Canterbury mental health services 'stranded' at Princess Margaret Hospital

Mental health services remain stranded at the Princess Margaret Hospital while debate continues about where they should go.
IAIN MCGREGOR/FAIRFAX NZ

Mental health services remain stranded at the Princess Margaret Hospital while debate continues about where they should go.

Mothers with postnatal depression, mentally-unwell children and those with eating disorders serious enough to need hospitalisation have been "stranded" at Princess Margaret Hospital.

These mental health services were  left out of a restructure proposal in 2012, which saw most PMH services moved to other hospitals, documents show.

Emails between Canterbury District Health Board (CDHB) chief executive David Meates​ and Ministry of Health officials released under the Official Information Act to Labour reveal a drawn-out dispute over the future of the services.

Canterbury District Health Board chief executive David Meates says clinicians are worried it will be more difficult to ...
EMMA DANGERFIELD/FAIRFAX NZ

Canterbury District Health Board chief executive David Meates says clinicians are worried it will be more difficult to ensure clinical safety while mental health services remain at Princess Margaret Hospital.

A child and youth inpatient unit, eating disorders unit, mothers and babies mental health service and regional community mental health teams remain at PMH after other services moved as part of the Christchurch hospitals redevelopment.

Plans to move mental health services from PMH have been left in bureaucratic limbo. The CDHB will have to come up with at least $30 million to relocate the services, the emails show. 

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David Meates, chief exective of Christchurch District Health Board, left, Jonathan Coleman, Minister of Health, Bryan ...
JOHN KIRK-ANDERSON/FAIRFAX NZ

David Meates, chief exective of Christchurch District Health Board, left, Jonathan Coleman, Minister of Health, Bryan Spinks, Burwood Hospital project director, and Michael Hundleby, acting national director, during a visit to Burwood Hospital.

An original business case for the hospitals redevelopment prepared by the CDHB in 2012 included the relocation of PMH-based mental health services to the Christchurch Hospital Parkside building.

In February, Meates told director general of mental health John Crawshaw the final business case submitted to Cabinet had cut the planned move without the CDHB's knowledge. 

"These services are now stranded at PMH site and will require additional operational resources to maintain them on what will be an empty site. Concerns are being raised by the clinicians as it will be more difficult to ensure clinical safety," Meates wrote.

About 31 patients from three specialist mental health services and staff remain at the earthquake-damaged facility. 

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Critical structural weaknesses were identified in the hospital buildings after the 2011 earthquake, and engineers recommended making seismic upgrades. The decision was made to keep services at the facility only until they could be moved. 

Ministry of Health projects director Michael Hundleby said in a statement to Stuff the original plan was "not being progressed … as there is not the space to accommodate [the services]" at Christchurch Hospital. 

The emails show Meates raised the issue of relocation multiple times, often highlighting the urgency of the situation.

"There is a real urgency required to review options, models of care and potential funding options," he wrote to Hundleby in July.

In December 2015, the ministry's capital investment committee chairman, Evan Davies, told CDHB chairman Murray Cleverley​ in a letter that a "two-step" business case would need to be developed by the CDHB as the project would cost over $15m. 

Davies' letter made it clear the cost would be born by the health board.

"There is no Crown funding, so it will need to come from CDHB's baseline resources or the Earthquake Repairs Programme of Works," he wrote.

An independent "clinical review of the proposed models of care and options" for the services was requested. 

In another letter to Crawshaw, Meates said a wide range of temporary and permanent options costing "from $30m upwards" had been explored, including using Burwood and Christchurch hospitals, the temporary police station or various locations at Hillmorton Hospital. 

It would take 12 to 18 months to approve any of the options, with a longer timeline needed for temporary service arrangements in the interim, he said.

"Any requirement to retain these services on the remaining PMH facility needs to consider that the facility contains significant critical structural weaknesses and fragile infrastructure including sewage and water."

Meates said minimum repairs were made to PMH over the past four years, "under the clear basis that the facility was to be vacated as planned in the [original] detailed business case".

A CDHB business case sent to the Hospital Redevelopment Partnership Group (HRPG) in March was "not formally considered … as a source of funds had not been identified", Hundleby told Meates.

Nurses working at the affected services were not happy about working at PMH due to the lack of supportive infrastructure.

"We want to see a solution but there doesn't seem to be one in sight," New Zealand Nurses Organisation organiser Lynda Boyd said.

Cleverley said he was not on the board when the original business case was drafted and submitted.

He said work was being done on a business case for the relocation of those services, and all the options would be considered once that was completed.

Meates declined to speak to Stuff about the situation.

 - Stuff

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