CDHB and ministry mend fences

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.