The Waikato District Health Board is still getting plenty of things right.
That's the view of health board chairman Bob Simcock, who said he remained adamant a recently published Ministry of Health report finding fault with the board's management in several areas was far from a damning indictment of the organisation.
"I believe the report is reasonably balanced. There are bits that people disagree with . . . [but] what is recognised is this DHB has continued to perform comparatively well when measured against the other DHBs in this country.
"Waikato DHB has delivered over target on electives. People are getting access to surgery . . . the building project has been managed successfully. There's a whole bunch of things that are going well."
Another positive aspect the ministry reviewers found in their investigation was how openly they were received by health board staff and the willingness of the staff to share their views.
"That's a credit to the current management," Simcock said.
He was unable to say whether the job description for the health board's next chief executive would be tweaked in light of the report.
"The bottom line is the people of this region get access to world-class medical systems. That's the real context of the report.
"I'm feeling challenged. We are needing to move from being a building-focused organisation to making sure we are providing the services we need to. The senior and clinical managers have been working their guts out trying to change things for the better."
Earlier, Simcock posted a message to staff on the health board's intranet denouncing the Waikato Times' coverage of the ministry report.
"Most people I have spoken to believe the conclusions in the review are fair, but it is only a snapshot and does not accurately recognise what is already occurring to deal with the operational issues identified.
"If we are to improve the way we care for our patients and our community we have to be open and recognise and understand what we do well and what we need to improve on.
"We cannot allow others to stop that process. If the sort of reporting the Waikato Times has done stops us being honest with ourselves, that will disadvantage our community. We had the courage to ask for the report and the courage to make it publicly available."
Meanwhile, the New Zealand Nurses Organisation says it will keep a close eye on the board in light of the report.
Professional nursing adviser Kate Weston said that, if management felt under pressure to improve performance, the danger would be transferring that pressure to frontline staff.
The Waikato DHB situation was not unique, she said. "What's interesting is that this is the second large DHB getting into hot water over the past week."
The Capital & Coast District Health Board, battling to overcome a forecast $6 million deficit, had gone to its staff for their ideas on how to cut costs.
"It begs the question of whether a similar situation is happening at Waikato."
The union had for some time been calling on Waikato DHB's managers to buy a staff-planning system known as an acuity tool. Most of the country's health boards used an acuity tool called TrendCare, which matched the number of nursing staff with patient demand.
Waikato had refused to buy the TrendCare tool.
"Most New Zealand DHBs have it, yet Waikato have steadfastly refused to and we don't understand why. It would help with standardisation and benchmarking and sharing of learning.
"Certainly there would be an initial fiscal impact, but the benefits would soon start to flow through."
The union had other questions - of the Government as well as the board.
"Why is this board being put under such pressure at a managerial level? The DHB has to be supported at government level but, instead, they are getting hassled. Is it a fair set of rules they are being asked to play by?"
The full report is available for the public to read on the health board's website - waikatodhb.health.nz/about-us/key-publications/.
Good points and bad points found in the ministry review
DHB performing well financially in light of Waikato Hospital campus rebuild.
Elective surgeries at 113 per cent ahead of planned discharges.
Waikato's mental health service working well and a model for good governance.
Excellent "care pathways" developed with community nursing and primary care teams in Taumarunui.
Some savings being made through improvements in pharmacy supplies and other areas.
Proportion of patients being seen within six hours has lifted from 87 per cent to 94 per cent over recent months.
Clear evidence of commitment to health service delivery, loyalty to Waikato Hospital and the community served.
The DHB is considered by staff as "still a great place to work despite the frustrations".
DHB not managing demand "at the front door" well.
Flow of patients between hospital services, particularly emergency department, is often hampered.
Executive leadership team does not appear to operate well as a collective and is not visible to staff.
Organisational structure too complex, with an array of positions and titles added or tweaked over various restructures.
Unclear lines of authority, responsibility and accountability.
Lack of staff buy-in and poor understanding of the DHB's plans and priorities.
Staff frustration at introducing innovation or change without having to go through laborious approval process.
Some issues are affecting operating theatre performance and productivity.
Waikato Hospital site lacks "patient-friendly" feeling.
- Waikato Times