Glossy goals are not a strategy
The Southern District Health Board has been pulling in hasty responses from the general public in the last spasm of consultation for a handover document for the incoming Health New Zealand and Mā ori Health Authority that will replace health boards at the end of the month.
In truth, anyone expecting to be commenting on a farsighted visionary perspective would find it more kaleidoscopic than strategic.
Shiny goals that most people would have scant problem agreeing with are emphatically presented. But the work to achieve them is hardly made clear – depicted more by signposts of intentions rather anything as thought-through as pathways, the potential effectiveness of which might be judged and usefully commented upon.
Still, the outgoing DHB needed to prepare this and, to that end, it has earlier consulted with more than 80 stakeholders.
That wasn’t a bad start, though plans for a useful roadshow to connect the wider public with the emerging vision were confounded by the pandemic fallout’s burgeoning workloads.
With scant time left before the new entities take over on July 1, a super-short survey form for last-ditch feedback was made available a week ago.
It truly reads like a box-ticking afterthought.
It asked how strongly people agree or disagree with a handful of statements – among which was that we already ‘‘have an available, robust and well-trained workforce, suitable to meet future health needs’’.
We should add there was provision for people to explain their answer. But if you actually agreed with that statement, almost every single member of that fully functioning workforce would probably want a word with you about how hard they’ve been struggling in what’s widely regarded as a crisis of service delivery.
Another statement for feedback was that, ‘‘we will achieve better health outcomes if we focus on providing ‘closer to home’ health services within communities’’.
The question is not airily asked. The document proposes that Southland be divided into Gore and the rest of Southland as two localities. What the implications of this might be is surely unanswerable without a great deal of information that is . . . let’s see . . . nowhere in sight as yet.
Whether our present system is whā naufocused and patient-centred, and whether a more central role for Mā ori will address inequality issues, are questions that are reasonably enough on the survey.
But in the context of a report days away from the transition date, these questions are popping up a tad late in proceedings for the outgoing board to do anything other than pass them on for the new agencies to make of them what they will.
What of more specific plans? Given that the Southern DHB has voted to prioritise capital funding for a fifth operating theatre and emergency department expansion at Southland Hospital, there’s now some curiosity about whether this work will go ahead under the new health structure.
Nothing in the transition document directly speaks to that level of detail.
What we do get is such ringing declarations as this: ‘‘Public health expertise in the region should be engaged to support the establishment of effective population health structures and programmes in localities. There may need to be investment in public health resources – as these resources are currently stretched.’’
Oh there may, may there?
The new agencies will have towering decisions of their own to make, and have issued assurances that local voices would be heard. But in a terribly over-stretched time, the transition document is far from the useful briefing it could have been.