Health Boards’ merger less certain

Otago and Southland District Health Boards have been developing a closer relationship for some time.

They have a single chief executive and chair and have been consulting on a full merger.

Public meetings on the proposal haven’t been well attended which indicates people don’t have strong feelings on the issue.

The most heat about the the proposal was from Central Otago where people who are caught between board boundaries were in favour of the merge. They gave the example of someone in Queenstown who needs chemotherapy who has to go to Invercargill under the current structure but would be able to make the shorter journey to Dunstan Hospital if there was a single board.

However, Southland Hospital doctors wrote an open letter opposing the merger, just a day before submissions closed.

Dr Charles Lueker, who chairs the senior medical staff committee in Southland, said the letter was signed on behalf of “well over 90%” of senior doctors at Southland Hospital.

The doctors expressed concerns about services being centralised to Dunedin and the loss of the board’s advocacy for the people of Southland.

Reducing costs, sharing resources and providing more convenient service for many rural patients has a lot to recommend it.

It would be a pity if the merger which would do this was to fail at this late stage.

Southern DHBs to merge

The Otago and Southland District Health Boards are expected to merge.

The boards have been working closely together with some members from each sitting on both. A merger is the logical next step.

A merger of the Otago and Southland district health boards would immediately save a minimum of $500,000, with savings of at least $1 million expected longer term as duplication of board and committee meetings was cut, ODHB chairman Errol Millar said last night.

 It will also mean better service and some choice for patients, especially in Central Otago.

Cancer patients from Queenstown have to travel to Invercargill for chemotherapy treatment even though it could be provided at Clyde Hospital which is closer because Queenstown is covered by the SDHB and Clyde is under the ODHB. When the boards merge this sort of bureaucratic line drawing will stop.

The merge might persuade neighbouring boards in other areas to join forces too. Twenty one district health boards for a population of 4 million is administration overkill and a ridiculous waste of time, energy and money.

Sharing CEO sensible step

The appointment of a single chief executive for the Otago and Southland DIstrict Health Boards is a very sensible step.

Brian Rousseau who was the Otago CEO and has been interim CEO for Southland since last year will take on the joint role which is a first for district health board management.

The chairmen of both boards say the appointment enhances the strong commitment to regional collaboration over services, but neither is suggesting the boards should amalgamate.

I think that would be a sensible aim. There would be economies of scale and it would be welcomed by the many people on the heath board borders who want to use Dunedin services but have to use Southland’s and vice versa.

Otago chair Richard Thomsom said:

The appointment did not change anything fundamentally for the boards, but would make it easier to further develop a regional focus on services.

“As Brian would say, it’s difficult to argue with yourself when you’re the CEO of both boards.”

The boards have two services in common, Southern Blood and Cancer and cardiac surgery, and several senior management staff work across both organisations.

Two of the boards’ advisory committees share membership.

Southland chairman Dennis Cairns said the boards faced the problem of catering for populations spread over a large area.

The average number of health service users over the country per square kilometre was 13.1, compared with 5.6 in Otago and 2.8 in Southland.

In an area such as Counties Manukau there could be one hospital catering for 250,000 people, but in Otago and Southland there were seven hospitals.

It’s always going to be more expensive to treat people scattered over a large area than if they’re concentrated in one place. A closer working relationship between Otago and Southland ought to ensure that less is spent on overheads leaving more for services.

The Southland Times’ report is here.