Tracey Maisey recently started her role as the new CEO of the Northern NSW Local Health District. This is no ordinary job as health and hospitals have been experiencing severe staff shortages for quite some time, affecting their Bureau of Health Information quarterly reports. This is especially the case for Lismore, due to its housing situation. We wanted to know who the new CEO is and where she came from. Tracey found time in her busy schedule to talk to Simon Mumford.

I was born in Zambia, in Africa. I've got quite an interesting past. My parents are British, and my father was working there in the diamond mines. I left Zambia when I was six months old, so I don't know a lot about Zambia.

We went from Zambia back to England, where my sister was born and then my parents emigrated from England to New Zealand, and my brother was born. So we have quite an international family.

My parents were actually from the black country, Wolverhampton in the UK, but they went back to Kent, the Isle of Sheppey to be specific. It's at the bottom of bottom of the UK.

(Tracey and her mother, in the UK)

My dad was working there in a pulp and paper mill. He's an instrument engineer, and that's why they ended up immigrating to New Zealand. I don't remember much of the UK as a child. We emigrated when I was five.

I think my parents would say they wanted what was best for the children at the time. The black country is called the black country because of all the steel mills. There was a lot of industrialisation there and the steel mills were closing, because of the international impact from Japan and other places. Wolverhampton, alongside Birmingham, was becoming quite a depressed area. Jobs were hard to find and Mum and Dad made the decision that they wanted their children to grow up in a clean green country with opportunity.

At the time, Forest Products, which is where Dad went to work, was actively recruiting overseas and was bringing families over, and so my parents moved at a time when quite a number of families emigrated from the UK. They all sort of settled in Tokoroa. I'm pleased I did. I mean the UK is a nice place, but New Zealand is a pretty good place too.

So my parents went to Tokoroa, which is in the middle of the North Island. It's a large paper-producing area. We grew up in the middle of the Waikato, not far from Hobbit country.

At its peak, Tokoroa got to about 25,000 people. So, it's a pretty small place and its main employer was, at the time, Forest Products.

During the peak, when there were still newspapers, they had six pulp and paper machines operating. My dad's still in Tokoroa and I was there recently, I think it's down to one machine now. With the advent of technology, Tokoroa's population has gone down, but other things are picking up, you know, there's still a lot of big pine forests, so wood has sort of become king as distinct from pulp.

(Growing up in Tokoroa, Tracey aged around 8)



I went to Balmoral Primary School, and then I went to intermediate school for two years and then I went to Tokoroa High where I finished my schooling before I went to Waikato University in Hamilton, which is about an hour's north of Tokoroa.

During my school years, I did archery. That's how my parents met actually. My Dad, in particular, was a very good archer. He founded the archery club in Tokoroa. I won some national junior girls trophies in archery but when I grew up I just never kept it going. People have strengths and sports probably isn't one of mine. I'm an avid sports watcher but I'm not so good when it comes to participating in it (laughs).

At Waikato Uni I did a Bachelor of Social Sciences so I did geography and sciences. I was originally going to do resource management but the year I graduated, they changed the resource management act in New Zealand, and I would have had to do a year of law, and I don't think I've got the patience for law. So, I decided I didn't want to do that and I ended up working for what was called Housing New Zealand, which is the public housing provider.

So, I went from university to that job, and that took me to Auckland.

I quickly moved around in that organisation and was the Neighbourhood Unit Manager within a few years, and they basically managed all of the public housing properties for protected areas in Auckland. That was a pretty interesting experience.

I got to learn about how socio-economic disadvantage can really impact on health status and access, and so I've been quite a staunch supporter since then about holistic health care. Research shows that the social determinants can be more important than health care or lifestyle choices in influencing health. Numerous studies suggest that social determinants of health account for between 30-55% of health outcomes. In addition, estimates show that the contribution of sectors outside health to population health outcomes exceeds the contribution from the health sector.

I saw that firsthand when I was working in public housing as a public housing provider that sort of followed me through my career.

