Sensible to investigate PPPs for hospitals

23/12/2011

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

27/08/2008

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.


ORC Backs Dunedin Stadium

11/06/2008

The Otago Regional Council has voted 7-4 to back the proposed Awatea St stadium in Dunedin which will replace Carrisbrook.

The decision commits the Otago Regional Council to a contribution of $37.5 million towards the $188 million project. Councillors now have to discuss the details of the funding.

One of the decision will be whether or not to impose a rate for the stadium – and if so how. Rates are never popular and if people are rated on capital values farmers will pay proportionally more because their properties are worth more than the average 1/4 acre urban property.

The stadium concept is attracting vocal opposition, as these projects always do. I was a director of Waitaki District Health Services when the decision was made to build a new hospital in Oamaru, it wasn’t a popular move but people have forgotten that now it’s up and running. 

At the same time there was a proposal to replace the old outdoor swimming pool with a new indoor one. It too attracted heated opposition – now some of the most vehement opponents are among the frequent users.  


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