Commissioner for SDHB?

June 9, 2015

The Southern District Health Board may be replaced by a Commissioner:

The board has until Thursday to respond to Health Minister Dr Jonathan Coleman’s proposal to consider appointing a commissioner under the New Zealand Public Health and Disability Act, it was revealed yesterday.

A commissioner would have the powers and functions of the board, except for procedural aspects relating to meetings, a letter from Dr Coleman to chairman Joe Butterfield says.

”Based on the board’s previous history of failure to deliver on its annual plan expectations, I do not have confidence that the current governance arrangements are suitable for overseeing the strategic plan or delivering on the changes required in Southern DHB,” he wrote. . .

The SDHB might not like this but the boards of the smaller hospitals it funds will be relieved.

The proposed action follows months of uncertainty after Dr Coleman confirmed in February he wanted to replace Mr Butterfield with a new chairman, but no appointment was made.

In the meantime, proposed cuts to head off a projected $42million deficit in 2015-16 met opposition and put pressure on Dr Coleman and local National MPs.

About 1700 people attended meetings in Central Otago last month to protest against possible reductions to Dunstan Hospital services.

George Berry, chair of Waitaki District Health Services said the proposed cuts would result in a serious downgrade of Oamaru Hospital.

The cuts to funding of Oamaru, Dunstan, Balclutha and Gore hospitals would be serious for them and make only a small difference to the SDHB’s deficit.

They’d also add to costs in Dunedin Hospital when patients unable to be treated locally were transferred to the city.

I was deputy chair of WDHS from its formation in 1998 until 2005.

It and the boards of the other rural hospitals have had an on-going struggle to get their fair share of funds and the financial situation of the SDHB has deteriorated.

Sacking the board and replacing it with a commissioner is a serious step but one which must be taken for the security of health services in the south.

 

 

 

 

 

 

 

 

 


National working for and in the south #17

September 4, 2014

Fantastic Fact # 17:


Norovirus strikes Dunedin Hospital again

October 20, 2008

Dunedin Hopsital is in code black – it’s highest alert – as it tries to contain its second major outbreak of norovirus in recent months.

The last outbreak, in August, led to a ban on visitors and a cancellation of clinics and non-urgent admissions.

Last week the Oamaru Mail reported a high incidence of stomach bugs in North Otago but the cause wasn’t identified.


Too clean and too dirty

August 18, 2008

Dunedin Hopsital is closed to visitors and all but emergency, mental health and maternity patients because of an outbreak of norovirus.

It’s only a couple of months since the gastric illness swept through Gore Hospital and other hopsitals, resthomes and schools have also had outbreaks.

Southland principals say one of the reasons the infection spreads is that people don’t stay at home when they are ill. I wonder if another cause is lowering standards of basic hygiene and an increase in practices which reduce immunity.

My mother was a nurse and when I was a child we weren’t allowed to come to the meal table until we had washed our hands – and washed them properly. Now people tend to graze rather than eat meals and from my observations few bother to wash their hands before eating.

But it’s not just pre-dining hygiene that’s lacking. A New Zealand Food Safety Authority  survey showed that only 7.8% of people followed the 20/20 rule for hand washing after going to the loo – 20 seconds washing with soap and hot water and 20 seconds drying with a clean towel. But worse nearly 10% of women and 20% of men didn’t bother washing their hands at all.

Then we have the other extreme where life is too clean.  We use antibacterial cleaning products which may lead to the development of superbugs from the .1% that aren’t zapped by the cleaner; children aren’t allowed to play in the mud or with animals; and we become so fastidious we’re not exposed to germs which help build our immunity.

Maybe we’d be healthier if we  stopped worrying about clean dirt and became more particular about the dirty dirt.

If  Mum was here she’d recommend we get back to the basics of housekeeping with hot, soapy water and elbow grease; wash our hands more thoroughly and more often; and stay at home when we’re ill so we keep our bugs to ourselves.


Radical thought – put patients first

August 8, 2008

Now here’s a radical thought – Dunedin Hopsital’s emergency department wants to put patients first.

The simple premise of putting the patient first may help to fix Dunedin Hospital’s emergency department woes and save up to 50% wastage at the hospital, the Otago District Health Board was told yesterday.

