Disturbing report for DHB to action
Reviews, commissions of inquiry and their ilk can seem like convenient political devices.
Some, it seems, are set up in order to take the heat out of an embarrassing situation and find a contrived solution, revealed as quietly as possible and long after the dust has settled.
Much can depend on the terms of reference. Another key is who will conduct the inquiry, how well resourced they are, and whether they are allowed sufficient access to the main players.
A thorough examination by a credible outside party can also be a powerful and valuable initiator of change. It seems likely this positive approach was sought by the Nelson Marlborough District Health Board when it commissioned a review into Disability Support Services in Nelson. Surely, it is what has been delivered in the review findings.
Some might question the decision to engage former health board chair Suzanne Win to head the inquiry. Some of the issues and problems she reports back on would have occurred on her watch - for five years, up until 2010.
However, she also brought particularly relevant local knowledge and contacts to the task. Besides, two years ago, Ms Win received a national "trustee of the year" award. In part, this recognised her involvement with Gracelands Group, a charitable trust which supports disabled and disadvantaged people. Indeed, she has worked with the sector for more than 40 years. So any questions about partiality are easily answered. With such keen awareness of the needs of both parties, she was an inspired choice.
No-one could accuse her of pulling punches in the final report. It was called for after the board became aware there might be some systemic management issues within its disability support service.
Its concerns came to light after a court case following what the board terms unacceptable care of a client. The staff member involved was held directly responsible, summarily dismissed, and charges laid. At a trial last October, the jury was unable to reach a verdict. It is not clear whether the charges will be re-laid.
Regardless of that, any organisation can have one-off issues regarding an individual worker. It is disturbing that Ms Win's report suggests problems and concerns with the support services culture that go much deeper. Her picture of a culture of bullying, confusion and a lack of professional standards, in which staff are afraid to lay complaints, is painted sharply and in precise detail.
Equally, it is heartening to hear the board is already moving to deal with the issues highlighted and introduce the recommendations of the report.
This is especially important in light of the health board's plan to shift direct responsibility for providing disability support from itself to an independent trust. The move has been controversial, and in part underlines a philosophical debate around where health responsibilities begin and end. To have any chance of succeeding, the current system would need to be working smoothly before being handed over to community stewardship - apparently this is to happen before the end of the year. Ms Win's report suggests the board has much to do in the coming months.
The Nelson Mail