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.

 

 

 

 

 

 

 

 

 


Sensible to investigate PPPs for hospitals

December 23, 2011

Health Minister Tony Ryall has asked the Canterbury District Health Board to investigate Public Private Partnerships for the $600 million rebuild of hospitals in Christchurch.

“This could include design, build and management of buildings, and some non clinical support services – while the DHB maintains full responsibility for delivering public health services,” says Mr Ryall.

“The process will explore whether or not a PPP may suit the Canterbury redevelopment. In the current economic situation, the Government expects DHBs to look outside the square when it comes to achieving value for money in capital projects.

“There is already a wide range of private involvement in the public health service – and similar public private infrastructure partnerships have worked well overseas.”

A decision on any public private partnership would be considered as part of the business case.

Considering PPPs is sensible, reasonable and moderate when so much money is involved and there is such an imperative to reduce debt.

But the PSA doesn’t see it that way:

“The Health Minister talks about future proofing Canterbury’s health infrastructure, but a PPP to build a new hospital, manage it and run non-clinical support services will be a black hole in which to pump tax payers’money,” says Richard Wagstaff.

The PSA is basing its criticism on British examples. It should look closer to home.

Oamaru Hospital is owned and run by a Waitaki District Health Services, a Local Authority Trading Enterprise. It provides publicly funded health services for the people of the district and also offers some private services.

It’s been operating that way for more than 10 years.

The PSA might prefer to have scarce money tied up in bricks and mortar rather than paying wages and providing services. The government is more concerned to ensure that every public dollar is spent wisely and where it would do most good and using PPPs to build hospitals could be one way of doing that.


No pay rise for non-DHB staff

August 27, 2008

Oamaru Hospital support workers are missing out on a pay rise because the Ministry of Health doesn’t recognise that staff at smaller hospitals aren’t employed by District Health Boards.

Last year the Ministry of Health provided DHBs with funds to boost wages for low paid staff but gave only enough to pay DHBs’ direct employees.

Unfortunately for Oamaru Hospital staff they are not direct employees of a DHB. They are employed by Compass Group which is contracted by Waitaki District Health Services and WDHS is contracted and funded by the Otago District Health Board.

This is not the first time Oamaru staff have been disadvantaged by the Ministry providing funds for DHB employees but not those at hospitals contracted to a DHB. Nurses missed out on Multi Employer Collective Agreement rates for the same reason in 2003.

I was deputy chair of WDHS at the time and remember the frustration as we wanted to work with staff to pressure the ODHB, ministry and government for more money. But the Employment relations Act stopped us from talking to staff directly, so we had to work through the union which called a strike.

Eventually the ODHB agreed to fund WDHS to meet MECA rates for nurses even though it wasn’t funded by the Ministry. However, someone didn’t learn the lesson and now Oamaru support staff – cleaners, kitchen workers, orderlies and security – are missing out on pay rises given to people doing the same jobs at other hospitals.

The Ministry doesn’t appear to realise how health services work down here. When what was then Healthcare Otago announced it was pulling out of rural hopsitals a decade ago the Waitaki District Council leaped into the breach and formed a Local Authority Trading Enterprise – WDHS – to run the hospital. It’s the only LATE operating a hospital and it’s been doing so successfully for 10 years except for the on-going problem over funding because the ODHB doesn’t get additional funds for staff not in its direct employment.

The charitable interpretation is that it’s bureaucratic blindness which prevents the Ministry from understanding that we do things differently in the provinces. A more cynical view is that its political ideology which won’t accept that publicly funded private hospitals work. But whatever the cause its the staff who miss out on pay increases.


Yes Minister approach to funding

July 30, 2008

Yes-Minister  approach to funding means Dunedin women are not getting treatment for post-natal depression.

Women with postnatal depression in Dunedin are missing out on support because a $140,000 service which should have gone ahead last September has not received Otago District Health Board funding, Plunket says.

Plunket Society operations manager for Otago-Southland Barb Long says lack of the service, which will proceed only in a limited way next year with private funding, is a huge gap in services.

She said the society, which had been identified by the board as the preferred provider for the service last July, was only advised in May that the board would not be funding it.

Board chairman Richard Thomson said while he understood Ms Long’s disappointment, it would have been irresponsible for the board to introduce services it could not fund in the long term.

He describes the board as being stuck in a “Yes, Minister” situation (a reference to a British television programme which highlighted the foibles of bureaucracy) where it may get money to start up a service but not be funded to sustain it.

This is not the only Yes-Minsiter aproach to funding in the region.

Oamaru Hospital bought a CT scanner last year but the ODHB which holds the contract for scans will not pass over payment for North Otago patients. This means North Otago patients who qualify for ACC are getting scans locally but other people have to travel to Dunedin Hospital for publicly funded scans or pay to have them in Oamaru.

This is a ridiculous situation when Oamaru has the equipment and the expertise to provide the service while Dunedin has a waiting list for scans and it is a three hour return journey from Oamaru to the city. 

If people require a scan funding shouldn’t be dependent on where they get it.


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