Garry has put together some interesting articles on the CDHB – worth perusing, including a letter to and from the Minister of Health and several OIA requests.
1. A letter from the Minister of Health:
I received a letter from the Minister of Health this week. In the letter he included:
“There is absolutely no doubt that Canterbury DHB staff have responded superbly to the significant challenges they have faced over the last ten years including the Canterbury earthquakes, the Christchurch mosque attacks and the COVID-19 pandemic.
It is also the case that over the course of the last three Budgets this Government has significantly increased DHB funding, including Canterbury DHB funding, following 9 years of under-funding. In these circumstances I am confident that the funding we have provided to Canterbury DHB in recent years means that they are able to deliver a sustainable financial plan without cuts to services. I have similar expectations for all DHB’s, although I expect most other DHB’s to achieve a break-even position more quickly than Canterbury.
I am having ongoing conversations with the DHB Chair, Sir John Hansen, about the best way to both maintaining services and achieve a sustainable financial plan. I recently spoke with the Director-General of Health, Dr Ashley Bloomfield, about his visit to Christchurch on Thursday 27 August. It was useful to hear Dr Bloomfield’s feedback following his meeting with Board members, staff and senior managers. I will have further conversations with the DHB and the Ministry of Health in the coming weeks and months.
I have had considerable experience in public finance over the past few decades. I have maintained an interest in Health finance since spending time on the Area Health Board, appointed by your predecessor, Helen Clark, when she was Minister of Health.
I cannot understand how you could state in your recent letter to me:
“I am confident that the funding we have provided to Canterbury DHB in recent years means that they are able to deliver a sustainable financial plan without cuts to services.”
How, precisely, can you sign your name to this statement and express such confidence that there will be no cuts to services? Have you a different definition of what makes up “services” than people in Canterbury? Would you bet your house on your statement being correct?
It was interesting to note in the Minister’s letter that he made no references to lobbying by local MP’s. So, my message to you, our local MP’s, I think you have been pissing into the wind if you expect the MOH to back down on a position they have had towards the CDHB for years. Is deluded Chris Hipkins the latest puppet in their game? It’s time for Hipkins to sack the Board and start afresh.
2. Official Information Act request:
I have submitted the following OIA:
Could I please have copies:
- of all correspondence between the Ministry of Health and the Minister of Health and all documents of advice, on the handling of the Canterbury District Health Board deficits.
- Copies of written advice from the Director General of Health to the Minister following his visit to Christchurch on the 27 August.
- Correspondence on the decision to appoint Sir John Hansen as chair of CDHB and all subsequent correspondence with him about the appointment of other Government appointed Board members.
- All correspondence between the Chair of the CDHB, Sir John Hansen, and the Minister and the Department of Health.
3. Ian Powell’s article on CDHB this week:
Ian Powell continues to follow the CDHB debacle with the precision of a surgeon who has had a lifetime at the end of a knife.
His comment on the new “temporary management team”:
Health Minister Chris Hipkins has disingenuously claimed that CDHB now has a new senior management leadership team implying that things are back to normal and there is nothing for Cantabrians to worry about.
In fact, what CDHB now has is a temporary decent but relatively inexperienced chief executive from a DHB – Nelson Marlborough – much smaller than Canterbury (who will soon be replaced by a more inexperienced temporary chief executive whose career prospects are shaped by being in the armpit of controversial crown monitor Lester Levy) and others who are acting up in the senior management roles.
The Minister is correct in one sense, however. CDHB has an in effect new senior leadership cabal comprising both the politically appointed Lester Levy (crown monitor) and John Hansen (Board Chair) along with Director-General Ashley Bloomfield through his Health Ministry. Cabals comprise a small group of people united by a common design and often functioning with a level of intrigue. It appears that EY consultants can also be thrown into the cabal mix but that’s a subject for another blog.
