Health Ministry puts MidCentral on performance watch
An investigation into the circumstances around the death of an infant hours after she was born has been launched by the MidCentral District Health Board.
Charlotte Barrell-Harding was born at 5am on August 11 at Palmerston North Hospital. She died 10 hours later.
A knot in her umbilical cord left her with irreversible damage to her organs and brain. Her parents Stacey Barrell and Kris Harding say if hospital staff had listened to their concerns Charlotte might still be here.
Barrell, who has had problems giving birth naturally in the past, had asked for a caesarean section.
Barrell went to hospital because she had not felt the baby move in a while. A blood test on the baby broke her waters and they proceeded to have a natural birth.
‘‘While we were in that room, I probably said ‘c-section’ about a hundred times,’’ Harding said.
Eventually, they were able to book the c-section, but that was then cancelled by their doctor.
‘‘If the c-section had been done, there still may have been complications... but they took that away from us.
‘‘I’m pissed off and upset and hurt that everybody could drop the ball so much,’’ he said.
Harding said all indications were that the baby was perfectly healthy until the day they went to hospital.
Harding said he asked the staff ‘‘why didn’t you listen to me when I said c-section? You know her history.’’
He said he was told they did not read her history.
Specialist community and regional services operations director Nicholas Glubb said Charlotte’s death was a ‘‘tragic outcome’’ and the DHB wanted to provide answers to the questions the family had raised.
The care provided to Charlotte and Barrell is being reviewed internally though a process known as a Root Cause Analysis (RCA). He said the RCA would establish the facts regarding what took place and the care that was provided.
Arrangements were also being made for an external independent clinical review of their care from a medical and midwifery perspective.
Regional clinical director Dr Digby Ngan Kee said that umbilical cord knots were not uncommon.
However, Glubb said the DHB expected the reviews to give a better understanding of what took place and the impact.
‘‘When we have the information and findings of the targets, which is made plain in the board’s meeting notes from August.
For the month of June alone, MidCentral spent $1 million more than it expected to.
For the year to June, MidCentral was expected to have a $2m operating surplus. Instead, it posted a $1.9m deficit.
The reason for the financial flip was not a lack of revenue – MidCentral banked $1.1m more than it thought it would – but increased spending. There was $4.3m more spent on outsourcing than expected, and the clinical supplies budget was out by $2.3m. reviews we will make that information available to the family.
‘‘We expect these reviews to be complete by late November 2015 given the structured nature of the review and the complexities of the issues involved.’’
Police are also investigating on behalf of the coroner.
Harding said the past five weeks, since his daughter’s short life, and death, had been hard.
‘‘I’ve got five other kids... that I have to be strong for.
‘‘I don’t know how I can cope at the moment... I don’t think I’ve actually grieved properly.’’
The family were left to decide when to turn off life support or
The ministry’s letter specifically referred to the June results as reasons it stepped up its involvement.
The watch change, made in August, means the ministry and senior MidCentral staff will meet monthly. The ministry will run those meetings, and use them ‘‘to work through the range of issues’’. A ministry spokesman said MidCentral had been moved from ‘‘standard monitoring’’ to its new status. It could go up to ‘‘intensive monitoring’’ once its performance was back where it should be.
While the Southland District Health Board was sacked earlier this year after forecasting massive deficits, there was no suggestion the same action would be taken at MidCentral, the spokesman said.
This notice comes while choose to send their child to Wellington Hospital’s neonatal intensive-care unit.
If she had been sent to Wellington, there was a 1 per cent chance of survival.
They decided to spend the little time they had left with their newborn daughter before having to say goodbye.
‘‘I got to sing to her and hold her. She was a beautiful little girl,’’ Harding said.
Harding and Barrell plan to spread Charlotte’s ashes next year, on the anniversary of her short life.
A givealittle page has been set up to help with costs associated with Charlotte’s funeral. MidCentral is going through its annual reporting phase, which includes revealing its annual financial result and reasons why targets were or were not hit.
In July, MidCentral chief executive Kathryn Cook said the financial result would be within 1 per cent of their $600m annual turnover. Some reasons for missing budgets included the ‘‘demanddriven nature of hospital services’’ and investments made in mental health, she said.
On Monday, she said MidCentral was already making changes before the monitoring change, including a review of financial functions. ‘‘We will also look to shift funding from lower priority service areas into areas where they will deliver better gains, particularly for our highneeds population.
‘‘We continue to focus on improving productivity, reducing any service duplication, increasing revenue, and looking at backroom functions, such as procurement.’’
While there have recently been changes in MidCentral’s management structure, they were unrelated to the financial position, Cook said. No-one had left as a result of the monitoring change.