This week I haven’t been able to think about much other than the disaster which is occurring at the CDHB. Having a chance to listen to Sir John Hansen on Tuesday night didn’t settle my concerns.
Time and again I turned my mind to what a friend wrote to me some weeks ago that we are dealing with the struggle between ethics and economics.
To this I would add a struggle between leadership and faceless bureaucrats wielding enormous power behind politicians who aren’t asking the right questions.
When I consider the achievements of the staff at CDHB throughout the last decade as they faced their enormous challenges, the accountant in me wants to say to my profession, we’ve got it wrong. We’re measuring the wrong things.
I have asked a fellow accountant to search whether or not academic researchers in the Accounting profession have been considering the sort of perverse outcomes which CDHB has turned up. An institution which has amazingly positive responses to health challenges. It constantly restructured itself and changed to meet those challenges. Somehow, it seems that the accounting system is recording the wrong things.
The rest of New Zealand might write off what is happening down here as “Canterbury again”, but when they have large rebuilds all at the same time, they will have the same problems with finance as Canterbury is currently experiencing. CDHB is just the first through the door.
I received this from a Doctor in private practice on Saturday:
In the space of 20 days our DHB has imploded from a collaborative innovative world leading organisation running an operating surplus while saddled with historic structural debt, to a leaderless, shocked, dismayed, disillusioned organisation who will be less able to deal with the current and upcoming health challenges affecting it. Our local politicians on the ground should have been engaging with the senior management team and senior clinicians to find out what has happened to cause this implosion in the leadership of their local DHB weeks ago – an unprecedented breakdown that is made more concerning by the spectre of a Covid pandemic and largest hospital migration in NZ imminent.
I can understand Chris Hipkins, the Prime Minister, and Megan Woods dropping the ball on this – they have huge responsibilities dealing with the Covid crisis – but for Poto Williams, Duncan Webb, Ruth Dyson etc there is no excuse. Ironically by failing to do so they indirectly led to the political scrambling on Friday when there was a realisation from the Prime Minister and Minister of Health that what was filtering up to them from the board chair and ministry of health had led them to woefully misjudge the seriousness of the situation – if only some well-informed local MP’s might have been giving them more of a heads up!
We are right in the middle of a health crisis. Political loyalty to Parties and political rivalry between parties need to be left at the door. We need to all work on this together. I have written to Chris Hipkins (and received the standard “I am busy” email response, so it probably won’t be read) and stated my concern, and offered that I will do whatever I can to assist with this crisis. I do know that I will keep writing and speaking up. The Minister can’t take that off me!
Having sat and discussed this vexed topic with many people, and read numerous documents, and considered Sir John Hansen’s talk last week I have arrived at one conclusion. Sir John Hansen has to go, and, as he leaves the room, he should take the Crown Monitor, Lester Levy, with him.
Then the Minister needs to meet the people of this City, demonstrate real leadership and work on a plan which will settle the staff and people of this province down. It’s not good enough to make pronouncements from Wellington. We have had a gutful of that down here. That started with Gerry Brownlee.
You will just have to listen to us, Chris Hipkins. You should ask which members of the Board wish to remain. If some want to leave with the Chair then you need to fill the gaps with strong people. There’s plenty of people down here more than capable of finding a solution. It’s our health solutions we are talking about. Not Wellington’s.
If I were you, Chris Hipkins (and I think you are an able Minister) I’d start applying a large discount factor to the advice you are getting from the Ministry of Health. I’d engage the services of an underutilised Duncan Webb, the local MP, instead of leaving him outside your doorway. He was, after all, before going to Parliament, a Partner in a major law firm and before that a Professor of Law at Canterbury University. Instead of continuing the normal pecking order politics of Parties in Parliament you should use the skills of the man whose electorate covers much of the Centre of the CDHB’s activities. When you have Duncan at your side I’d sit down and ask the people of Canterbury what we think would work.
And I’d start by asking David Meates to re-consider his resignation.