Meanwhile the ‘new senior management team’ are well-meaning people required to do what they are told. They are not required to provide advice that the cabal doesn’t want to hear. After all, to do so would not be in the interests of employment security, let alone career enhancement.
He concludes by saying:
Health Minister Hipkins is not responsible for causing Canterbury’s health crisis. This was well underway before he took over the portfolio. But he is responsible for fixing it. He needs to front up and provide firm principled leadership. He can’t leave the current debacle to further deteriorate.
4. Article by Mike Beard on CDHB:
Dr Mike Beard worked as a Medical Specialist for 30 years for the CDHB. During the late 1990s he was a Medical Advisor to the CDHB and was a member of the Hospital Advisory Committee. He wrote an opinion piece which was printed in the Press this week. He concluded with these recommendations:
Of course, the key question is what can be done to address these issues. I have some suggestions:
- Appoint a Commissioner and thus remove Sir John and the current Board. The Commissioner will need to have the power to increase CDHB funding. This will be needed to enable the CDHB and the MOH to achieve a compromise, and then work together in a collegial manner.
- Remove the Crown Monitor.
- Recommend to the Commissioner that a six-month contract be offered to Meates, Mary Gordon, and Sue Nightingale to ensure continuity of Covid-19 management, and the efficient transfer to the new Hagley hospital.
- Require the Minister of Health, currently Chris Hipkins, to review the financial issues clearly described by Meates in his CEO Update of August 31. He must show more flexibility than the two previous Ministers of Health have done in order to resolve this crisis.
- Decide how to run the many differing services required to maintain high quality services of all types in the Canterbury DHB, consistent with the funding increase allowed.
Here’s the link to the article https://www.stuff.co.nz/the-press/opinion/122740715/what-should-be-done-about-the-cdhb-crisis
5. Lester Levy
For the life of me I cannot understand that a man who was used by the National Party as a hard-arse to review DHB funding, was appointed as a Crown Monitor by the Labour Party which had campaigned against the injustices toward CDHB when they were in opposition. After listening to him being interviewed by Kathrine Ryan on RNZ recently I personally find his sort of analysis quite offensive.
So, I have sent off another OIA request requesting:
- All the documents from the Ministry of Health advising the Minister of Health on why Lester Levy should be appointed as a Crown Monitor of CDHB.
- Copies of all advice given by Lester Levy to the Ministry of Health, and the Minister of Health, on the Canterbury District Health Board finances since he has been appointed as Crown Monitor.
6. Catherine Chu CDHB Board member speaks:
At a candidate’s meeting this week James Dann recorded Catherine Chu’s answer to a question about the disaster at the CDHB, which she had voted for. She was asked what she thought of the situation and what was her role in it. Her answer is published verbatim:
How do we address this deficit situation, how do we liaise with not only the staff but also the Ministry, but also the community, because we’re elected there for the community?
The loss of organisational knowledge with senior management being exited, I think that the Ministry really needs to step up and show leadership, and I’m quite optimistic because we did have Dr Ashley Bloomfield come down to Christchurch and begin conversations and I believe that they are quite open minded as to what the next steps should be. The management has made the case quite clear that the $60m of the deficit is due to the facility delay such as the Hagley Building and the National Party if we were elected in government we would remove any hurdles that were in the way of not making this happen and we’d make this happen as soon as possible.
My question would be why did the government top-slice $94.8m of funding for CDHB this year, the biggest increase in dollar terms of any DHB? But my response as a National Party candidate is that National will provide clear leadership because I think it is time that the Ministry did step in. I do think that it has got to the point unfortunately and I’m very realistic of the position in the board is in, I get a lot of feedback that the community has lost confidence in the board, so I do think it is time that the Ministry showed leadership and the Ministry did step in in order to resolve this quickly. I always say this time and time again, but trust isn’t something that you can just get with a click of a finger, it is something that is earned. While the community has lost trust in the health care system in Canterbury, I think we really need to work hard to restore that trust with the community. I think the only way now at the moment to be able to do that is for the Ministry to step in, and if National was elected into government we would show strong leadership and step in to make sure this issue was resolved.
