For older people and frail people, the long-term benefit of medicines reduces and the potential for harm from adverse effects increases. When the benefit–risk balance changes in this way, medicine review and optimisation are important to simplify the therapeutic regimen, reduce inappropriate medicines and minimise risks. In this article, pharmacist prescriber Linda Bryant uses two case studies to illustrate important considerations during medicine reviews
Ministry starts new restructuring nine months after the last
Ministry starts new restructuring nine months after the last

“The changes are focused on the tier-two leaders”
The Ministry of Health has begun a fresh round of restructuring under its new director-general, Audrey Sonerson, just nine months after the last one finished.
Last September, the ministry’s latest formulation came into effect, involving the disestablishment of 247 jobs (30 per cent of which were vacant) and the creation of 124 new positions. The net reduction was 123.
Yesterday, the ministry told staff of proposed changes, mainly to its second tier of leadership, Ms Sonerson says in an email responding to a query from New Zealand Doctor Rata Aotearoa today.
“The changes are to ensure the ministry is structured to deliver on its strengthened focus on policy, monitoring and regulation,” Ms Sonerson says. “The proposed changes will merge four internal groups across other parts of the organisation and create two new ones. The changes are focused on the tier-two leaders within the organisation with minimal immediate impact on other staff.”
After last year’s restructuring, deputy director-general corporate services Celia Wellington said the health reforms refocused the ministry on its stewardship role and its strategy, policy, regulation, monitoring and public health responsibilities. Structural changes were necessitated by the reforms, government priorities, cuts in time-limited funding, and the Government’s requirement for savings of 6.5 per cent or $12.6 million a year from 2024/25.
Last month, RNZ reported that Health New Zealand Te Whatu Ora had confirmed job cuts at five divisions – Hauora Māori services, Pacific health, procurement, planning and funding, and auditing. The total confirmed net loss of jobs at the agency was 750, including more than 400 in the digital services team. Most of the positions had been vacated. Consultation with staff was continuing over proposed changes in three other teams.