Medical boss cut would be 'destabilising'

20:26, May 21 2014

Golden Bay community leaders are alarmed that the head of the area's new medical centre could lose her job.

Health professionals, including recently retired centre charge nurse manager Alexia Russell, are part of the group of concerned residents upset at the proposed loss of Rhoda McDonald's role as community health service director.

Russell said the proposal was "far too early" and had the potential to be "very destabilising" for the Golden Bay Integrated Family Health centre that opened in Takaka last October.

McDonald has been in the role for 18 months.

A consultation paper outlining the proposed restructuring of Golden Bay community health, circulated among health centre staff, has proposed that McDonald's role be disestablished.

Feedback on the proposal is invited before this Friday. The document found its way into the wider Golden Bay community, resulting in an informal group of community leaders uniting to respond.


Helen Kingston, a retired general practitioner who worked for the Golden Bay medical centre for 27 years, is part of the concerned group.

She and Russell say they feel "alarmed" at the prospect of the disestablishment of the service director's role, which they say was the "linchpin" that held everything together through the establishment of the integrated health centre.

The pair represented a group from a variety of backgrounds, including iwi, Rural Women, Grey Power, St Johns and other health professionals such as a physiotherapist and retired midwife.

They understood that the health centre was running at a loss of around $200,000 to $300,000 per year, with an annual budget of around $5 million.

"I would like to emphasise that this facility, and this combination of services, is unique in New Zealand. How can you budget accurately for a brand-new facility that has never been done before? Within six months of it opening, which was when they carried out the research, how can you start a process saying you're doing this all wrong?"

Kingston said the move was "hasty and ill informed". "To remove the very person who is holding things together seems to be risky and extreme."

The chief executive of Nelson Bays Primary Health, Andrew Swanson-Dobbs, has proposed that McDonald's role be replaced with a new nurse manager who would "focus almost exclusively on achieving and leading a fully integrated model of nursing care and nursing resources across the entire facility at Golden Bay."

"There is much to celebrate but the recent review highlights the need for greater emphasis on the integration of the clinical services within the facility and proposes a structure to achieve that," he said.

Swanson-Dobbs said the organisation had not yet reached a conclusion and remained open-minded about the final structure.

"I am very pleased with the feedback to date, and it will help guide the decision on the best way forward for Golden Bay Community Health for ensuring effective leadership."

Russell and Kingston said the integrated health centre brought together more than 80 employees, the majority of whom were registered nurses and healthcare assistants.

The centre covers primary care, acute and palliative care, district and community-based nursing care, as well as residential care. "Finding an efficient way for these people to work together is going to take some time," said Russell. The pair were concerned that there was no possibility for the public to participate in the consultation process, despite Golden Bay residents raising over $1 million for the centre.

"I know there's cost effectiveness to consider, but I can't see that the disrupting of this can be

cost-effective. Can we slow down please, can we get some community consultation please?" said Kingston.

Both women felt the work of a service director could not be done from over the Takaka Hill, especially so early in the project.

Russell, who retired earlier this year, said McDonald was already working long hours.

She said McDonald was given the role after a "rigorous appointment process" and that she was "by far the best applicant".

"She was welcomed into this community and now she belongs here," she said.

"Her work is not finished," Kingston said.

The Nelson Mail