Nigel Murray, whose spending as Waikato DHB boss is being investigated, previously led a Canadian health authority also investigated over spending and overcrowding.
Dr Murray spent $218,000 in three years at Waikato DHB on travel and expenses before resigning in early October.
The man who hired him, DHB chair Bob Simcock, told RNZ Health Correspondent Karen Brown this week that concerns raised about Dr Murray's potential appointment had been assuaged by the referees he had given them.
"When those issues were raised in the media and then raised by one or two of our staff members with me, we immediately went back," he said.
"We'd just completed reference checking - we went back to all of the relevant referees and put those questions that were raised with us to those referees.
"All of them rejected the claims that Ian Powell had made."
No one has said who those referees were, or what they said, even after Official Information Act requests.
However, Dr Murray was hired after heading up a similar organisation, as president and chief executive of state-funded Fraser Health Authority in British Columbia, Canada.
He quit that C$444,000-a-year job in mid-2014 as the highest-paid chief executive in its history, with no severance, just weeks ahead of the release of a government-ordered review.
The review was looking into "persistent fiscal difficulties and hospital congestion issues" with a focus on "the authority's operations and leadership".
"Several Fraser Health Authority hospitals have some of the worst results in Canada on various measures of patient safety and quality of care," it read.
As at Waikato, his travel expenses were high and raised attention.
"When he was at Fraser Health, Murray claimed $140,000 in expenses over an 18 month span in 2008 and 2009, with officials citing demand for his service at conferences around the world," British Columbia newspaperThe Abbotsford News reported at the time.
However, it was hospital conditions that prompted Global TV's Jill Kropp to interview him for 11 minutes, three months before he resigned.
"What do you say to these medical professionals who are really raising the alarm in a fairly public way about overcrowding, particularly in [emergency rooms]?" she asked him.
Mr Simcock hired him despite those problems, and despite complaints not just from Head of the Association of Salaried Medical Specialists Dr Ian Powell, but former Labour MP Sue Moroney.
She told Checkpoint last night she met with Mr Simcock in June 2014 because of media speculation that Nigel Murray was frontrunner for chief executive role.
"He had double-checked his referees and [said] that the referees that Nigel Murray had provided for him were glowing in their praise of him," she said.
Mr Simcock has refused to resign over Dr Murray's spending, saying it was not his fault.
"You know I don't see every invoice that comes into the organisation. I see the applications that are put in front of me for authorisation, and I authorise things that I believe to be appropriate," he told RNZ yesterday.
"There is nothing in the recruitment process, there is nothing in our investigatory process, and there is nothing that I believe that I have done over the last couple of years that would justify [my resignation]."
Some of Dr Murray's spending and travel was unauthorised and the State Services Commission is set to investigate.
The DHB's own investigation into it has already cost the DHB nearly $150,000.
An audit set to be released this afternoon was also withheld by the DHB today, which said the report was only a draft and more work needed to be done.