Commission ‘future-proofed’ SDHB
When Kathy Grant walked into the Southern District Health Board she says it was showing clears signs of pressure.
In fact, when she was appointed commissioner of the DHB in 2015, she says it had been under stress for years.
The then Health Minister Jonathan Coleman sacked the board, largely due to financial mismanagement and a forecasted deficit of $42 million.
And, as Grant exits stage left with the introduction of a new board after the local body elections this year, the deficit has doubled.
It’s expected to hit $85.8m this year, but includes one-off expenses like Holiday Act compliance.
If the Holiday Act compliance cost is taken out of the equation, and money spent on improving systems is taken into account, the deficit is sitting roughly where it was back in 2015.
The SDHB had managed to maintain its deficit in relation to other districts who were seeing rising costs, Grant said.
While past board members and the general public expected the commissioner to fix the deficit, Grant says she was more focused on creating a sustainable, futureproof health care system.
‘‘Change requires investment. It costs money to implement strategies.’’
She also staunchly defends the decision to downgrade the Lumsden Maternity Centre from a birthing centre to a hub.
It’s widely unpopular decision from residents in northern Southland that resulted in petition to the Government and submissions to the Health Select Committee.
Grant is ‘‘entirely comfortable’’ with the resolution that was based on a district-wide view.
The SDHB had previously said low birthing numbers didn’t justify the resources it took to keep the centre running, and Grant stands firm by this decision.
‘‘My responsibility as commissioner is to look at the allocation of resources.’’
After nearly four and a half years in the role – that was without question tough to take on – Grant is measured in her responses to the impact and changes her role brought about.
Dunedin-based Grant, who’s a mother of an adult son and daughter, grew up in Oamaru.
It was her love of the South Island that made her accept the role. ‘‘I said ‘yes’ because there were significant challenges to be undertaken and in my view, it was better that they were addressed by a local.’’
Grant described her appointment as a ‘‘circuit breaker’’.
It was a chance to reassess operations at a level a traditional board never could, she said.
The organisation she inherited showed clear signs of the pressure and stress it had been under for years, she said.
Trust between management and doctors and nurses had deteriorated. Staff felt disempowered because decisions like appointments had to go through many levels of approvals.
Grant’s first job was to fix the workplace culture where staff were unhappy.
This meant talking not only to staff, but also patients, their families and communities to establish what they needed. ‘‘This was a massive task,’’ she said.
Some projects included introducing staff recognition like long service and excellence awards.
A community health council was set up to advise the SDHB and create an opportunity for patients to share their views.
‘‘They’re people who have had experience of the health system and feel motivated to share their experience with a view to improve delivery.’’
Grant admits there are areas within the SDHB that still don’t work as efficiently as they could and said these are areas where the SDHB ‘‘simply needs to do better’’.
‘‘I remain concerned about the impact of the DHB’s failure to deliver services in a timely way and how it’s caused harm to patients. We’re absolutely focused on finding ways to address those challenges and ensure those sequences of events are never replicated.’’
Service delays that have hit the headlines cover urology, ophthalmology, colonoscopies, and elective surgeries.
While the SDHB runs two principal hospitals – Southland and Dunedin – Grant said the district also has five other rural trusts and hospitals, along with primary care and community providers, at its disposal.
The rebuild of the Dunedin Hospital – which is expected to cost up to $1.4 billion – has prompted the SDHB to rebuild its healthcare structure.
Part of this focus is to reduce the pressure on Southland and Dunedin hospitals by shifting some services into primary care centres – or GP’s offices.
Grant hopes the new board, who take over next week, will be able to continue with the framework her team have put in place.
The elected board includes Southlanders Lesley Soper, Terry King, and Kaye Crowther.
They’re joined by John Chambers, former Dunedin mayor Dave Cull, Ilka Beekhuis, and Lyndell Kelly.
Health Minister Dr David Clark will elect the chairperson and up to four more members to the board if he chooses.
‘‘Service delivery is a pretty big beast,’’ Grant said. ‘‘Healthcare is a complex challenge.
‘‘The arc is wide, but we’ve turned the rudder . . . the ship is turning.’’