Unfortunately, the DHB’s have been assigned to the dust bin of history. Within my lifetime I believe that future politicians will be asking how the hell we got the restructuring of the health services wrong, again. I was challenged last week to acknowledge that the reforms will be just what we need as a society. I completely disagreed with my correspondent, but isn’t that the beauty of democracy.
If you want to find what the future holds, think about what happened to an outstanding executive at CDHB which had the audacity to stand against the MOH.
The Democracy Project has just published the second part of a two-part series on the bureaucratic coup against the senior management team of Canterbury District Health Board, one of New Zealand’s largest DHBs which are responsible for community and hospital care for geographically defined populations. It highlights the fact that the Labour Government completely let the people of this province down by promising one thing before the election, and afterwards falling into line with precisely how the National Party had been behaving. All the local Labour MPs obediently complied with how their Cabinet colleagues expected them to behave. The rest is history.
The accusations made against the CDHB executive have focused mainly around finances. The article below covers firstly the Audit report of the finances of the CDHB by Audit NZ:
Audit NZ are the Crown auditors. This responsibility includes ensuring that audit results are tabled in Parliament. It is independent of crown agencies and departments. If one can’t trust Audit NZ’s financial audits, who can you trust?
Over the past decade of its audits Canterbury was either the highest rated DHB or in the top quartile of DHBs. Given that no other DHB (or other organisation outside Canterbury) had gone through a decade of natural disasters beginning with earthquakes, this is an impressive performance. It was rated ‘Good’ for both ‘Management control environment’ and ‘Financial information systems and controls’ for each of the 2016-17, 2017-18 and 2018-19 financial years. For ‘Performance information and associated systems and controls’ CDHB was rated ‘Very Good’ for each of these same years.
The audit for the 2019-20 financial year is yet to be published but it appears that CDHB’s high ratings continue. This is reinforced by reliable accounts that Crown Monitor Lester Levy, who described CDHB’s finances as being in a “terrible shape”, tried to contest Audit NZ’s assessment. This behaviour raises a serious ethical issue of appropriateness for a crown monitor.
If Audit NZ’s 2019-20 audit of CDHB finances is consistent with previous years, then surely those who have been blackening the reputations of the previous senior management team (and continue to do so) will need to reconsider their positions and the Government reassess their appropriateness to continue in their roles. If Audit NZ doesn’t bow to Levy’s pressure (there is no reason to believe that it will) then his credibility is in tatters.
The article concludes with:
To conclude with a touch of irony Health Minister Andrew Little is known to be highly impressed by Auckland DHB’s new Chief Finance Officer Justine White. CDHB’s Chief Finance Officer was a key part of the senior management team attacked by Levy for poor financial management. That person was Justine White. In February Little reappointed Levy crown monitor for CDHB. Words like egg, running and face readily come to mind.
The link is immediately below:
The second part begins by discussing the lightning rods that triggered the escalating clash between the conflicting leadership cultures of the Ministry of Health and Canterbury DHB in the context of the response to the 2010-11 earthquake devastation. The first part covered the period up to the general election and change of government in 2017. This started with the short-lived facilitated reconciliation between the Ministry and CDHB which was then followed by a smear campaign (aided by business consultants) against the financial management of CDHB’s senior management team and the role of key appointments by the Minister and Ministry of Health including crown monitor. It concludes by commenting on why and how this happened and its implications for the future under the Government’s intended health system restructuring.
The link to the first part of this series is https://democracyproject.nz/2021/04/15/ian-powell-a-very-bureaucratic-coup-part-one/.