Back to Columns

1 December 2006

MAYOR’S E-COLUMN

CAN WE FIX THE HOSPITAL?

One of the great shames of Wanganui is the inwardness and inertia of too many of its citizens. I am oft reminded of Yeats’ ‘The Second Coming’ whenever in discussion of quite why Wanganui has evolved the way that it has.

There is a line that reads “the best lack all conviction, while the worst are full of passionate intensity.”

And on many issues that’s true. The nay-sayers and the cynical outnumber and often overwhelm the positive and the doers. Virtually every one of council’s critics fit the former category – none of whom have ever been elected to public office because they are never prepared to do other than carp and criticize.

Contrast with the wonderful and unheralded efforts of Ratepayers Association operative Jason Todd and his wife. They organized a kids’ concert at the Opera House and raised $1,500 for the Child Health Taskforce.

Then there is the innate ability of those who should know better to allow themselves to be distracted from the big picture by minor and petty detail.

Child Health Services
The rundown of Wanganui’s health resources is, in part, due to that negativism but also to demographics.

The 2006 provisional Census stats marked the third consecutive census in which the region’s population shrank. I fear a good number of optimists, workers and go-getters have been lost in that shrinkage.

It was inevitable that the hospital – and hospital services – would suffer as a consequence. Health funding is based upon population and our DHB’s boundaries are probably too small to sustain a full secondary hospital. By ourselves – and that’s an important rider.

Recruitment and retention of specialists and clinicians has been the topical issue of late. We currently don’t have sufficient paediatric or obstetric specialists and that directly affects maternity, child health and gynecological services. It is possible other specialties could face similar problems in the future.

Again, a part of the reason is due to population loss.

Part is due to the relative attraction of a provincial centre against metropolitan areas where the demands are less and the entertainments more.

And part is due to the fact that the DHB reacted late – possibly, too late. The specialist shortage should have been anticipated and there are obvious and admitted HR deficiencies. None of which is a revelation and has been privately admitted by most DHB board members.

Hospital Redesign Project
Of course, my intention – along with my council colleagues – is not so much to worry about why and how we came to this impasse – but how we get out of it.

I was very pleased with the reaction of Health Minister Pete Hodgson when Dot McKinnon and I met him earlier this week. The minister appreciates the nuances that have created our current crisis. And that it will require his direct intervention to resolve the maternity/child health issue.

That public assurance this week – along with his avowed intent to ensure all future services are Wanganui-based – should give Wanganui people a good degree of hope and optimism.

We also met the NZ Medical Council this week to get clarification around registration issues. Wanganui hospital has been utterly dependent upon the recruitment of foreign-trained specialists. Something like 36 out of the last 40 specialist appointments at Wanganui hospital were of foreign-trained clinicians.

Getting a new – or rather, upgraded hospital – should assist future retention and recruiting. But I was interested in a letter from the Minister to the Whanganui DHB – dated 9 November – where the conditions as to the $30 million funding was made explicit.

In short, the monies will not be delivered until -

1. “models of care for paediatric and obstetric services having long-term clinical and financial sustainability”;
2. “a demonstration of how the models of care for paediatric and obstetric services affect co-location of service within the redeveloped hospital campus”;
3. “confirmation of commitment by other DHBs and health providers, to any collaborative activity associated with these models of care.”

And fair enough. I have no problem with these demands and neither should Wanganui. That the Minister has added the words “based in Wanganui” to Condition #1 above is very welcome indeed.

In other words, there must be a regional approach to finding a solution. Mid Central Health, the Taranaki DHB, Whanganui and possibly Capital Coast will all need to be part of that.

Which could mean that paediatricians and obstetricians are based in Palmerston North but deliver around the clock rostered care in Wanganui. That certainly seems feasible. Although it won’t be easy. That the Minister is taking a direct interest gives me more optimism than I possessed before Tuesday.

Good on Pete Hodgson.

Yeah, but our local DHB has to get its act together
That also requires some leadership, efficiency and teamwork from our local DHB – both at board and senior management levels.

Which is why I was stunned to learn that this morning [Friday] an emergency meeting of the DHB board had been called with the intention of sacking a couple of elected board members.

I understand that two non-elected board members –Kate Joblin and Ormond Stock – are leading the charge. Their political naivete is stunning – their timing simply appalling. At a time when all members should be trying to find solutions, some seem determined to root out those members who are voicing independent concerns.

To put it in context – it would be like my council trying to sack, say, a couple of councilors because they spoke out against a council decision. On that basis alone, we wouldn’t have a council. Even I’d be gone!

It’s time for the DHB – individually and collectively – to pull their heads in and work together to find solutions to the messes over which they have presided these past two years. If they can’t do that – they should get out and let the Minister appoint a Commissioner. The community needs leadership: not internal bickering and ridiculous witch-hunts.

Let’s hope wiser heads have prevailed by the time you read this column.

It is, officially, summer
Just in case you didn’t know. The first of December.

Is it my imagination or is Wanganui wetter than it used to be? Last summer was shocking and 2004/5 season ended with that mid-February weather bomb.

I would all in favour of global warming if it raised temperatures and produced more sun for Wanganui. On the evidence of these past few years, Al Gore still has a lot of work to do.

Until next week, hope you and your family stay well.

Cheers,
Michael Laws
Mayor