Merger fear as health boards pool resources
Wellington's three health boards will move to share services and management in a radical move described by some as a merger in disguise.
Under the plan, dubbed the "3DHB programme", Wairarapa and Hutt Valley boards will amalgamate their senior management teams and share a chief executive by the middle of next year.
They will also increase links with Wellington's Capital & Coast District Health Board.
The changes are intended to improve the quality and efficiency of patient care, and have mostly been driven by doctors.
But Association of Salaried Medical Professionals executive director Ian Powell has warned that the announcement "raised alarm bells" about a full-scale merger.
All three DHBs will keep their own elected boards, although there are many overlaps in membership.
The partnership comes after two years' work by a group of clinical leaders and managers from the three boards, known as the Sub-regional Clinical Leadership Group. Having developed partnerships in specialties such as ENT, child health and palliative care, the next stage will extend this collaboration to various fields.
But Mr Powell said there was concern the DHBs were using the amalgamation of their management teams as a "back door" to merge the organisations.
Capital & Coast chairwoman Virginia Hope rejected Mr Powell's claims and said there had been no discussion about a full-scale merger between the three boards. "It's absolutely not the case; this is a genuine partnership: we're calling it a partnership programme and that's what we mean."
Each elected board was being maintained because it was important to retain accountability to local communities.
Though saving costs was an important consideration, the changes had been driven by clinical staff rather than management. "We're not doing this with the aim of cutting services, quite the opposite. We want to be able to better utilise the resources we have got . . . and make them sustainable into the future."
Mr Powell said he was not specifically against mergers, but there needed to be transparent discussions before it happened.
Caution was needed as the merger of Otago and Southland DHBs, which Mr Powell described as "a debacle", lacked the support of health professionals.
The Wairarapa DHB had the most to lose from the move, and risked being swallowed up by Hutt Valley, which would then be in the path of Capital Coast. "Wairarapa needs a good, strong voice . . . Once it becomes merged you need that strong operational Wairarapa input. Wairarapa is the most concerning: it's the smallest fish that also loses its voice and that I think is shortsighted."
Resident Doctors Association spokeswoman Deborah Powell agreed the move was a merger by "any other name".
But plenty of positives could arise from the move if it was done properly.
"If this is rip, shit and bust it will be a disaster. If it is done with clinical staff leading the charge it could be quite positive."
The final structure of the new management team had yet to be finalised, but redundancies were unlikely and most staff would simply move to different roles, Ms Hope said.
Clinical staff could also find themselves working between the DHBs more frequently.
FRUSTRATING BARRIERS BEHIND MOVE
An elderly female patient being moved from Keneperu Hospital to a Hutt Valley rest home had to be first admitted to Hutt Hospital's emergency department - an example of the frustrating barriers holding back health services in the region.
Speaking at a press conference about the 3DHB changes yesterday, Clinical Leadership Group chairwoman Iwona Stolarek said poor integration between the district health boards affected patients and staff.
Some junior doctors on short-term contracts also had to be rehired every time they moved between the three DHBs, which could be as frequent as every three months, she said.
This meant they had to fill out all documentation needed for a new job up to four times a year.
Prominent plastic surgeon Professor Swee Tan, who was also part of the Leadership Group, said there were "a lot of frustrations" within the system.
But better integration would mean specialised services would become more available.
"The boards are singing from the same hymn . . . to me this is the greatest Christmas present for our combined population."
- © Fairfax NZ News
With festive flags and trees out this year, is council killing Christmas?Related story: Council takes the cheer out of Christmas