CDHB and min­istry mend fences

The Press - - News - Oliver Lewis and Cate Broughton

Me­di­a­tion has brought an end to a bit­ter stand-off be­tween Can­ter­bury health lead­ers and the Gov­ern­ment over a post-earth­quake fund­ing bat­tle – but the wounds have not healed com­pletely.

In­de­pen­dent fa­cil­i­ta­tor Garry Wil­son was ap­pointed to get the par­ties talk­ing again in a se­ries of meet­ings that be­gan ear­lier this year, a process re­ferred to as the ‘‘way for­ward’’ or ‘‘truth and rec­on­cil­i­a­tion’’ process.

Doc­u­ments pro­vided to The Press af­ter a com­plaint to the Om­buds­man re­veal the re­la­tion­ship had be­come so rocky se­nior Gov­ern­ment staff lob­bied for changes to the gover­nance and man­age­ment of the Can­ter­bury District Health Board (CDHB).

‘‘It would be dif­fi­cult to find a sit­u­a­tion where ... wellinten­tioned and well-mo­ti­vated gover­nors and se­nior ex­ec­u­tives have, in the past, seen the same is­sues so dif­fer­ently,’’ Wil­son wrote in an April re­port.

In a brief­ing to the Health Min­is­ter last month, Wil­son said con­tin­u­ing the ‘‘busi­ness as usual’’ fund­ing ar­range­ment af­ter the re­gion’s quakes con­trib­uted to the CDHB’s dire fi­nan­cial sit­u­a­tion and ag­gra­vated its re­la­tion­ship with the min­istry. ‘‘CDHB’s pop­u­la­tion-based fund­ing was not ad­justed to re­flect the changed pat­terns in health ser­vices con­sump­tion aris­ing from the need to treat a pop­u­la­tion deal­ing with the psy­choso­cial im­pacts of a nat­u­ral dis­as­ter,’’ the memo said.

While other fund­ing was pro­vided, he said: ‘‘Al­ter­na­tive ap­proaches that bet­ter re­flected the sit­u­a­tion faced by the CDHB could have been utilised, and go­ing for­ward an ap­proach that bet­ter re­flects the is­sues fac­ing the CDHB is needed.’’

Wil­son said that would be dif­fi­cult given the mag­ni­tude of the is­sues and the min­istry’s lim­ited abil­ity to ad­just pol­icy set­tings to meet Can­ter­bury’s unique needs.

The CDHB be­lieved it had missed out on more than $60 mil­lion a year in ad­di­tional rev­enue be­cause of faults in the way fund­ing was al­lo­cated. How­ever, the min­istry ‘‘can­not rec­on­cile these fig­ures and does not sup­port this ar­gu­ment’’, Wil­son said.

The par­ties had not agreed on how much debt was re­lated to quake costs, in­clud­ing de­lays in the com­ple­tion of the new Christchurch Hospi­tal acute ser­vices build­ing. The costs, which in­cluded out­sourc­ing surg­eries to pri­vate providers be­cause of the­atre ca­pac­ity, were es­ti­mated at $36.4m in 2017-18, grow­ing to more than $50m in 2018-19.

Changes to the de­pri­va­tion in­dex from 2013 cut a fur­ther es­ti­mated $21m in fund­ing, but the is­sue was un­re­solved, Wil­son said.

CDHB anal­y­sis of ser­vice gaps and un­met need es­ti­mated a fur­ther $2.96m was needed in 2018-19, grow­ing to $6m for the fol­low­ing two years.

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