I've been married twice. My first husband got a job in Hawke's Bay, which is part of the North Island. I was looking for work and ended up getting a job at, I think from memory, the Area Health Service doing sort of business management and helping sort some of the medical and surgical services out and sort of fell into negotiating contracts with the funder. I don't quite know how I did that, but I seem to have a bit of a knack for it for some reason.

I gradually took on more and more responsibility and ended up being with the Hawke's Bay Area Health Service for a number of years before I split from my husband and decided I wanted to do something else.

At that time I met another man, Paul, who's my husband now, and we've been together for 20 years.

(Wedding – In Masterton NZ in 2013. L-R: Paul and Tracey with stepdaughters Katherine (L) and Nicole (R), and son Dylan)

Paul, has two girls, Nicole and Katherine, and they were both in Scotland and at that point, we had a child, Dylan. Paul said he really wanted to spend some time with the girls and I said I've always wanted to go to the other side of the world, so Dylan was one when we moved over to the UK in 2005.

I got a job with the Oxford Radcliffe NHS Trust. John Radcliffe was one the second largest hospital site in Europe and I was there helping with a whole range of things, including doing the Foundation Trust assessments. I was there for about three years in Oxford.

Paul, my husband, is a professional golfer. So, he was playing golf and bringing up Dylan and he got to spend a lot of time with his girls, which was really nice, really special.

I got a bit homesick and I wanted Dylan to go to school in New Zealand, Paul said ok, so I started looking for work in New Zealand. But I couldn't get any work at the time and then a job came up in Sydney.

A colleague of mine from Hawkes Bay had been working at the Northern Sydney Central Coast Area Health Service and said, Tracey, we need you, come over. It was good timing. So, we ended up moving over to Sydney for two or three years. I really liked Sydney.

Then Dylan was ready for school and I said to Paul I really want Dylan to go to school in New Zealand. I wanted him to spend some time with his grandparents, his aunties and uncles and people. So, I got a job as the CEO for the District Health Board in New Zealand in Wairarapa at the bottom of the North Island. It is a very good wine-growing region which, of course, was an added benefit.

District Health Boards in New Zealand plan and fund all services, including hospital primary community, public health, mental health, and an NGO sector they funded.

I helped make myself redundant by saying Wairarapa is too small to be a District Health Board by itself, we really needed to combine services with Wellington. I knew that I wouldn't be interested in applying for the new job, so I basically took myself out of a job. I then did some consulting work.

Dylan was going to primary school in Wairarapa in Masterton, so he grew up in a sort of country school, which was great. It was a wonderful education, really, a combination of real life, you know, tough it out and grow up and take a few knocks and bruises along with a really good education because the class sizes are quite small and the teachers are pretty focussed.

Then, I get a call out of the blue from Hamad Medical Corporation, which is an organisation in Qatar in the Middle East.

They employ about 30,000 staff and it runs about 90% of the public health system. They said we've seen your profile on LinkedIn, Tracey, we're looking for a Deputy Chief of Planning and Performance and we want to recruit from Australia or New Zealand because we like the idea of whole system thinking, would you be interested?

It's funny because my husband and I had always said we quite liked the thought of going to the Middle East. We love travelling and so we'd quite like the opportunity to travel.

Dylan was still at an age where he could move around a bit, so I went through the application process. At the same time, I was getting married, so I was organising my wedding at that time.

I got down to a shortlist interview, and I said to Paul, I need to take this a bit more seriously. Here I was trying to sort out this job as well as get married. They said they wanted to fly me over for an interview and I said okay, can I do that after I've got married? (laughs) I need to focus on getting married.

They flew me over to Qatar and obviously, I got the job and then we moved on a three-year contract.

(Tracey in Qatar in 2015)

Qatar is really not much bigger than the Northern Rivers actually. It's quite a small country, but there are 2.8 million people in the area. It's obviously Middle Eastern, it's Muslim, so it was a mix of Arabic in terms of government, but all of the health services the language was English.

There was a massive redevelopment program going on. They were getting ready for the World Cup so there was significant investment going into infrastructure. They had one and a half million labourers at the time working on infrastructure, new Metro, new motorways, it was just a crazy time. I was asked to try to help sort out planning and health services whilst building lots of big hospitals.

