The data which we produced in the last Tuesday Club notes about the miserable failure of CDHB’s Board of containing costs produced some interesting responses this week.
Before we reprint these comments maybe we could, in the interests of transparency and for the well being of our community, suggest of a cost saving for CDHB. We give this to you, the Board, in all sincerity. Send Lester Levy back to Auckland. That will save considerable funds for the CDHB. Don’t consider redundancy payments. We offer this to the Board and won’t expect consultancy fees.
Here’s some feedback:
When an annual plan is not signed off, all the financial and fiscal performance reporting is against the plan approved and submitted by the Board. The Board signed off the 2020/21 plan.
There have been times when Annual Plans are not signed off until into the next fiscal year.
The Crown Monitor / MOH all believed that it was possible to reduce the deficit by a further $50-60m without having any impact on services. All they have been able to do is deliver close to the previous Execs’ agreed deficit level of $145m.
Given that the Chair stated to the Health Select Committee that they would probably make some further savings and the Crown Monitor advising the MOH that it was entirely possible to reduce the deficit by a further $50-60 m and EY’s assertion that there were 200 too many nursing FTEs at Christchurch Hospital, the fiscal result is a “wee” bit disappointing.
The DHB have had 12 months to better the position forecast by the previous Exec. They had the EY review (which according to the OIA material stated: “no further specific savings initiatives were recommended by the review.”). They brought in ALMA Consulting to drive additional savings (and the MOH are supposedly funding that according to the OIA release). They did have an advantage that there was very little impact of covid during that 12 month (the current lockdown came after the financial year end) AND yet there was still a $4.8m deficit variance to the $145 deficit budget.
So, the question being posed. Really! Is that all? Your justification for the Exec changes was that they weren’t being serous about reducing the deficit and in fact weren’t being serous in proposing / agreeing to a $145m deficit.
My observations are:
Perhaps the previous Exec understood their business. An Exec team that delivered on its Board agreed financial budgets in 9 out of 10 years. The only year it wasn’t delivered on was due to a Board approved $4.0m Mental Health overspend to prevent a full-blown mental health crisis playing out in Canterbury due to the earthquakes that was being actively undermined by the MOH.
Here’s those dreadful results again:
When the Press asked Chair John Hansen for comments they reported:
Board chair John Hansen did not respond to a request for comment.
Of course, he didn’t. He had told a Select Committee earlier this year:
“In actual fact there might be savings because we brought in acting chief executives with the experience we felt were needed … but the other roles were filled by the people … who have stepped up. So, I don’t think there will be a financial impact.”
This comment really should be caste into a brass plaque and planted outside the CDHB Board building. A reminder of how a small group sold out to the MOH and destroyed an amazing leadership team in health.
What also worried me in the Press article, which is here https://www.stuff.co.nz/national/health/126220305/cashstrapped-health-boards-deficit-ballooning-despite-ambitious-savings-plan., was the comment from Andy Dickerson about not being able to comment publicly on the results.
I researched this comment and found that the State Services Commission had ruled in March, about the time that the health reforms were being announced, that:
Members must also consult with the board chair on any “proposal to make political comment or to undertake any significant political activity”.
This is dreadful. I voted for people to be my eyes and ears on the CDHB. If they are unhappy, I expect them to be able to say so. Publicly. I served on the Area Health Board (until we were sacked by Ruth Richardson in the mother-of-all-budgets) and there were no constraints put on any of us, elected or appointed, stopping us saying anything publicly. That’s what should still be in place. If I were on the Board, I would be telling the Chair I will say what I like. That’s what an elected rep is required to do, within reason.
This ruling is anti-democratic.