Written By:
Anthony R0bins - Date published:
12:36 pm, June 17th, 2015 - 53 comments
Categories: health -
Tags: health, Southern DHB, underfunding
So the Minister of Health has just dismissed all members of the Board and replacing it with a Commissioner:
Southern DHB Board dismissed – Commissioner appointed
Health Minister Jonathan Coleman has today written to Southern DHB dismissing all members of the Board and replacing it with a Commissioner.
“The financial problems at Southern DHB are longstanding. I do not have confidence that the current governance arrangements are suitable for delivering on the changes required in Southern DHB,” says Dr Coleman.
“Southern is forecasting a final deficit of $27 million for the current financial year. That figure has effectively doubled in the last six months.
Southern covers the Otago and Southland regions. Here’s some background reading on the problems:
Southern DHB financial crisis lies with underfunding
DHB’s funding below inflation – Labour
Southern hospitals bear the brunt of Government underfunding
Hundreds of DHB workers on less than ‘living wage’
SDHB ‘in extreme difficulties’
Democracy under threat as axe hangs over SDHB
There are real and significant problems in Southern’s jurisdiction, especially around the state of Dunedin Hospital. They stem from underfunding by the government. No doubt a new Commissioner will save money. They will do it by cutting services, and placing further pressure on staff who are already at breaking point.
The current rise of populism challenges the way we think about people’s relationship to the economy.We seem to be entering an era of populism, in which leadership in a democracy is based on preferences of the population which do not seem entirely rational nor serving their longer interests. ...
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What a useless lot of incompetent idiots we have as a so called “government”. A do nothing minister of “finance” and a uncaring pony tail pulling “prime minister” who has little conception of what constitutes truth.
When are the people of NZ going to wake up from their sleep? The longer this shower remain warming their fat arses on the treasury benches the more NZ as a whole will suffer.
have details been given around the commissioners kpi’s
Will we be told precisely what the government believes the DHB has done wrong? No, we won’t be. It’ll be government spin like what Coleman’s already saying: “I do not have confidence that the current governance arrangements are suitable for delivering on the changes required in Southern DHB”. Wait for how many ways government can say the same thing without telling us what the DHB has done wrong or what it believes the DHB is incapable of doing.
What’s worse, though, is the opposition’s inability to ask the right questions or to do what’s necessary to find these things out. Half our problem at the moment is the fact we do not have an Opposition.
kpi = kill poor innocents.
New appointed board member been sacked once already!!!
Richard Thomson
Mr Thomson was chairman of Otago DHB (2001-2009) before being sacked by then Health Minister Tony Ryall who held him accountable for the $17 million fraud which took place at the DHB over six years.
How much of the $17m fraud is responsible for the short fall?
The fraud was between 2000 and 2006.
“Swann spent just under $8 million of his $15.2 million booty on cars and boats, $3.7 million on real estate, a little over $1 million on food, liquor and household items, with $1.1 million taken in cash.”
http://www.spcs.org.nz/michael-swann-checketts-mckay-fraud-and-otago-dhbs-missing-6-million-report/
well, none really.
$27M this year isn’t really impacted by $17M ten years ago.
Basically Southern DHB isn’t given enough money to run, and some of the funding is ringfenced (which is good because it helps guarantee funding for those areas) which means that the shortfall has to be made up by cuts in other areas alone (which is bad).
DHBs are funded pretty much at a fixed per capita rate for their resident population.
There are significant building costs that need to be funded, both to dunedin public hospital and to satellite hospitals like upgrading queenstown. These costs are basically funded on a desperate-priority basis (like roof leaks in operating theatres).
Then there is the issue that DPH is a tertiary-level hospital and needs to fund specialists to serve the population in a halfway decent period of time, especially after trauma. We have a pretty large surface area compared to the population that needs to be served, so that impacts on things like the golden hour. And then there’s another full DHB between the northern border of Southern and ChCh hospital, which is the next closest tertiary-care hospital. Even with helicopters, invercargill or Remarkables to ChCh just isn’t cool for urgent treatment.
So we need a lot of infrastructure that a population doesn’t need when there are two tertiary hospitals in your metro area even though you’re in a different DHB.
Thanks dofurl and Mc
However that Thompson ‘allowed’ the fraud AND was sack would suggest his governance is not to good
He’s not too bad – Swan kept the IT budget with spec, and used an undisclosed conflict of interest in the “servicing” company for the fraud that started prior to Thomson turning up.
Thomson seems pretty capable, really. As soon as the CFO picked up that something was amiss, the entire thing was handled pretty smartly. I reckon the previous CFO has a fair bit to answer for, though.
Thank]x
The real donkey was the CEO. Invoices of that scale should have been approved beforehand and werent.
The whole thing is a case study of incompetence and poor governance
because he never saw them because the CEO never kicked them upstairs and the auditors never flagged that point.
Captain and all, but still, a bit of a bad rap.
Underfund it, run it down, gain direct control from the democratic boards you placed in an impossible position, privatise.
BAU.
