The people of the South care intensely about the quality and range of their health services.
They demonstrated that emphatically during the neurosurgery campaign, and many years earlier with fights to retain rural hospitals.
That is not unusual. People everywhere rally for something as fundamental as health.
There is an extra element, nevertheless, for Otago and Southland, and Dunedin in particular. We have been fortunate to be the base for a teaching hospital, an historic situation that has become entwined with the University of Otago, the city and the region.
The hospital’s health is about far more than just our health. It is vital for the future of the city.
It is, thus, with extra trepidation the South faces the appointment of a Government commissioner and her deputies.
As former chairman Joe Butterfield and Association of Salaried Medical Specialist executive director Ian Powell have in essence said – be careful what you wish for. No-one should think the intense pressure on funding and the cuts will abate.
No-one should imagine it could be business as usual.
The southern deficit next year could be ”north of $42 million”, and something had to change.
The last major management restructuring and efforts of the now sacked board failed to arrest the financial slide.
It should be noted, however, that
$42 million is not an astronomical amount when compared with the Southern District Health Board’s annual budget of about $870 million. Nor does it seem quite so large when $26 million is being spent on flag referendums.
The fairness of the opaque population-based funding model again has to be questioned. The South failed to attract the increases of other areas in recent times and for various reasons could be seriously disadvantaged.
If the appointment of a commissioner is the signal for a fresh start then everything should be on the table, including how funding is calculated with an analysis of its fairness. After all, the South has to cope with the largest geographic area, the extra costs for teaching and many – and usually more costly – older patients.
It has been argued that elected health boards were fig leaves designed to partially cover-up central government’s primary responsibility and influence.
While the Government shrewdly appointed a local commissioner team – making it harder for southerners to blame everything on Wellington – the principal fig leaf has been pulled away and the Government is more directly exposed.
In one way that is positive, with the Government having a vested interest in the commissioner making progress.
It will do its best, in whatever way possible, to endeavour to make sure its appointees at least appear to be making a difference.
While expecting the deficit to disappear might be unrealistic, the Government will want to show the wisdom of its decisions and will seek to see the deficit trending downwards.
Commissioner Kathy Grant has a low profile for someone so prominent in Dunedin governance and public bodies.
Notably, she has been involved in the success of the Otago Polytechnic. Deputy Graham Crombie, too, is hardly a household name despite his pedigree.
The appointment of Richard Thomson will be a surprise to many. Sacked as Otago District Health Board chairman by National minister Tony Ryall, he returned to the board as an elected member. He has now been sacked again, only to take a new key role.
It is encouraging the last deputy role will go to a clinician (yet to be selected).
Health and hospital systems are fiendishly complex. Almost every change in one place inevitably affects other departments and wards.
It will now be up to the commissioner’s team and senior management to deal with that challenge and find further ways to save money, increase efficiency and reduce waste.
The battle-weary staff, meanwhile, again will have to do their best to help for the good of their fellow citizens in Otago and Southland, trying to overcome their understandable scepticism and fatigue.
The stakes for health in the South are high for both the Government and the people.
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