A health commentator isn't expecting new appointments at Health New Zealand to change much.  

The Government's appointed four Deputy Chief Executives to run different regions from next month.  

Ian Powell says if they come along with a change in culture, it could make a difference.  

He says there are bigger problems at Health NZ which need to be tackled.   

Powell says the leadership culture at the organisation is too top down when it comes to decision making. 

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