The board is mostly run by the Ministers appointments all ready.
As well some elected members were first appointed by Minister.
The Board consists of seven elected members (four from the Otago constituency and three from the Southland constituency) and up to four members appointed by the Minister of Health. The Minister also appoints the Board Chair and Deputy Chair.
Does that mean seeing as this government has run our country into the ground we can write them a letter sacking them?
Obviously there will be loads of ‘DEMOCRACY UNDER ATTACK’ banner headlines.
…oh wait, silly me this is Nats actually and directly attacking democracy. Again.
No, this will just earn praise from the Dirty Columnists :-/
part of the problem is the way funding is done, a physically large health board covering roughly the bottom 2/5 of the south island is funded using the same per-capita rates that one in Auckland is.
The Nats have squeezed hard on Otago, one assumes it may have something to do with our token National MP who used to run the only local private hospital
How many local bodies has the govt taken over so far?
Worth remembering the Southern DHB cut home help to many elderly people a few years ago, resulting in some personal health disasters for vulnerable older people in the community.
Also, remember this health board outsourced its meals on a fifteen year contract, provoking a very strong local reaction.
Was this an example of its poor decision making or a result of pressure to lower costs due to under-funding?
http://www.radionz.co.nz/news/regional/273059/southern-dhb-will-outsource-hospital-kitchens
Yeah, maybe the minister will sack all of the other district health boards which’ve signed the very same Compass contract as Southern; the one developed at great expense over several years by the Government’s very own Health Benefits Ltd.
From Anthony Robins’ post – “They [the ‘problems’ pounced on by Coleman] stem from underfunding by the government. No doubt a new Commissioner will save money. They will do it by cutting services, and placing further pressure on staff who are already at breaking point.”
This typifies the approach of this fetid, corrupt, lying executive. Act so as to render problems inevitable – once the problems manifest publicly abuse the elected decision makers as incompetent and worse – then drive a truck through Democracy by appointing a yes man/woman (outrageously remunerated [viz. ‘bought’] no doubt) to do their bidding. Those more knowledgable than me will have other examples.
Where’s the NZ Herald screeching “Democracy Under Attack” ?
+100…they should be taking to the streets in Dunedin
From time to time, over the last thirty years, various DHB Boards have been sacked when their performance is substantially under par. The common element is their level of incompetence, not particular features of their communities.
Helen Clark sacked the Auckland Board when she was Minister. Most people thought she had done the right thing.
These sorts of actions say very little about the ideological aspect of any particular government. To show that you would have to show that a particular govt sacked way more DHB’s than other governments. That does not appear to be the case here.
When those events occurred, did you make any political hay out of it much, Dr. Mapp?
In fact, it’s pretty much the duty of opposition to hold the government’s feet to the fire in any such situation, aye.
Otherwise witless and destructive ideology masquerading as “personal responsibility” might, say, kill lots of patients.
Like it is now.
Of course the Opposition has to deal with it. My point is the way they deal with it.
Of course they could say it is all due to gross underfunding, but that immediately raises the question of why other DHB’s are able to cope.
In my view Labour has all too frequently tried to argue that this govt is the most irresponsible ever.
Like Andrew Little saying not achieving the surplus was the worst political deceit in his lifetime (or words to that effect). It sounded just a little overwrought. It therefore damages his credibility.
Labour needs to choose its targets by focusing on the things relevant to the public. On housing they are doing that, and are having some effect.
But on a huge lot of other things, the public turn off (GCSB, ponytails, Warner Bros, cabinet club, charter schools, 90 days etc), since they are simply not sufficiently relevant, or the “scandal” is grossly over-hyped.
The health spend is declining as a % of GDP so looks like Nact is underfunding all. Nor does anyone know how large the unmet needs are. But hey why don’t we use that $26m of the flag referendum for health instead?
BTW don’t bother with any more uncaring remarks- this one is kinda personal –
wait till you know some young people who have serious but treatable issues not getting the care they need and deserve.
Some facts about what you call “underfunding”.
Health has risen from $11.297 billion in 2008 to $15.075 billion in 2015.
That’s over 30% increase – around three times faster than inflation which was 11% over the same period.
Or you could look at it on a population basis – $2646 / person in 2008 up to $3281 / person in 2015 – that’s a 24% ($635/person/year) increase – still more than double inflation.
The increases are even more remarkable if you factor in that 2008 was at the end of years of a boom economy and 2015 is after years of the global financial crisis,
All you have to do now is factor in the increasing age of the population, and the consequential increased costs, and you’ll look like you know a little bit about the subject.
The 2010 OECD per capita expenditure figures might enlighten you. NZ paid US$2454 per person for healthcare, the lowest of any comparable nation. The UK paid $2992, Australia $3357, Germany $3558, Netherlands $3837, Canada $3895, and the USA $7290.
My own experience of working in rural hospitals is that staff routinely work loooong hours to paper over the cracks.
And anyway, if you look closely at the SDHB’s deficit ($27 million), it’s a tiny fraction of their billion-dollar budget.
