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‘Dangerous’ to ignore iwi and locals — Scott

Concerns about possible DHB amalgamation

Any amalgamation of the country's 20 health boards must retain some form of local input into decision-making, says David Scott.

The recently-retired chairman of Hauora Tairawhiti, who suggested Heather Simpson's interim report into the public health system could lead to amalgamation, said a lack of community input would leave him concerned.

Mr Scott said that when Turanganui Primary Health Organisation came under the jurisdiction of the Midlands Health Network, the local community was “left bereft”.

“That would be one of the biggest dangers of amalgamation.

“The other big danger would be ignoring the leadership of iwi.”

Mr Scott, who served the maximum three terms as Hauora Tairawhiti chairman from 2010 to 2019, said it was time for new blood on the health board.

Looking back at his three terms, Mr Scott paid tribute to clinical director of medicine and mental health Dr Richard Moore — in conjunction with chief executive Jim Green — who had “revolutionised” specialist health services at Hauora Tairawhiti.

“We had a bad record in coronary/cardiac health. We had a bad record in diabetes. We didn't have anyone for the aged. We had no respiratory specialists in this region.”

Dr Moore and Mr Green, supported by the board, set out to “change the landscape”.

“That comes at a huge cost but it saves a lot of money in not needing locums or having to transfer patients to other hospitals.

Hauora Tairawhiti now had two cardiologists, including Dr Gerry Devlin, medical director of the Heart Foundation.

“That's huge for this region.”

Many patients would not have to travel to Waikato Hospital, or at least travel less frequently.

Diagnosis was now “more defined”.

“The clinical specialist can ring Waikato and say we want to admit this person. There's much less push back from them.”

Mr Scott said the community needed to know the health board did not waste money.

His first board, elected/appointed in 2010, immediately looked over the organisation searching for inefficiencies and savings.

New efficiencies introduced included tighter controls over purchasing equipment.

Staff could no longer purchase any item “they thought would be great” but had go through proper procedures including a designated purchasing group, and only purchase authorised items.

The rising cost of drugs was a problem for all health boards.

Drugs could now only be purchased from approved lists.

“Doctors can go outside it, but they have to make a special case.”

Mr Scott said a locally-owned pressurised and non-pressurised 24/7 air ambulance service was another achievement.

The previous outside service was expensive.

The board approached Air Gisborne offering them guaranteed capacity, which made it possible for them to buy two fixed wing aircraft for the service.

“The rest is history, it's been huge for us.”

Mr Scott said the health board had always been very conscious of the East Coast.

Boards had worked hard to support and improve services on the coast.

Final decisions concerning the review of Ngati Porou Hauora (NPH) services had not yet been made.

The health board always passed on to NPH any allocated increased funding, Mr Scott said.

Nurses from NPH had presented their case for increased pay to a Hauora Tairawhiti board meeting.

The health board did not control what the nurses were paid, said Mr Scott.

NPH should be able to have total control of their own budget rather than it coming through Hauora Tairawhiti.

“Under current legislation their budget has to come though Hauora Tairawhiti, but the board had made an unequivocal statement that we would pass on all allocated funding.”

The situation was not ideal because it looked like the board controlled what funding NPH received.

Mr Scott said Gisborne Hospital did not have major infrastructural issues like other hospitals with leaky buildings, asbestos and other concerns.

He gave another example of more than 200 elevators in the Auckland health board regions needing to be replaced at a cost of around $350,000 to $500,000 each.

Various health ministers had no idea how severe the deterioration and lack of maintenance was in the “bricks and mortars“ of health boards throughout New Zealand.

Mr Scott said the previous government had told health boards any new buildings or developments would have to be paid out of existing funding.

“We are fortunate, our buildings are in good shape.”

The Morris-Adair building, (formerly the maternity hospital), closed for several years because of earthquake safety issues, is due to be demolished this year.

The government has allocated $20 million for an in-patient mental health and addiction unit at Gisborne Hospital.

The funding comes out of the rolling four-year $1.7 billion capital allowance announced for health boards in December.

Mr Scott said the layout of the Gisborne Hospital campus, built in the 1980s, was a concern.

Some departments were in the wrong place because of the architectural designs of the time.

He gave the example of the Intensive Care Unit being distant from the Emergency Department.

“But we are fortunate that we don't have issues like neglect, asbestos and leaky buildings.”