The Government wants less health system centralisation - and it could lead to job losses

It's the focus of the Health Minister's latest letter of expectation to health bosses - released today.

Simeon Brown says Health NZ is too centralised - and it's frustrating local providers.

He's ordered a devolution plan by year's end - and wants decisions made in communities as much as possible.

He says the goal is better outcomes, not cost-cutting - but this could lead to a smaller Wellington head office.