Pharmac’s recently released summary of an independent external review of their workplace culture concludes that their current operating model is “not fit for purpose” and recommends a reset of vision, strategy and operating model. The report notes that New Zealand is ranked 32nd out of 32 OECD countries for access to modern medicines and calls for a significant programme of change in Pharmac that will require “inspiration, tenacity and commitment from leadership”.
Organisational expert Debbie Francis was commissioned to conduct the review and her recommendations echo the requirements outlined in David Seymour’s July 2024 Letter of Expectations, which called for changes in organisational culture, roles and responsibilities, and methods and processes to meet these new challenges.
The Francis report follows that released by Kerry Prendergast who was commissioned by Pharmac’s Board to run two consumer engagement workshops aimed at resetting the organisation’s relationships with patient groups and advocates. Her report concluded that this aim was “too lofty and one-sided to realistically achieve over two days”. BCAC and other attendees concurred and penned a letter to Pharmac’s Board pointing out that meaningful change is unlikely until the underlying political issues of a grossly inadequate medicines budget and a restrictive statutory objective are addressed.
The Francis report notes that Pharmac’s current vision is vague and focused on managing costs, and that this is unlikely to inspire staff or drive the behavioural change needed for a wider, more positive focus on improved health outcomes for New Zealanders.
It also notes that Pharmac’s current strategy is set largely from the top-down, resulting in a Statement of Intent which is not based on wide engagement or co-creation with staff and stakeholders. The review recommends a complete strategy reset, including establishing a unit to forecast and respond to trends in medicines, ideally working in partnership with other industry and health system players.
The passion and commitment of Pharmac staff are acknowledged by the report. Pharmac has recently developed a set of values, but further effort is needed to create a workplace culture that reflects them. The report suggests that leadership will “need to reflect on how they can best shape culture” to meet the needs of stakeholders and the Government’s expectations.
When refreshing its operating model, Pharmac will need to consider the entire agency and treat this as a “single, integrated project and not a series of one-off sequential changes”, says the report.
Pharmac’s Board is currently seeking a new CE, as former leader Sarah Fitt resigned in February. Brendan Boyle has been appointed Acting CE for six months. Mr Boyle has set up a series of regular meetings with representatives of patient groups, including BCAC. “We welcome this new opportunity for communication with Pharmac’s leadership” says BCAC Chair Libby Burgess, “and look forward to hearing how the organisation responds to the challenges presented by the Francis report.”
4 May 2025
