Finding a cure for Health Ministry dissonance
Why is the Ministry of Health so poor at doing what it’s told, and how can this be fixed? This is the crux of the independent report by Heather Simpson and Sir Brian Roche, who were brought in to babysit the ministry when the testing at the border wasn’t being done properly.
The report and its recommendations are yet to be released, even though a draft was sent to the Government two and a half months ago.
But the issues it seeks to address are not new.
On June 23, Cabinet had said border-facing workers would be regularly tested, but after the August cluster emerged, almost two months later, most of them still hadn’t been tested once.
The ministry had its own notes on the testing strategy, saying asymptomatic testing at the border wasn’t even viable.
Covid-19 Response Minister Chris Hipkins called the yawning chasm between Cabinet and the ministry “frustrating” and “disappointing”.
Director general of health Dr Ashley Bloomfield called it “dissonance”.
There is plenty the ministry has got right, and our Covid-free communities are a testament to this.
But it is also not the first time there has been such frustrating dissonance.
From June 9, no one was meant to leave managed isolation until they had tested negative, and they were meant to be tested on day 3 and day 12.
Then two sisters, who later tested positive, were allowed to leave early on compassionate grounds without a test.
It took a further week for the ministry to tell us how many other people – 53, it turned out – had been able to leave MIQ early without a test result, while hundreds of others had completed their 14-days but had only been offered a test.
You would think these would have been quick and simple answers to very pressing questions.
But the health system has become such a fractured consortium of different appendages and blurry accountability that getting basic information was apparently next to impossible. Same with contact-tracing. Running a national pandemic response to an immediate threat was not ideal when the country’s 12 public health units were all essentially blind to each other, all running different information systems— some even paper-based.
How they talked to the ministry, to the 20 DHBS, and to each other was all unclear.
This was a problem the ministry had to overcome in a hurry. And it did, but it took an independent review – by now-cabinet Minister Ayesha Verrall – to push those changes into urgency.
It took the sisters’ road trip and an uproar – from Prime Minister Jacinda Ardern, even – for the ministry to implement the predeparture MIQ test that should have already been in place.
For months, the ministry told the Government regular testing at the border was being rolled out. When the August cluster hit, the implementation challenges were suddenly more easily overcome.
It appears in these cases, then, that the ministry is the challenge.
The Simpson-roche report includes recommendations to harmonise the dissonance, but the report’s release is hardly setting speed records.
It landed on Hipkins’ desk at the end of August, but he revealed in early November Bloomfield hadn’t yet seen it.
The ministry also took exception to the findings.
But Simpson and Roche are no pushovers, and it can hardly be said that Simpson is out of her depth; her health system review is now the driver of the upcoming changes to the DHB system.
Labour’s 2020 election promise for a national Public Health Agency further underlines how unfit-forpurpose it thinks the current system is to handle a pandemic.
And Hipkins has already talked about streamlining the response.
The report will be released after the Government decides how to respond to its recommendations.
It may not seem important, given our Covid-free status.
The people let out of MIQ without being tested didn’t pass the virus into the community.
Testing at the border, if it had been in place, might not have minimised the August cluster.
But it could have been a different story.
— Derek Cheng is a New
Zealand Herald political reporter