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Heather Roy's Diary: Capital and Coast

Heather Roy's Diary

Capital and Coast District Health Board

Given the current serious situation at Capital & Coast DHB doctors, nurses and other health professionals at Wellington Hospital must be feeling as though they've been caught in a tornado.

At times like these the focus is usually on the patients and what has gone wrong, which is exactly as it should be; at the same time, however, the hard work and frustration of the clinical staff - the visible front line, and the first point of contact that the public sees - is often lost in the fracas.

This is no picnic for clinical staff. While patient safety is the first concern, a safe staffing environment is also imperative. Staffing shortages, difficulty recruiting, and retaining health professionals leads to a killer situation of its own. Overworked clinicians are often left by management and governance to 'carry the can' - with even more likelihood of mistakes being made. Systemic issues are as dangerous for staff as for patients.

The situation at CCDHB - particularly Wellington Hospital - has been in the news all week, with a long list of serious medical events and deaths published in the 'Dominion Post' on Wednesday. Directly after this, CCDHB Chief Executive Margot Mains brought forward her resignation, effective immediately.

On the political front, Prime Minister Helen Clark and Health Minister David Cunliffe have said how seriously they are taking the problems - but, with no decisions made or action taken over the past six years, there has been much speculation about a promised announcement.

I've said for some time that an independent Commissioner should be put in place - one with the ability to appoint their own team, with a record of being able to turn troubled organisations around, and the capacity to think outside the square and to think broadly about all options. Most importantly, they must be able to act - free from any political meddling from the Health Minister and Ministry, which is almost unheard of in the public health sector.

The commissioner should have a simple, clear brief: to provide the best services, in the best time, at the best cost. This, combined with the instruction to look at all health providers, would give the Commissioner free rein to sort this ailing DHB out. What's important is that Wellingtonians have access to quality healthcare - not arguing over where the care is from. Someone in pain doesn't care where they go for treatment, they want quality care quickly.

Also missing out are patients from the lower North Island in need of tertiary care - heart surgery and the like. Wellington Hospital is funded to provide these services to those from the Hawkes Bay, Wairarapa, Whanganui, Mid Central and the Hutt. These patients are admitted for treatment, wait for theatre space and too often sent back to their own DHB because their surgery has been cancelled. I'm told that some are too sick to go home - so sick that they require intensive care - and some have died unnecessarily while waiting to be re-scheduled at Wellington Hospital.

So what's the hold up? Why won't the Minister act? One possibility is that he knows a commissioner should be put in place but can't find anyone willing to take the job. Seven newly-elected and four selected - by the Minister - Board members are due to begin their term next week. While standing a democratically-elected Board aside is a serious thing, this is an organisation in crisis - only bold and innovative initiatives will change the culture and appalling financial position the Board is in.

The other possibility for Minister Cunliffe's inertia is that a commissioner will act swiftly to stem the financial haemorrhaging, and look to private health services to gain efficiencies. Labour hates the private hospitals and providers with a passion: if it goes into an election with one DHB able to buy operations wherever it likes, and 20 other Boards looking on enviously wishing they could the same, where would that leave the 'State is best' ideology?

It's time Minister Cunliffe stopped thinking about votes and start thinking about saving lives and protecting front-line staff. If he'd broken his foot bone in Wellington, he would have waited five-six hours instead of two in A&E. Perhaps then he'd have had some appreciation of the full extent of the problem for those with health needs in the capital.

To view my comments on CCDHB visit: www.tv3.co.nz/VideoBrowseAll/HealthVideo/tabid/372/articleID/40778/cat/59/Default.aspx#video

Lest We Forget - 0800 VALOUR

This week also saw the nation in an uproar over the brazen theft from the Waiouru Army Museum of around 100 war medals - including nine Victoria Crosses, two George Medals and on Albert Medal.

A single Victoria Cross can reach $200,000 at auction, and police have launched a massive investigation. Latest media reports claim police are now considering the possibility that the heist was an 'inside job' pulled off with the participation of someone in the military. Anyone with information on the theft is urged to call the police's dedicated line 0800 VALOUR.

British authorities have also been alerted, and Britain's Lord Ashcroft - a multi-millionaire who owns the world's largest collection of VCs - has offered a $200,000 reward for the return of New Zealand's stolen VCs.

While nothing has yet been said in the media over what the punishment would be for the culprits if caught, ACT has always maintained that the punishment should fit the crime: given the nature of this abhorrent crime, wouldn't it be great - not to mention appropriate - to see the perpetrators subjected to a military punishment.

My suggested sentence would be putting the convicted medal thief or thieves into uniform: enlist them into the Army to complete Basic Training at Waiouru Military Camp, and then send them on a six-month tour of duty overseas. After this, they would be eligible for a campaign medal - by which time they would hopefully thoroughly understand what the recipients of these medals did to earn them, and have witnessed first-hand what it is to serve rather than living a life of selfish disregard for anyone else.

If already in the military, the thieves would be detained in the service's prison - military prison is different from civil prisons, and about administering deterrence rather than correction. The goal is preventing more offending, punishment such that no one wants to return.


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