Your say: Serious errors at CCDHB

Stuff readers have their say on the recent failures by the Capital and Coast District Health Board and the decision by chief executive Margot Mains to bring her resignation forward.

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Should the CCDHB board be sacked and replaced with a commissioner? Send us your feedback or email editorial@stuff.co.nz and we'll publish your comments.

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RE: DHB boss quits early over hospital failures

Feedback (latest posts at top):

I am appalled by the drive by politicians and the news media against this group of hard working people. We have had a grandchild cared very well, even though he has had to go to Starship for his care. What few readers realise is that current system for allocation of funds is totally askew. Wellington's population is approx 250,000, which is what the Board's funding is based on, but they receive approx 1 million cases as it is the main Health Centre in Central NZ. So it has to fund 3 out of 4 patients from it's allocation based on 250,000. Get real Health Minister, this current system of allocation is not working.
Mark

In reference to Clyde and his feedback regarding the good quality care he received at CCDHB, no one is bringing into question the abilities of ALL staff at the hospital, merely those who should not be allowed to do their jobs due to their sheer lack of professionalism and care for patient safety.  I have had many a great experience with my care at Rotorua hospital, but I have also had occasion to see the lows to which patient care can sink and the massive cracks through which patients can fall. I am pleased to hear positive things about anyones care in any hospital, but a few good staff unfortunately does not make up for all the bad ones! There seems to be something endemically wrong with the culture of healthcare, that allows a situation such as CCDHB's current expose to occur, it is an absolute disgrace and my congratulations to the Dominion Post for bringing this situation to the attention of the public, as it is most definitely NOT something that should be kept under wraps.
Jennifer

Having an idea of what the paper pushers in the DHB are earning, I   would suggest they are worth dumping.  One or two of those gone would cover the cost of the real workers, the medical team, who face threat of job loss due to lack of money. The medical team are already over taxed and there is now suggestion of making that worse? What mentality are we living under now. Cut the office workers and run a hospital properly, putting the money where it is really needed, into the medical staff! Our progress is regression and maybe we need to go back to basics, throw out the modern systems that are not working and get back to what did that was working.  We keep fixing things that are not broken and it is all over money and someone looking good for a brief time  while they shunt or brunt the load under some ridiculous pay packet. Of course, we will waste more valuable doctor money in a new  investigation and a new head of department who is paid 10 times more than the average... for WHAT? Let's get real here!
Di

Razor Gang want to slash doctors to save money? How about they half all the salaraies of ALL the upper management, fire the razor gangs, slash and burn the army of beauracracy running the joint, only retaining the 'bottom of the food chain' administrators, as they are usually the only ones who manage to achieve anthing in an office. Then you let the Doctors and Nurses dictate to the CEO what they want. It is then up to the CEO to figure out how to achieve it. No5t enough money? Lay off more management! Not doctors you greedy pricks! It is a bit like the mistake we keep making with those  idiots in Parliament: We tell them what we want and it is up to them to figure out how to achieve it. Not the other  way around.
Jeffrey Kendall

The proposal to cut 50 doctors from the hospital to save costs is ridiculous.  Hospitals need doctors, not an increasing bureaucracy, that sucks money and resources that are needed to carry out the functions of a hospital. How about cutting 50 unnecessary bureaucratic staff and let the doctors get on with their work of saving lives.
Dave Miller 

I am totally opposed to the sacking of the Capital and Coast District Health Board, and replacement of the conscientious and competent Board members with an appointed Commissioner who may be less competent than they are. It is a forbiddingly difficult task to run a hospital service and the associated services.  If there are difficulties and from time to time failure to achieve standards that should have been achieved, then I am confident the present Board members will address themselves to the problems energetically and conscientiously.
John Morgan

I say that for every doctor booted out of a job, three bureaucrats/board members also lose theirs. Oh, and the departing doctor gets to pick the bureaucrats that go.
John Waterman

How can you sack an incoming Board? That is a mixture of old and new faces with medical and business management experience. Does anyone recall the local body elections two months ago? That's right many of us were too apathetic to vote. Health workers do a fantastic job. The whole problem is systemic - management, policy, CCDHB, Ministry of Health, Minister, funding and importantly Me, Myself and I who do not think it could happen in our patch.
Bernie

It is sad that this awesome woman gets to be the scapegoat! The board should go! This is all the tip of the iceberg... lots more happens because this DHB's middle managers fail to heed the staff who are the health professionals and who know the consequences of having too few /or too new staff. Some areas are trying to work with 1/3 vacancies. Having said this it is also clear that the  Independent midwifery service system is exactly that - independent of the DHB and autonomously responsible for its own action or inaction. The recent case is sad but not due to the DHB this time!
Concerned ex staff member

Having worked at Wellington Hospital from 97 until 2001, it's about time Margot Mains left, the hospital starting losing the best staff when she came on board.  Theatres were told to run like a business hence why surgeries got postponed and surgeons left due to incessant cost cutting and staff shortages.  Keep the Board but get in a CEO who has run a public hospital successfully.  Although for all CCDHB's faults it's still a stand-out over some Australian public hospitals hence why the majority of Australians take up Private Health Cover.
Vanessa