Emergency specialist Dr Tim Kerruish asked the board not to make any radical changes in the emergency department until a pilot project to increase efficiency and optimise “patient flow” through the hospital had been given a chance.

The project is based on car manufacturing company Toyota’s way of thinking, which involves putting the customer – or in the hospital’s case, the patient – first, as well as looking at how the entire hospital system works and getting everybody working together.

Aiming for perfect patient care should underpin how and why everything was done at the hospital, Dr Kerruish said.

Wastage in hospitals was also “extraordinary” and common estimates of 40% to 50% wastage were probably applicable to Dunedin Hospital, he said.

Otago is one of two district health boards which are trialling the “Optimising the Patient Journey” project in their emergency departments.

I spent a lot of time in Dunedin Hopsital, sometimes more than a week at a time,  when my children were young. That is now a couple of decades ago, however more recent experiences of family and friends indicate that some things haven’t changed: the staff are wonderful but the system needs radical surgery.

Wary as I am of catch-phrases, the thinking behind “optimising the patient journey” sounds like a good idea for staff and patients. Especially as Dr Kerruish said it would come from staff generating ideas and solutions and did not require more resources.

Similar projects adopted in hospitals in United States and the United Kingdom had shown incredible achievements, Dr Kerruish said. Getting everybody working together would be crucial to the success of the project.

“The emergency department cannot fix its problems without help from the rest of the system. This includes GPs and other hospitals.”

For example, emergency department overcrowding was often the result of patients not being able to be transferred to wards which were full because ward patients had not been discharged early in the day.

My baby son had been a patient for about 10 days when I was told he’d be discharged “tomorrow”. When tomorrow came we waited all day for the consultant to come so we could go. By the time he got to us it was early evening but it was the middle of winter and we were 120 kilometres from home so he said it would be safer for us to stay another night. It was early afternoon the following day before we finally left – so we spent nearly a day and a half longer than we should have and the hospital had incurred the extra cost of that.

Another common problem was the way things were done often went back “years and years” and had never changed.

“We never take anything away . . . we just add it to it. We end up with this very complicated system and a lot of the time people don’t know why they’re doing stuff.”

Overseas experience showed staff bought into ideas when they could fix the “Why do I have to do this?” frustrations, Dr Kerruish said.

Putting patients first, simplifying the system, improving co-operation between departments, GPs and other hopsitals and allowing staff to fix the problems doesn’t sound difficult or expensive. I’m sure the friend’s daughter who spent all yesterday afternoon waiting in the emergency department would think it’s worth a try.


Dunedin Hospital runs out of beds

August 4, 2008

Dunedin Hospital has run out of beds for patients.

About 18 of 32 people expecting to be admitted today were last night contacted by staff and told their procedures or surgery had been postponed because of the high number of unwell people who were unable to be discharged.

The hospital reaches “code black” status when it has fewer than six beds available.

Yesterday morning it had no free beds and, by mid-afternoon, 33 people waiting for treatment in the emergency department, Otago District Health Board operations manager Megan Boivin said.

There was one available bed at 8pm and 26 people waiting in the emergency department.

If no beds became available last night, those patients would stay overnight in the emergency department or an extra bed would be added in each ward.

There seemed to be no single reason for the high demand. People were presenting with a range of problems from traumas to infections and flu, she said.

Usually, there would be a drop-off in admissions during a weekend. This had not happened and the emergency department had also been consistently busy.

Another reminder that Labour pledged to take more tax and fix health but have kept only the first half of their promise.


They’ve kept the wrong half of the promise

July 31, 2008

A Tuatapere courier driver has become blind in one eye while waiting for cataract surgery.

 John Harvey, 70, has been waiting for the surgery on his right eye since having the procedure done to his left eye in March 2005 at Dunedin Hospital.

And now he’s been told Southland Hospital’s ophthalmology department is accepting only sight-threatening referrals until further notice.

Remember how Labour promised in 1999 that if we paid a little more tax they’d fix health?

In spite of taking a lot more tax the health system is ailing which means they’ve kept the wrong half of the promise.


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