Contract explanation wanted
Sadly, I disagree with the Southland District Health Board's decision on awarding the Home and Community Support Services contract.
Three providers chosen - two nationwide New Zealand firms; one Australian company. The latter will take a sizeable share of New Zealand dollars out of the approximately $13 million contract.
The local provider of 15 years, Disability Resource Centre Southland and tender partner Presbyterian Support Otago (PSO), tried and true, non-profit providers of longstanding, have lost out to the Australian Royal District Nursing Service. Its New Zealand experience has been a small contract in Auckland. Why?
If it ain't broke, don't fix it, especially not with an overseas contracting-out model.
The tactic of announcing this just before Christmas, when those affected are likely to be busy elsewhere, also has to be roundly deplored.
I'm not privy to the detailed criteria the SDHB might have used in reaching this decision, but here are the sort of criteria I would expect.
Quality of service: The resource centre and PSO are long-standing, well-respected providers of care services. Both are held in high esteem by clients for going the extra mile. They work collaboratively with the SDHB, with families/whanau, primary caregivers and with other networks, to address unique client needs. They are successful local services servicing the area they live in and putting back into the local community. Neither has a history of industrial problems or client complaints.
Experience: Between them, the resource centre and PSO currently provide care for 43 per cent of people aged over 65 in Southland and Otago, who need personal care and home help. That is more than 1800 people, 700 of them in Southland. Long-serving staff means more experienced and knowledgeable staff. Resource centre has staff in Invercargill and Queenstown. PSO staffs multi-sites in Otago. PSO also has specific experience as trial provider for the SDHB's new "Restorative" care model. People might like to refer to the November, 2012, GreyPower magazine. It describes the four year long "Enliven Taieri" and 10 year long CommunityFIRST programmes.
Local community relationships: The resource centre and PSO are community-based local providers with local knowledge and links that take years to build. They are accessible - you can talk to the locals making the decisions. They have local, mutually-respectful relationships with the Needs Assessment Co-ordinators, primary providers and other specialist networks. They know local resources and how to access them at all hours to make sure care happens.
Staffing: There is a great advantage in a local carer organisation, where you know long-serving staff are happy working for their organisation and provide stability for older clients. These local providers have a record of staff retention; and a commitment to staff training and quality improvement; to culturally appropriate services; and to health and safety in a variety of workplace settings. In Southland, the resource centre puts great emphasis on providing the right person for each client and supporting staff in excellent service delivery.
Regional reach: The SDHB is the biggest district health board in New Zealand by area; much of it rural. The resource centre and PSO know their region and how to operate throughout it. The mantra of "Right Care - Right Place - Right Time" is not an abstract when you are a locally based provider with a physical presence on the ground. It means you collaborate locally and are responsive to local needs.
Innovation: If the SDHB wanted providers to adapt to the new restorative model of care, the innovation and initiatives already taken by the resource centre and PSO have to rate. Enliven Taieri and CommunityFIRST are mentioned above. The resource centre initiated a hospital courtesy van and the employment of a recreational therapist to support its SDHB clients. PSO also has a respite care initiative in Central Otago. Both organisations are innovative and responsive. People choose them as providers because of their good reputation.
Is there any evidence at all that an Australian firm can near match what the resource centre and PSO have been doing locally for years? A very different health context exists in Australia (even between Auckland and rural Southland).
So that leaves the elephant in the room.
Price: If two long-established, reputable local providers rated highly on every criteria but lost the contract, did it come down to the overseas firm undercutting on price? Is this part of a general National government steer towards a contracting-out/lowest price/no responsibility model? Another Novopay in the making? And if the same quality service can be guaranteed for a cut-rate price, why is this argument not used when it comes to top executive salaries?
This is a five-year contract, with the current decision having the potential to disrupt and upset large numbers of clients and families; let alone the possible effects on many vulnerable workers.
I urge the SDHB to rethink; or at least publicly explain its decision and what possible gains it will bring in terms of "Right Care - Right Place - Right Time".
Lesley Soper was elected to the SDHB 2000-04; was deputy chair 2002-04, and chaired the Disability Services advisory committee. As a Labour list MP 2005-08 she served on Parliament's health select committee.
The Southland Times