CCDHB Board should resign. The problems are not caused by the actions of just one person but symptomatic of the poor attitude by management towards clinical staff. This attitude is supported by the board as were the actions of the CEO thus it is the board that should resign for while they are in place the problems will continue.
Nigel Hefford

Sack the whole board, appoint a Commissioner, and overhaul the entire CCDHB management and administration structure.  Then do the same for the entire health service. The decentralised DHB model for Public Health Service does not work. Not only does it not deliver value for money it consistently fails to deliver any appreciable increase in the quality, quantity or availability of health services.  Tony Ryall describes the management of CCDHB as toxic.  The Dominion Post's articles today suggest it would be more accurate to describe CCDHB's management as terminal.  The wonder is not that so many things have gone seriously wrong, but that the dedicated, overworked, under-supported doctors, nurses and other clinical staff employed at CCDHB have managed to fulfil their responsibility to provide adequate (and even superb) standards of care to so many thousands of patients in the face of such an incompetent, destructive, un-caring administration. Hospitals will not be run properly in this country until the fashionable Labour-encouraged, decentralised and sub-contracting culture is eliminated and senior clinicians are once again given more say in the funding and running of hospitals. You know it won't happen under Labour.  They'll want to bring in consultants to investigate the issue and do a report. Doesn't look like it's gonna happen under National either but, maybe, Messrs Ryall & Key you would like to have a cup of tea and a re-think?  There's an election next year you know.
John O'Donoghue

The issue is systemic government underfunding. To hold senior managers accountable for under-delivery as a result of chronic underfunding is  a nonsense. If we want better service we simply have to pay for it, no bones about it.
Russell Kirkpatrick

Too many middle managers running around protecting their $100,000  jobs and bullying clinical staff who geniunely care ... get rid of the lot, lets go back to the matrons taking  charge!  By the way, these problems are rife in all of NZ's DHB's. The media needs to dig deep and expose them all!
Not prepared to give name as I work for a local DHB

Like the vast majority of my fellow patients (we had a dinner last night), I find it hard to reconcile the invective generated by the DomPost's current campaign against the DHB - with the care and service that I received at Wellington Hospital earlier this year.  From the emergency ward staff, the mobile bed 'couriers'; those dedicated people in the Cardiac Care Unit, the lab staff, the cleaners -  to the 'post release' care and advice that was available,  I saw some wonderful staff working in a difficult business and doing a fantastic job. The Board and Management may have issues that need working through - but this hospital does a great deal of very good work and this ought to be kept in our minds.  wish the politicians would save their breath and get off their band wagons. Good luck Derek Milne!
Clyde

My God, how has such a flawed management of a huge and important organisation gone unnoticed by cabinet and the minister? Does "the buck stops with me" not mean anything to Ministers of Health?!  It's hollow for the new minister to be throwing his weight around now and demanding improvement, when it is his predecessor's neglect that has allowed it to get into this state.  
Hugh Lopdell

Yes, they should be sacked. They need to get a board of people that actually think about the people and how there actions affect a wide range of ethnicities and issues. I had my son in Wellington Hospital 10 years ago, and even back then they gave you an incentive if you left early, I left after 3hrs and was given a choice of a carton of nappies, a food voucher or a house cleaner for 25 hrs.
Cassandra Holm

CCDHB Board should resign. The problems are not caused by the actions of just one person but symptomatic of the poor attitude by management towards clinical staff. This attitude is supported by the board as were the actions of the CEO thus it is the board that should resign for while they are in place the problems will continue.  
Nigel Hefford    

What the public are seeing now has been common knowledge within CCDHB circles for years.  The board and senior management have been ineffectual time and time again - and should all be replaced, every one.   
Mike Lloyd

Well, the government wants us to assist in increasing the NZ population yet they stand by and allow this kind of thing to occur. Shockingly enough, it's been over a long period of time. Not only should the board be held accountable, but who in Government has been leaving this in the 'too hard basket' till the last moment?! I'm happy to help increase the nation's population, but I want to know that I'm going to get the right care when it's needed!
Esther Nicholas

I do agree that the board of this troubled organisation should be sacked, but I also think that the government should stop demanding that hospitals be run as businesses. These institutions are supposed to be there to help us in times of need, but seem so top heavy with highly paid management staff and consultants reporting on everything from the type of teabags to use, to the size of beds needed in 10 years, that they have lost sight of their prime goal and responsibility - helping people! Hospitals are a service which can not be run effectively when you're worried about the financial bottom line and staying in the black. I know that there were problems with inefficiencies and massive overspending in the old system, but it seems to me that the governments push to solve this has gone too far and has created  hospitals run by accountants who don't give a dam about helping people. They only care about staying within the budget. Sack the board, but sack the Minister and the Department of Health as well. They're all just as guilty!
Danny Hopkins

