Govt’s move on Canty health
The relationship between the Canterbury District Health Board (CDHB) and the government plumbed new depths this week as local doctors launched a co-ordinated counter-attack to an earlier ‘‘Pearl Harbour’’-style raid from Wellington.
The latest skirmish flared up when Treasury unleashed a blistering critique of the CDHB’s performance, particularly its board members, last week. Through a series of advisory documents to Finance Minister Steven Joyce published on its website, it cast board members as obstinate do-nothings; unwilling to pull management into line on governance and spending and partial to using the media to heap pressure on ministers and secure more funding.
The CDHB did not flinch in responding. In an opinion piece, Dr Alistair Humphrey, the deputy chair of the Canterbury Hospitals’ Medical Staff Association, which represents more than 500 of the region’s senior doctors, likened Treasury’s move to the surprise Japanese attack on Pearl Harbour in 1941, ‘‘coming out of the blue and without any local consultation’’.
He said the CDHB was essentially being punished for implementing a cost-saving patient management system over the past decade – having proven its fiscal prudence, it was now being asked to do more with less.
At the heart of the debate is funding, which has been a sore point for years, more so since the earthquakes. The CDHB says it is being short-changed by a population-based formula that sees it get less money per capita while demand for services, especially in mental health, grows.
The Government rejects that, and says that if the CDHB read the demographic data properly it would see Canterbury has a falling share of older people, who cost the health system more, and that its mental health service capacity is comparable to other regions. Its chronic financial woes (it faces a $61 million deficit this year) are a result of its own mismanagement.
The stand-off has consisted of each side essentially repeating these arguments and the time has long passed for one of them to break the pattern. The onus here is on the Ministry of Health to make its case. If the CDHB and its board are as irresponsible as the ministry claims, this would not be difficult. Hard information that explained what the current funding was, why it was fair and how it was or was not affected by the earthquake recovery would help reassure a Canterbury public largely in the dark about why its health system is the way it is. The media, often through the Official Information Act, has shed some light on this, but the explanations should not be so hard to acquire.
If the ministry needed another reason, it could consider the other part of the two-pronged response from the CDHB this week. Three senior doctors drew comparisons between between the current crisis and the nadir of Canterbury’s health system woes in the late 1990s, when claims of board mismanagement and underfunding were magnified by avoidable patient deaths. A subsequent report by health and disability commissioner Robyn Stent found a ‘‘dysfunctional and grief-stricken health system’’ that breached several health and disability rights. She made 112 recommendations, noting it was ‘‘a miracle more people did not die’’.
There is some distance between bickering over statistical modelling and patients dying because of poor treatment, but Canterbury has proved that it can happen. It would be unforgivable if it reached that state again. The surest way to avoid it is for both sides to stop trying to prove the other wrong and focus instead on fixing the problem.