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DHB's A Corporate Management Pawn

Tue, 24 Aug 2004


Philip Bagshaw's timely observations on the futility of DHBs confirms what has been recognised for some time by many board members some of whom have resigned despite the extremely generous fees paid for doing little more than nodding whenever another management agenda was placed before them, according to former West Coast elected member David Tranter who resigned after one year.

My reasons for going were that as a minority of one on many issues it actually disadvantaged those issues because they were dismissed by what rapidly became an unholy alliance between corporate management and the then board chair Wellington-based Rick Bettle (who resigned after attending just eight board meetings) who simply directed the board as to what they should do. This reached a head when the board backed management's dumping of widely-respected Grey Hospital surgeon Hugh Bodle for no better reason than he wasn't wanted by Grey's head surgeon Michael Sexton. (Mr. Bodle was then snapped up by Nelson Hospital and later by Blenheim's Wairau Hospital).

Mr. Bettle had promised "public discussion" of this at a monthly board meeting but in fact the matter was only discussed at a secret board meeting before the public meeting when Mr. Bettle threatened board members that Mr. Sexton's lawyer was waiting in the wings and that "we didn't want that". He also told us that we would be breaking the law according to the Health and Disability Act by publicly disagreeing with a management decision. At the public meeting the other board members dutifully endorsed management's decision and although I publicly stated my disagreement I have - somewhat to my disappointment - yet to be charged with supposedly breaking the law!

That, in a nutshell, sums up the absurdity of the processes of DHBs which are obviously there for no better reason than to put a thin veneer of pseudo-democracy on a health system where the public have no more direct representation than before the elected boards came into being.

Board members who have been hiding behind such public speaking bans as that of the Canterbury board should be asking themselves why they don't simply ignore those bans and speak out because when it comes to the crunch there is nothing more than convention preventing them from doing so. I supposedly broke the law under health legislation but nothing whatsoever happened as a consequence - so what are they afraid of?

Annette King's claim that 500 people standing somehow proves their disagreement with Philip Bagshaw is utter nonsense. Of course people will stand when there are large financial rewards for little work or, if money is not their motivation, they simply don't understand the futility of the DHB process. Mrs. King's attitude was clearly shown when, soon after I was elected, she wrote to me saying that as a board member I was no longer an advocate for the public. So what are elected members there for if not to advocate for those who elected them?

Philip Bagshaw is spot on in saying local commissioners would be a better way of running health. Apart from curbing the bureaucratic empire-building (eight-fold on the West Coast in ten years) there would be huge cost savings in abandoning the farcical pretence of democracy in health. When the West Coast's total budget was $35 million the cost of "democracy" was $1.4 million. If that is replicated throughout the country (the Coast has about 1% of total population) the waste on democracy would be around $140 million. Adding that to funding saved by eliminating the dead wood in the corporate offices and one could only guess at how much funding could be transferred to actually providing health services at a time when such outrages as limited access to Christchurch Women's hospital are occurring


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