CDHB Chat Questions/Comments 18 August Tuesday Club with Sir John Hansen, Chair of Canterbury District Health Board
///// what do you know about the CDHB
- I am disappointed by Meates leaving
- Ta Mark is on the board
- dismayed at the departures
- Is the CDHB now getting its full population funding allocation
- Gravely concerned about staff wellbeing and patient care
- It provides amazing services to Cantabrians, is full of hard working health professionals who have our best health interests at heart, is underfunding because of shitty public policy
- CDHB has a reputation of challenging MoH, which is to be encouraged.
- Why are the elected members of the Board so quiet and invisible?
What is the primary point of accountability for the CDHB – Is it the Government? The Ministry of Health? the People of Canterbury? The health of the People of Canterbury?
Why have the Board Members not spoken about what is happening??
Are the records and decisions of the Capital Investment Committee available for the public? Without Official Information Requests?
Does John accept that those DHBs that had to have recent major capital works have bigger deficits than those that don’t and that no DHB has yet to incur major capital works of the magnitude of Canterbury?
Does JH agree that most of the deficit is due to the capital charges ( including on insurance paid for buildings), the increased in depreciation costs due to the earthquake ( more than 50%more than the average of other DHBs) and the increased expenditure from Acute Services Building being > 2 yrs late ($20 million for outsource surgery alone) .
As a GP I am very worried about the prospect of any further reductions in specialist support – we have been seeing real difficulties in some services. Most of our ENT referrals except for cancer aer being declined, we have virtually no dermatology service, hardly any help with type 2 diabetes, higher thresholds for orthopaedics etc etc. We feel the problem lies with the level of funding from the Ministry and the people of Canterbury should not be penalised.
Why does not CDHB stare down the government more and for longer than it did over both the latest hospital rebuild business case and the deficit as it did do previously?
It is concerning that under this elected board CDHB has seen a mass exodus of senior management who have the full support of the Senior Clinical Leaders. Is it just coincidental, or is the trajectory of the CDHB Board for the future of our Canterbury community not something that our team are willing to carry out. Therefore, they move on. Should we be concerned.
What part did you a chair of the board have to play in the resignation of David Meates and the other senior staff?
Q 2. – How does he and his Board plan to reduce the deficit ( which is due the capital charges, depreciation/increase costs from the late completion of the Acute services building) WITHOUT cutting services?
Did the CDHB buy a Lotto ticket?
In this context equity is a red herring – we have a high proportion of Maori patients and do not see that they are disadvantaged any more than other people living in equal poverty and unable to afford private care.
The three largest areas of total Crown expenditure for the 2018/19 financial year were:
- Social security and welfare: $34 billion
- Health: $18.7 billion
- Education: $15.3 billion
These figures are taken from the Analysis of Expenses by Functional Classification – Total Crown Expenses in the Financial Statements of the Government of New
What is the update on the new hospital (opening times) and why do I feel that as a resident of chch that I am being penalized for the delayed opening and construction issues if it?
Do you think you can make money from healthcare – is that the aim?
The CDHB has a considerable property portfolio.Are there better / more innovative ways of leveraging off this to generate operational spending or raise capital?
Why did the Board not agree to the suggested Budget that the Senior Exec team had put forward which cut the deficit by some $57 million and instead insisted that the Senior Exec Team should decrease it by another $50 million ? This would not be possible without cutting serivces .
Irrespective of numbers around capital charges or anything else, here we are with the challenges of one of the biggest hospital migration/expansion in NZ, amidst largest public health crisis in a century (we could be weeks away from a Melbourne situation that will stress the healthcare system to the limit) and the actions of the board have contributed to the sudden resignation of 5 locally, nationally and internationally lauded EMT who have the full support of the clinical staff behind them. I wonder whether the boards contribution to this situation has now left CDHB staff and Cantabrians worse off, with less resilience and less able to manage these very real challenges?
We are facing the issue that we cannot fund the level of health care we are currently practicing. While there is inequity in the application of limited funding, surely the key issue is that we need to start working differently and that the health system is resistant to re-evaluating how it works.
The answer on senior staff departure was very evasive.
Why was some of these ‘excellent people’ not given interim CE? The 5 top people leaving at once does not just ‘happen’ in my 50 years in health. Is the clearly divergent directional thinking fixable?
The budget deficit is not operational. Is the board going to accept that to ‘get into the black’ the health of our community will suffer because the board will not challenge the financial methodology.
yes ,Why are operational cuts being used to fund structural deficits ? the board should not be supporting this . and why isn’t the cost of delay to Hagley being taken off the deficit/ bill
Why has the board stood against their senior administration, and not with them?
Against their Exec and Clinical Leadership
Sir John stated that one way to deal with a budget deficit is to bang the table in Wellington more loudly. The other way is to crack the whip in Christchurch. Does he agree that his board has cracked the whip louder than it has banged the table?
we cannot deliver the level of care canterbury patients are used to , ask the GPs . we have been declining referals due to capacity since terror attacks / white island / covid . we are still not ” open ” as BAU but yet the board concur with supporting the more severe cuts rather than back the clinicians concerns in their response to MOH .
What is the mandate of the Board in regards to their duty to the community of Canterbury.
yes you report to the minister but the elected members are accountable to the Canterbury community – or should be,
Pardon, our operational budget is in the red?
From memory the capital charge is 6% but there isn’t transparency over 6% of exactly what.
At least Andrew Dickerson has made his views public in a letter to the Press today
Does JH agree that David Meates and his team have been acknowledged as some of the most innovative and put in place some of the best cost-effective systems in Health internationally – Does he agree that it will be harder to reduce this deficit when his Board has lost such talent
There are regular league tables published showing how the DHB’s compare with each other. Are we going to lose ground?
$145million deficit is about 8% of annual turnover of CDHB. Surely that deficit is recoverable over 2-3 years?
Rod, that assumes that savings aren’t already being made
What about the CDHB hosting some conversations about the Heather Simpson review and the community and where to from here?
There have been 4/5 commissioned investigations into the CDHB finances with the same answer. The CDHB Exec team are doing very well. This Board commissioned another. What answer are they wanting?
The objectives of DHBs are set out under s22 of the NZ Public Health and Disability Act 200022Objectives of DHBs
(1) Every DHB has the following objectives: a)to improve, promote, and protect the health of people and communities:
not to balance the books?
under s22ba it states: (ba) to seek the optimum arrangement for the most effective and efficient delivery of health services in order to meet local, regional, and national needs:
and what if the savings dont work and services drop off …inequities increase , what will the board do then ?
s22 is quite clear – the board’s primary responsibility is to its community
- thank you for a very interesting evening.
- Great session! thanks GM and JH.
- thankyou for fronting up John – good job Garry
- Thank you for coming along John and hosting it Garry.
- I have more respect for Sir John by fronting versus what I read in the media.
- I’m certainly not reassured by anything we’ve heard.
- Thank you Garry for an excellent session!