auckland company IMAC fell under - would confirm the scale of the cuts or the impact on the centre's workforce.

University of Otago professor Michael Baker said IMAC's work was vital in increasing immunisation rates, responding to a range of disease threats and rolling-out new vaccines, especially as the country grappled with low vaccination rates, a whooping cough epidemic and the threat of a measles outbreak.

"It's really important work and it's not getting any easier," he said.

New Zealand was facing historically low vaccination rates, with childhood immunisation coverage dropping back to levels not seen in about 15 years and overall coverage of 80 percent or less, which was a disaster for controlling infectious diseases, Baker said.

He questioned the potential savings from IMAC cuts.

"When economists look at vaccinations, it's about the most cost-effective thing you can do for any country. If you vaccinate enough people you actually stop the infection altogether - that's the idea of herd immunity, that's why New Zealand was so lucky to achieve measles elimination a few years ago," he said.

Health NZ insisted it had increased IMAC funding, while UniServices acknowledged the loss of "some funding" had meant a reduction in services. A current staff member, speaking on the condition of anonymity, confirmed the more sweeping cuts outlined in the restructure document.

Both organisations refused to comment further when asked to explain the discrepancy.

National Public Health Service director Dr Nick Chamberlain said Health NZ had provided a "significant increase in total baseline funding for IMAC this year".

The increase excluded Covid-19 specific contracts, Chamberlain said.

UniServices chief executive Greg Murison said IMAC had cut some services, including reduced hours for its clinical communications centre, moved most courses to online only and reduced staff capacity.

Since its creation almost 30 years ago, IMAC had held the National Immunisation Education and Co-ordination contract, securing an additional contract in 2020 to provide Covid-19 education and clinical support, he said.

Both contracts were rolled into one integrated contract for January 2023 to December 2024, along with some separate Covid-19 funding. IMAC was advised in the middle of last year that Covid-19 funding would likely end from January this year, Murison said.

However a "change process confirmation" document obtained by RNZ detailed deep cuts.

"Heath NZ have offered less than half of the funding we have previously enjoyed for the next IMAC integrated contract," the document said.

"In real terms, the level of funding we have been offered is lower than the funding IMAC had prior to Covid-19."

The new contract meant "a significant reduction in education and clinical support services for the immunisation sector", it said.

Changes included reduced 0800 IMMUNE service hours (an 0800 number that provided support to vaccinators), a reduction in the number of advisors on each shift, reduced medical advisory availability, a freeze on new courses and post-course support, and a reduction in the number of antigen reviews and updates to the immunisation handbook.

The final decision was delayed due to the volume of submissions from staff, who raised concerns about the proposal's risk to clinical safety, saying it "jeopardized the safety and well-being of individuals as well as eroding the public's confidence in the immunisation programme" and hampered the organisation's ability to respond quickly and effectively in a health emergency.

The document confirmed just over 16 roles would go, leaving a new structure of 28.9 full time equivalent positions.

Staff urged UniServices to consider a reduced working week or reduced hours for some jobs to retain more roles.

Some staff whose role had been cut complained of finding out in group meetings or via PowerPoint presentations.

"This is impersonal, callous, distressing. Left me feeling unsupported and undervalued," one said.

The review panel agreed with many of the concerns staff raised and said it had warned Health NZ of clinical safety risks, while risks for the university and its staff had been "communicated at the highest level in the university".

The proposed restructure "was not taken lightly and was made on the need to fit resource within the funding envelope".

Staff warned job cuts would place additional strain on those left behind, heightening the risk of burn-out and resulting in course cancellations.

They described feeling blindsided by the process immediately before Christmas.

The panel said the reduced funding was only confirmed in December, despite the contract coming into force on 1 January, which lead to timing it described as "not ideal".

A current staff member, who RNZ agreed not to name, said the cuts were anything but minor and disputed Health NZ's claim of boosted funding.

"I can definitely confirm funding has been significantly cut and it meant we lost nearly half of our staff at the beginning of the year," she said.

"It's significantly impacted our ability to support the sector and it's put our staff under a lot of pressure."

She said the restructure was taking a toll on staff.

"We're starting to see internally the pressure is building for people who are left, and it means the job is very unenjoyable, which then means senior and experienced staff want to leave," she said.

"When we get that sort of exodus of experience, you lose the crux of our organisation essentially, because it is such a complicated environment you can't just backfill those positions with anybody."

IMAC had pulled back on working with the university's nursing students and community work with Plunket, which were not considered a priority, while cuts to the 0800 IMMUNE line had the potential for serious flow-on effects, she said.

"We service about 150 calls a day and on busy days - flu season and that sort of stuff - it goes up to over 200 calls a day," she said.

"A lot of people will turn patients away because they don't feel comfortable vaccinating, or they'll make errors because they couldn't get the information they needed."

The Ministry of Health would not comment on whether a separate contract providing vaccine training, information and communications support in the Pacific Islands had also been reduced, citing commercial sensitivity.

A polio epidemic was confirmed in Papua New Guinea last month.

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