Future Risks For Public Health In Hawkes Bay

The recent debacle on the escalation of costs on the new Acute Unit at the Regional Hospital has raised some very important site issues, bearing on the very security of health delivery for the region as a whole. These issues are not new. They were raised strongly ten years ago by several professional parties, when the site selection process was proceeding and were ignored by the decision makers at the time. Those findings of ten years ago have recently been rediscovered the hard and expensive way. Kept records would usually provide the knowledge required but that was not the case in this instance.

The document on which this article is based was to be tabled at a recent Council Health Advisory Committee meeting in Napier, but it’s exposure was thwarted by the Chairman, David Sabiston, thereby denying the meeting information vital to the health security of the people of this region.

Essentially, the site is unconsolidated river silt which can present problems for multilevel buildings and will result in expensive extra foundation work. Such was the case when the Memorial Hospital was built and was the case recently with the new Acute Assessment Unit.

Nor do the problems necessarily end there.

The cost over-runs of over $5m dollars on the Acute Unit and the reasons for this clearly show the difficulties of building on foundations of river silt. This subject was comprehensively dealt with in a report by Dr. Maxwell Gage, a long time resident of the district and a very highly qualified Geologist, whose expert advice was never considered by the then CHE, the Ministry of Health or the Booze Allen Taskforce.

Nor was this the only document, proffering professional advice, ignored by them.

Natural disasters are inevitable in countries on the margins of geological plates and New Zealand is one of those. Geologists don’t speak of “if”, they speak of “what” and “when”. These events are continuous and our building codes recognize these risks.

Did we learn nothing from the geological events that took place in our region in 1931? If the potential of serious earthquake is factored into health-delivery planning, it would be hard to imagine a more unsuitable site than the current Regional Hospital one.

The Gage document conclusively shows that the whole of the regions health services are at risk, should a natural disaster strike the region in the form of a major flood or earthquake, and these are real possibilities, considering the geological and geographical circumstances peculiar to the present hospital location. Access to the Regional Hospital site due to liquefaction in a major earthquake is a strong possibility.

Dr.Maxwell Gage,PhD,FRSNZ, Professor of Geology at Canterbury University and not really an authority to ignore, produced a comprehensive report showing that the whole region’s health services would be at risk were they to be exclusively clustered at the current Regional Hospital site. Any major flooding or earthquake could see the entire health region deprived of health services at all, by the potential impacts of such events on the ONE hospital site. At a time of greatest need for health services, their availability could be greatly restricted or non-existent.

Unwisely, the then Crown Health Enterprise , the Ministry of Health and the Booze Allen Taskforce ignored the report. The problems experienced with the construction of the Acute Assesment Unit are a direct consequence, but the worst case scenarios of natural disasters have the potential to impact on the Regional Hospital site at a far greater level.

At the time, other professional submissions were ignored , leaving with many, the distasteful conclusion that politics not expertise, was driving the changes.

Indeed, the very thorough report compiled by the Board’s own architects, the Natusch Partnership Architects, consulting with Works Consultancy Ltd, Graeme Harrison Consultants Ltd, Brian Eddy and Associates, and Valuation New Zealand , went down a similar path.

That report slates the Booze Allen Hamilton Taskforce for pre-determination when it recommended the Memorial Hospital site for development as the Regional Hospital . It accuses the Taskforce of ignoring the known geological condition of the site as well as discarding their responsibilities to the communities that could be put at risk.

This combined, comprehensive, and very professional document dealt thoroughly with all of the possible alternative configurations for health services delivery in the region.

It had clear reservations about the selection of a single, stand - alone hospital site, especially one such as the Memorial Hospital (Regional) site, considering that too many eggs would be in one basket which would increase the risk of not having a hospital operational following a major natural disaster.

The document implicates and damns successive governments for their lack of concern for the safety of the people of this region.

This along with the scholastic Gage Report, and others, were ignored. So were the 33,500 people who signed a petition seeking the retention of the Napier Hospital site for a promised sub-acute hospital as regional back-up.

Predetermination and political considerations appear to have triumphed over common sense and professionalism in determining the shape of public health in this region and the costly problems with the Acute Assessment Unit are a result. Other problems attending this predetermined decision-making have a much greater potential for disastrous outcomes for the people of this health region in the years ahead.

Viv Lawton

Napier Public Health Action Group Inc. / Research PO Box 471 Napier

vtjmlawton@clear.net.nz

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