Editorial, December 7: Health service betrays capital

New Zealand's health system has been shamed this week with the news that a baby died in her home after being removed from hospital less than six hours after a traumatic birth. The baby's mother had been in labour for 30 hours. She was given an episiotomy where a cut is made into the vagina to make childbirth "easier", and an epidural which is an extremely painful injection of anaesthetic into the spine and looked a sure candidate for a caesarean section. But after delivering her first baby without the operation at 5am, the exhausted woman was on her way out of Wellington Hospital at 10.30am, apparently after discussions with her midwife and under the impression she could not stay. The new parents took their baby home - and within 24 hours were mourning the death of a little girl who should never have left hospital.

It was little wonder that after Capital and Coast Health pointed the finger at the woman's midwife, Prime Minister Helen Clark announced she "deplored" the board's behaviour. The case lifted the scab on the country's most dysfunctional health service a "toxic management environment" as National's health spokesman Tony Ryall called it. Health Minister David Cunliffe yesterday elected not to sack acting board chairperson Judith Aitken, instead announcing he would take the matter to cabinet. But with chief executive Margot Mains gone, courtesy of her decision to bring forward her retirement from February to Wednesday, the way is clear for the minister to remove Ms Aitken and appoint a commissioner. The other option, to sack the board as Helen Clark did in 1989 in Auckland when she was health minister, seems less logical given the new board, with some members elected last October, has yet to take office and the outgoing one had its final meeting this week. The Government had no option but to move in. This week's news of the death of the baby was one of four major issues which had shamed the board in recent weeks.

Late last month an embarrassed Ms Mains withdrew $100 grocery voucher bribes which were being offered to mothers who left hospital within six hours in December and January. It got worse this week with the release of a report, applied for under the Official Information Act, which spelled out problems at Capital and Coast District Health and gave multiple examples of where compromised care had resulted in patients suffering or dying. The outgoing board's credibility was shot when a secret report to the minister revealed it was in financial strife, needed to cut $22 million from costs, and managers and health ministry officials had suggested slashing doctor numbers.

Why the newborn died, and whether or not it was related to the early release from hospital, has not been established. But patients using the service can no longer be confident that they are receiving the highest quality of care. It has also been claimed midwives have been bullied into encouraging women to leave hospital sooner than they should. Regardless of who leads the board, issues must be addressed urgently and openly.