I don't know how much people know about the Middle East but Saudi Arabia is obviously quite conservative, and I wouldn't work in Saudi Arabia. Whereas at the other end, Dubai is very much westernised and very permissive. Alcohol is relatively freely available despite it being a Muslim country. Qatar is probably somewhere in the middle of that.

The managing director for Hamad Medical Corporation was a woman Dr. Hanan Al Kuwari and she subsequently became the Minister of Health. Women are treated well, like my views and my perspectives were welcomed and they were really clear that they recruited me for my expertise, and I was treated as an equal.

Culturally, there were a few things that were different. For men and women in the health system, the waiting rooms were separate. If you're a male under 12 you could go and sit in a woman's waiting room, but if you're over 12, you had to sit in the male's waiting rooms.

We were in Qatar for six years. I went over on a three-year contract and they kept extending, which was very nice. And then COVID came along. I was one of the incident controllers for COVID at a time when there weren't vaccinations. That was pretty interesting. There were labour camps full of COVID positive patients, and it was all pretty awful, really.

Qatar was like the third or fourth country in the world to contract COVID, so we were very early. Once it got into the camps, it just went through like wildfire. Fortunately, a lot of those individuals were quite healthy and quite well. But once it got into the Qatary population, who have a higher incidence of morbidity, we started getting some really difficult cases. It wasn't until some time afterwards that the vaccine came out, but unlike Australia and New Zealand, they didn't have time to close the border. It was just too fast. They did eventually.

We decided that six years in Qatar was enough. My son needed to finish senior school and because we've got British passports and were relatively well off, Dylan went to a private boarding school in Scotland, which had a golf academy attached to it. He's a very good golfer and I did a bit of consulting work virtually for the NHS from Scotland, and then got a job in New Zealand because I wanted full-time work. So, Paul and I and Dylan were apart for about 15 months. I was in New Zealand and Paul was with Dylan finishing his senior school.

(In Scotland in 2020 – Dylan, Tracey and Paul with dog Ziggy)

They were happy as I think my husband counted something like 40 golf courses within 30 minutes of where they were living. But most importantly, his daughter, and at this time grandchildren, were only three-quarters of an hour away, so he got to spend a lot of time with his kids, which was really nice.

We then spent two and a half years in New Zealand. We weren't going to move, we were going to stay put. My son had started university at Canterbury and I had a job and then the restructuring came along for all of Health New Zealand. I was seconded into a national role as Director of Strategic Planning and Performance.

I could have had that job but I thought it was too far away from the healthcare frontline delivery assignment. I'm pretty passionate about providing excellent health care services to our communities and it felt it was a bit distanced from that. I just didn't feel this was the right job for me at that time.

Then the Northern New South Wales CEO job came up. They contacted me to see if I was interested and they said Tracey I know you just landed in New Zealand and you didn't want to move but how about Lismore? And I thought, yeah ok, because our other daughter, Nicole, was now in Sydney and our new grandchild is one year old, Georgie, so we thought it would be nice to spend a bit of time with them. Plus, I did my homework on Northern New South Wales Local Health District and it's not too bad, like every health district, it has got some opportunities and challenges.

We went through the process and I got more and more interested as I went through the process, and here I am. Our family has moved around a bit.

(Extended family on holiday in Tauranga, NZ)

I've managed to get to all of the eight hospital sites, multi-purpose sites, and some of the community health services which is not too bad in the first three weeks. I think we did over 1,000 kilometres in the first seven days.

My first impressions are that we have a phenomenally committed, dedicated workforce who go above and beyond for the communities and the local health district. We've got some real energy and passion and I've been made to feel extremely welcome.

It's not without its challenges. In the health workforce across Australia and the world, there's more demand than there is supply. But there's a lot going for this local health district. We've got the Tweed Valley Hospital opening early next year.

Australia has one of the best health systems in the world. You look at the benchmarking, I think the Commonwealth Fund says that it's like the fifth or sixth best in the world. So sometimes we have to keep reminding ourselves of that.

That's not to say there aren't things we can improve on, but at the end of the day, if you come into one of the hospitals here, the chances of you having a good outcome are pretty high.