So basically the whole thing is another Tory jack-up, an excuse to seize control (see Christchurch etc etc).
@Malconz
Clear figures that indict us. Can you put the link to those stats?
The figures are on an OECD chart that I screen-grabbed a couple of years ago, and I don’t know how to post the image here.
But here’s a link to an equally damning 2014 EOCD report: it shows that in 2012 our per capita expenditure on health was US$3172, while the OECD average was $3484. That places us at number 20 out of 34 OECD nations. Not great!
http://www.oecd.org/els/health-systems/Briefing-Note-NEW-ZEALAND-2014.pdf
Thanks Malconz. Facts like that are gold when trying to get a handle on comparisons with the rest of the world. I’m always trying to find out if we are a banana republic already, or whether we can never hope to reach that level!
How could we possibly question the ethics of health minister Jonathan Coleman who after accepting an invitation to watch U2 in a corporate box from British American Tobacco in 2006 subsequently caused an altercation by blowing cigar smoke in a woman’s face?
http://tvnz.co.nz/content/910849/425825.xhtml
In those days they were all elected, whereas now the Minister puts his own people in the key board roles.
This board has been ineffective for a while, under Tony Ryalls oversight.
I still think they are underfunded, but Ryall was the one who sat on his hands for 6 years with his people running the show.
I struggle to see where this is democracy under attack. Surely a government has a responsibility to ensure the best possible services are delivered and DHBs are fiscally responsible.
*whoosh*
Are you suggesting that is not a correct assumption OAB?
The government’s failure to provide the funds for your first SDHB responsibility renders the second responsibility impossible and any attempt at it morally and possibly legally criminal.
Well said, McFlock. And let’s not pretend that other DHB’s are coping well. Their staff at the ‘coalface’ are all overloaded, and the whole system is under dangerous threat of errors and failures due to work overload. Moreover, what about the secret waiting lists that patients get pushed off – nationwide?
You need to read the released documents. Their is no suggestion that the DHB is under performing fiscally due to underfunding. Please provide a link to “possibly legally criminal” actions at SDHB otherwise I assume you are simply just talking shit again.
Their (sic) is no suggestion? Who are ‘they’ to whom ‘their’ must refer?
Please get literate. And please bear in mind that most Ministries now serve to cover the Govt’s backside rather than promote the social good. Their reports NEVER blame underfunding. Funny how people at the coalface have a different perspective.
No suggestion?
Well, that’s wrong for a start. Which means that there is at least a suggestion that my dichotomy reflects the situation facing the board, based on the two priorities that you initially identified.
I know shitheads like you actually exist in the world but fuck off to the troll hole you came out of.
You want anyone with an IQ bigger than 10 to take any documents released by this government as true and factual then you are a bigger fuckwit than you sound.
But as someone who has managed to read the documents only hours after their release, you give yourself away as the troll shithead you are.
Have a look before they came out did we?
Slater is missing you, fuck off home.
You are very quick to get this report and to comment. Are you associated with the Gov?
Maybe they can replace Southern DHB outright with some Social Bonds? /sarcasm
Sacking boards is becoming just another day in paradise for National. Can’t run your organisations on cut budgets, or stupid edicts and policy, well tough!
2009 saw the sacking of the Otago District Health Board (DHB) chairman Richard Thomson by Tony Ryall, Thomson, then a member of the Labour Party was the scape goat for a fraud that occurred by a pair of staff members both before and yet uncovered during his tenure.
2010 saw the sacking of 14 Canterbury democratically elected regional councillors after complaints by amongst others, former National Minister Wyatt Creech.
Then there is the revolving doors of school boards and commissioners.
The sundry threats to take over democratically elected boards or else or to do just that as with the governments response to sideline the Christchurch City Council in early 2011 and take over the rebuild to “punch through red tape”. I think I’ve heard that one since in Auckland too, none of this namby pamby democracy rubbish when we feel like it!
And now the entire Southern District Health board.
There is probably more but these control freaks with their warped economic management aren’t going to let democracy get in the way of the National Party!
You cannot cut a big deficit without cutting services or increasing revenue (ie more funding from the government). The SDHB realised that, and that is why this has happened. Most of the fat from the health system was slashed years and years ago.
Not all the fat has been slashed and this govt has done nothing about the dysfunctional politics, waste and highly paid paper pushers that are littered throughout the DHB system upper levels.
Combine that with year upon year under NACT of funding decreases in real terms, ryall’s shonky shell game with waiting list numbers and it’s another sector desperately in need of major reform in many areas that don’t actually treat patients.
Like education, research, social services etc it’s being deliberately run down by the haters and wreckers on treasury benches
Better start standing up, because there is so many democratic positions being ‘sacked’ at present.
Health in real terms is being underfunded 25%.
Hello, TPP will come and ‘help’ us reform.
We can just off shore the health jobs, and have health, USA, style, the worst health system in the world for a developed county.
“Better start standing up”
Well said. But I can’t see kiwis standing up for anything worthwhile anymore. There’s far too much fear and brainwashing.