Catherine admitted the community had lost confidence in the Board and mentioned that the Ministry of Health should step in 5 times. She was asked why she doesn’t resign to show her understanding of the magnitude of what she has been part of.
In my opinion Catherine Chu has been placed in a position of possibly winning a seat in Parliament way before she is ready. She needs to learn the art of politics.
She has not demonstrated a skill base which would serve her, or the voters of Banks Peninsula, well. She should have gained her confidence at the Council table over a number of years. This is the perfect place to learn how to debate, and how to convince your fellow elected reps what should, or shouldn’t, be passed.
I will make a prediction. If Catherine Chu is elected to parliament next month her career will be a short one. She is not ready for what is in front of her.
Here’s what the Press made of Chu’s comments https://www.stuff.co.nz/national/health/122797105/wannabe-mp-catherine-chu-raises-doctors-eyebrows-over-hospital-comments.
7. Petition by the PSA:
The PSA has a petition to sign on the disaster of the CDHB. Here’s the petition:
Stop the DHB cuts
We, the undersigned, call on the government to:
- End all requirements for aggressive debt reduction and the proposed clerical and allied staff job cuts by the DHB, and
- Work with unions, NGOs and tangata whenua to confirm what level of service Cantabrians need and commit to the funding for this to occur.
Please sign it https://www.letsdoevenbetter.nz/sign_up_to_stop_the_dhb_cuts
8. The “acting-acting” CEO hides behind not allowing public information:
Here we go. The new “acting-acting” CEO is already hiding behind “not in the public interest” smokescreen in the article below. They have started using a term “rip-cord” to describe, I guess, what can be removed. Are we entering an era of “Levy-speak”? A new variation on Animal Farm. All pigs are equal. Some are more equal than others….” Especially when some can operate behind the scenes working as a puppet master.
I kept hearing from MP’s that CDHB was undertaking tasks that it was not funded for. Last week we printed the response to this from the old CFO and her colleague. Then along comes this accusation again from the mouth of the acting-acting CEO, I assume speaking on behalf of their puppet masters.
Here’s what the Press wrote about these cuts which are cloaked in secrecy:
A communications FAQ document for managers, seen by Stuff, says some services “we are not obligated to provide by the Operating Policy Framework will need to be reduced or removed”.
The “discretionary services” were being reviewed “against the level of impact on patient care and the complexity involved in altering or removing them from our health system”.
Any decisions would require consultation with providers, and approval from the board and the Ministry of health, the document says.
A programme management office had been established, with a team of 10, including three clinical staff “who have picked up supporting the PMO within their current work portfolio”, acting chief executive Peter Bramley said.
He would not reveal which services were discretionary, saying it was not in the public interest.
Pegasus Health chief executive Vince Barry said using the phrase “rip cord” for health services was in poor taste.
Barry said a reduction of $500,000 to the “acute demand management service” would have “potentially catastrophic” results, including quickly overloading the hospital emergency department and “a very poor experience for the people of Canterbury”.
“You can call it discretionary but if you don’t spend that money then, your non-discretionary money going to services becomes highly inefficient.”
The acting-acting CEO will be pining for the quiet life he left, wherever he came from. This region is angry and he will find that hiding behind “not-in-the-public-interest” arguments don’t go down very well here. The Government has stuffed up by backing the MOH’s venom towards our local institution and we won’t rest until heads roll and a sensible solution acceptable to us down here is found.
9. We’re putting together a review team on CDHB finances:
We are assembling a small team of individuals with considerable accounting and technical skills to review the CDHB’s finances. We will review the accounts with the precision of a forensic accountant. The exercise will involve an OIA search through MOH and Treasury documents.
We don’t need too many people involved but if you have skills which could be useful please contact firstname.lastname@example.org.