We should not be at all surprised at the seemingly pan-departmental collapse of the Capitol and Coast Health system. The reluctance by this government to act earlier on any one of the serious issues that have limited the medical outcomes of this hospital, validates the un-published Labour Party policy which states that in order to save something, it is first necessary to destroy it. We see this with an absolute aversion to dealing with the many substantive issues causing significant loss to New Zealand. All this occurs amongst constant reference to OECD norms and rankings, and UN reports, which show a deteriorating economy and other social indicators falling dramatically. Labour will not move to adopt policy and practices which are proven to work overseas. Creating 23 DHBs, covering 4 million people, to do who knows what creates geographical silo thinking.  Of all the matters for which the government is responsible, health is one which allows for the easy application of national standards, yet we hear recently that most DHBs are working independently on the same stuff in different directions; one apparently has eight policies for smoking - that is really helpful.
Labour are now getting the blame papers out of the bottom drawer, and the Minister of Health and Prime Minister, who threw Cunliffe the ‘hospital' pass, are rank with indignation. They are starting use the ‘...we need to....' phrase. Next they will call for reports and throw money at it. That is a sure sign of madness as it has been done before and nothing happened. In spite of what has gone before you, David Cunliffe, show us what you can do and fix it up.
Christopher Webster

No more meetings,  no more discussions, no more group hugs. Middle New Zealand must make a stand here:  heads must roll, although Pete Hodgsen's already has - where is the accountability? Install a CEO immediately, and remove some of the layers of bureaucracy ( and I'm sure unnecessary costs)  from our most essential core service. To me - this is another prime example of the Labour lead coalition Government's All Care and No Responsibility attitude to situations such as this. I trust Ms Mains will still be given the good old "golden handshake" even though I am sure she is jumping before she is pushed. Gee - it must be nice to resign four months out, and then just bring it forward when the heat really comes on. Us poor saps in the private sector don't have that luxury, but I guess we take solace in the fact  that we do our bloody jobs properly.
Mark Chapman

Recent failures by the Capital and Coast District Health Board are abhorrent to say the least. The blatant disregard for public health and safety under the guise of restructuring, while the executives at the top enjoy pay rises, benefits and performance bonuses (wait did I say performance?) over and beyond by what most standards of pay are acceptable. Yet we still see a need by some in the public sector to make excuses. We wonder why the youth of today are not held accountable for their actions, why should they, when as adults we engineer our own excuses to avoid such accountability. I say good riddance to Margot Mains and the whole of the Board as well. Replace these people with those that have a common interest, in providing acceptable care (not a disgustingly high salary)  far and beyond of what is offered at the moment.
Cliff Robertson  

Sack them all.
Gary McPeake

A nationwide enquiry should be conducted to investigate the 'effectiveness' of the DHB model in Health Services throughout NZ. For far too long politics and powerplay has been the noose around the necks of health services. Professional jealousies and misuse of power has eroded the moral of frontline staff and the delivery of effective service. One final comment - Will Ms Mains be taking her overseas travel and 'study' package? It would be scandalous to even consider this as she has resigned and her 'up-skill' trip will not be used to benefit DHB.
Mrs Sue Reid

The CCDHB should be required to give credence to and follow the advice that has been proffered to them by senior medical consultants in Wellington Hospital, rather than calling in and paying for outside   consultants who then have had to find out for themselves the problems  that have already been identified in house. The board should be sacked and a commissioner be put in place who  will listen to the advice already given by those who have been  working and attempting to correct long identified and reported problems. It looks like investigative journalism is finally happening.
Norman E Davis

I feel that it is perhaps a little unfair to point the finger at Capital Health when I would think that most maternity units in New Zealand push to have women leave for home as soon as possible. If I had been made to leave the hospital within in 48 hours of having my first child (now 23) he would have starved to death as neither of us was very good at the breastfeeding lark and it took nearly 8 days to get it right! And yes, I stayed 10 days in the hospital with the first and 5 days with my second and third babies. Hate to say it but maybe they were the good old days. This was also prior to midwives having autonomy and my local GP provided all my antenatal, birth and postnatal care with weekly home visits from the Plunket nurse for the first 4 to 6 weeks. Glad I'm not having babies now!
Kathleen

You ask:  "Should the CCDHB board be sacked and replaced with a commissioner?" The obvious answer is: YES. A useful analogy is that of an orchestra.  First, there is the relationship between the orchestra and the audience - someone must decide what piece of music the whole orchestra will play to please the crowd.  Secondly, each player must come in at the right moment to combine the notes into the complete piece of music.  Finally, each performer must play to the beat and in tune. Thought of in this light, the way the Hospital Board has "conducted" the organisation appears to be a cacophonic failure.
Bob Kay

I applaud Margot Mains' decision to step down immediately instead of remaining at the helm of her rudderless ship.  It has been apparent for several years that serious problems exist between management and clinical staff. You don't keep on losing dedicated health professionals at the rate Wellington Hospital has managed to attain.
Barry Thomson

Now that Margot Mains has gone, too late for many, they should be given 3 months to bring the DHB around.
Mark Coton

Should be sacked.
Catherine Young

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