Last week I commented on the CDHB gloating about the MOH and the minister approving the latest CDHB budget.
From a senior person from within the DHB I received this:
It is galling to have the Chair of CDHB say “it is the first plan to be approved by the ministers of health and finance in four years, which showed the organization was moving in the right direction”.
Over the previous decade, Audit NZ (the external auditors of the CDHB who also report independently to Parliament) rated CDHB as the best performing DHB in NZ as follows:
- · Management and Control Environment – Good
- · Financial information systems and control – Good
- · Performance information and associated systems and controls – Very Good
The clinical performance of the CDHB has been amongst the very best in Australasia over the past decade. External review after external review undertaken on CDHB all showed that CDHB was a very efficient and cost-effective health system. Audit NZ in their discussion with e Board of CDHG regarding their last audit 2019/20 confirmed that the impact of the earthquakes and the need to replace so many buildings were the reason for the deficit NOT the underlying operating costs. In fact, CDHB over the past decade delivered on each of the plans signed off by its Board!!
The previous Executive had developed a credible plan to breakeven which was to be achieved in the 2023/24 fiscal year. What they did NOT agree to was a breakeven in 2022 /23 as that would have resulted in whole sale service cuts with over $100m of costs being removed – this was what the Crown Monitor and Chair and MOH wanted. This makes it even more incredulous that the Minister of Health and Minister of Finance have signed off a deficit of $149 million – THIS IS GREATER THAN WHAT WOULD HAVE BEEN DELIVERED. What is even more outrageous is the comment “The plan includes service changes but cautions they will require further consideration and discussion with staff, providers, the board and the Ministry of Health as they are developed and not all anticipated changes will progress”.
Just to be clear this means that there is NOT an agreed pathway to deliver on the “signed off” plan.
It makes you wonder what the current Board think that they are doing or have achieved. If it is achieving the following, then I guess you could say they have been successful
- · Creating a toxic / fear-based culture within the DHB
- · Dis-regarding relationships with clinical staff which are now strained, and in many cases broken
- · Dis-engaging and breaking relationships with primary care
· Wasting the past 18 months in ensuring that health services in Canterbury are well placed to deal with COVID as it becomes more of the norm in our community – why has the DHB not fitted out the empty space designed to fit 12 ICU beds (they have had 18 months to get that done)
- · Ongoing under investment in mental health services
- · Agreeing to a compromised plan for the next stage of Christchurch Hospital
- · Little visible progress on parking and access to Christchurch Hospital
We used to have a courageous Board and Exec who delivered. They guided our health system and community through the most trying of times including earthquakes, floods, fires, Whakaari / White Island, terror attacks and the initial response to COVDI in Canterbury, the impacts of 44 heath facility buildings being demolished while at the same time being rated as the best performing DHB by Audit NZ. And at the same time, they built an integrated healthcare system that was rated as one of the best in the world along with building a culture based on engagement and trust.
So, isn’t it fantastic that we have got a signed off Annual Plan? The only problem is should anyone believe it. This unfortunately is what our Chair, Board and Crown Monitor call progress!!
Ps the difference in 2019/20 between $243m and a budgeted deficit of $180m was solely due to dealing with a national process resolving how holiday pay has been treated nationally. Every DHB in NZ had a variance to budget as they were required to book the full impact of holiday pay .