Conflicts of Interest - Kimberley
Reports that an investigation is underway into a possible conflict of interest surrounding a multi-million dollar contract for IHC to provide care for intellectually disabled people deemed a risk to themselves or others, are surfacing at a time when the Ministry of Health is also finalising a report to the Minister on the future of Kimberley Centre.
The Health Ministry inquiry is expected to address concerns that two former Health Funding Authority employees involved in the contract process now hold senior positions within IHC, and that negotiations have taken place while the Intellectual Disability (Compulsory Care) Bill is still before the Select Committee.
Judy Keall, the chairperson of the Select Committee is also Patron of Horowhenua Branch of the IHC.
Meanwhile, Kimberley Centre, this country's last major psychopaedic institution is under threat of closure, and staff have already been advised that the working party recommendation is for deinstitutionalisation, assuming specialist services are in place to support all community living options.
MidCentral Health, the district health board responsible for the management of Kimberley, has recently announced support for this deinstitutionalisation, provided funding was sufficient to cover transition costs and other risks.
Kimberley Centre currently caters for the needs of 400 intellectually disabled people. A survey carried out by staff calculates that 150 residents require specialist care, and of these, forty will always need a high level of support in a safe, secure setting.
In the 1980's, Kimberley Centre adopted a policy to admit the "psychiatrically disturbed" and national statistics confirmed this facility had nearly 50% more cases in the severely handicapped range than the national average. The courts also referred young people with behavioural problems to Kimberley for compulsory care when Lake Alice refused to accept people with an IQ below 90.
However, the IHC disputes that people resident at Kimberley Centre are best served by a specialist facility.
Jeff Sanders, general manager of service development and training, last year confirmed that IHC believes strongly that people with an intellectual disability have the right and ability to live supported in the community alongside their non-disabled peers. The IHC remains totally committed to Kimberley's closure.
Former Health Minister Wyatt Creech admits that the Kimberley issue continues to worry him. "A relatively small group of officials push extremely hard for a total community devolution approach. Their view is based on ideology rather than practicality. As Minister of Health, I found I had to stand up to that kind of approach quite rigidly or they would have gone ahead and done what they wanted to do. And yet, when I asked them why they were so committed to the concept, they really could not offer substantial evidence or reasons to support it. It was as if they were all caught up in a cycle of arguing a particular cause almost for the sake of it."
As one of England's leading advocates of deinstitutionalisation, David King now concedes, "no rubric, whether it is a centre of excellence or care in the community can guarantee abiding quality. That can only be protected by constant vigilance."
Mrs Keall, who is also MP for the Otaki electorate, acknowledged in a letter sent to Bill English as Health Minister in 1997 that Kimberley Centre is the ideal location for a specialist support service because it has skilled staff, purpose-built facilities, a supportive community, quality standards and management structures under MidCentral Health and was large enough for personalised peer grouping to ensure compatibility and therapeutic value for challenging clients.
She said it was not simply a matter of shifting money used for care in the Kimberley Centre across to funding services in smaller units. "You must first be satisfied that the THA (Transitional Health Authority) has found suitable providers who have the capital to provide safe, purpose-built facilities in the community where they can be trusted to provide a high quality 24 hour service."
She informed Mr English that Kimberley had the critical mass to provide a professional, cost-effective specialist service.
In a press release issued last year, she says that properly-trained staff were part of her vision for a specialist centre and clustered housing.
The IHC justifies employment of two former HFA staff members on the grounds that there is a small pool of skilled and experienced specialists in this field.
The National Training School and the School of Psychopaedic Nursing were closed down a decade ago when the emphasis was placed on more generic staff training.
While in opposition, Annette King promised parents that as health minister she would move quickly to resolve this long-standing problem.
Last December she gave an indication that she expected to receive a report on the future of Kimberley during February this year and gave an assurance that no final decision had been made as yet. However she expressed her confidence that "all residents will continue to receive a similar standard of service regardless of the final decision on the future arrangements for Kimberley Centre."
Val Newman, whose son was transferred to Brackenridge when Templeton was closed last year said that, "In a specialist service, I expected trained, qualified, caring personnel. What did we get? Young women inexperienced with life, inexperienced as far as training was concerned, and inexperienced with residents with complex needs."
She says closing an institution is a very expensive business. "Eventually, in the final analysis it come down to the dollars and corners are cut, services insufficient."
It is interesting that the IHC, that is committed to closing Kimberley, is organising contracts to take over from it, yet views "specialists" as merely having a driving licence and no criminal record. Seems very like setting the scene for another disaster. Unfortunately we are all likely to be affected by it, not just those who are in Kimberley now.
For further information contact: Anne Hunt, ph 06 363 7750
Anne Hunt wrote the history of Kimberley - The Forgotten Years.
FEILDING R D 7
ph / fax 06 3289 618