David Meates, Chief Executive, West Coast District Health Board
In the last few days I have received a number of questions from members of the community about our decision to consult with staff on the permanent closure of the laundry at Grey Base Hospital. We know that our announcement last Friday was devastating for our laundry staff and for a town that in recent times has suffered a number of blows.
The proposal to close local laundry services is just one of the current challenges confronting the provision of health services on the West Coast. It is a story that dates back twenty years.
Since the health reforms of 1993, no less than 13 reviews of West Coast health services have been undertaken in order to address the complex challenges of providing clinically and financially sustainable health services to a geographically sparse and remote population.
These reviews consistently identified key priorities for the West Coast health system, including transAlpine collaboration with Canterbury for specialist services; generalist services and workforce based on the Coast; the integration of primary care [general practice] and secondary [hospitalbased] care; and greater use of nurse led services. Unfortunately, none of these priorities have been brought fully to life.
Two decades of health service reviews and the need for new facilities has meant that basic maintenance of our hospital buildings has not been prioritised. There has been serious infrastructure deterioration and the consequences of this are now becoming painfully clear. For example, in April this year we experienced 90 minutes of total power failure at Grey Base Hospital. A detailed external review commissioned by the DHB revealed serious weaknesses in the electrical infrastructure, and we now have to spend in the order of $1M to urgently upgrade the power supply to the hospital buildings just to keep health services running.
Two years ago, we made a commitment to ensure that the
West Coast would find a sustainable way to treat people –
we call this a model of care. To inform our model of care,
we went out to the community and held clinicianled
meetings up and down the Coast where we asked Coasters what
they expected from their health services. Unsurprisingly,
the building blocks for our model of care turned out to be
the same as the key priorities identified in the 13 reviews.
From our community and staff consultation, we prepared a business case which sets out a plan for sustainable and affordable healthcare services on the Coast. It also details facility requirements that are needed both in Greymouth and Westport. We presented the Greymouth business case to the Capital Investment Committee of the National Health Board in July 2012. P.O. Box 387 Greymouth
As we developed the business case, we commenced a process of undertaking detailed engineering evaluations on each of our buildings. We began with the laundry and the boilerhouse building. Our decision to close the laundry on 25 May, 2012 was taken upon receipt of an engineering report which indicated very clearly that the building was unsafe to occupy because it was less than 9% of new building standards and had critical weaknesses.
Some people have asked why we can’t invest money to fix the laundry. After closing the laundry in May, we continued to undertake detailed engineering studies of our buildings. During this time, and because of the uncertainty, we retained all our laundry staff on full pay and conditions while sourcing laundry services from Canterbury. Between May and November, we received the results of engineering studies for all buildings at Grey which describe significant seismic and infrastructure issues with most of the buildings at the hospital – buildings which house vital health services. As with the laundry, a number of these buildings also fail to meet seismic standards and need many millions spent on them urgently if continuity of health services is to be assured.
In addition, Crown company Health Benefits Limited [HBL] is working to consolidate and regionalise a number of services across all DHBs, including finance, procurement, food and laundry. While the outcome of this process is not yet finalised, it is clear that regionalisation of laundry services is inevitable. Finally, the DHB has lost money on commercial laundry services since day one. We have been crosssubsidising lossmaking commercial laundry operations from scarce health dollars and this cannot continue without compromising the delivery of critical clinical services. All up, it is neither affordable, nor responsible, to invest in the repairs and strengthening the current laundry building.
For the first time in nearly 20
years, the West Coast health system has a very clear path
towards clinical and financial sustainability. We have a
business case before the National Health Board to develop
new health facilities in Greymouth. The facility has been
designed to support the model of care elements which have
been articulated over the past two decades. The facility
proposed in the business case allows us to bring to life
long term financial and clinical sustainability of health
services on the West Coast.