Debate on Crown Entities, Public Organisations,and State Enterprises — Capital and Coast District Health Board

Like my colleague before me, I feel that this particular district health board is a window to the health system at the moment. I mean by that that a number of issues were raised in the financial review of the Capital and Coast District Health Board, and they give us a very clear picture of the hot spots in the health system at the moment. There have been some particular hot spots that I will lead in with, and one of those is around anaesthetic staff numbers, which reached crisis levels during the year. That is the very workforce that was reported on in the report.

We were told by the district health board that it is having huge difficulties in recruiting and retaining enough staff in certain workforce groups. We know how many New Zealanders are heading across the Tasman for better conditions and less tax; in fact, this seems to be having quite an impact on the Capital and Coast District Health Board, as it reported to us. There are issues around attracting specialists, and also mental health personnel. The problem is less so with junior doctors but certainly affects getting nurses.

The district health board also acknowledged that it has faced a significant financial challenge in recent years, but when looking at the many more billions—the extra $4 billion a year—that have been poured into the health system, we must wonder where the board’s extra funding has been spent, and we would suggest that it has gone to bureaucrats.

The district health board also mentioned, in terms of workforce, that it is having difficulties attracting a workforce to home and community-based care—we are talking about aged care now—and it is having to look at strategies to ensure that demand can be met. Although it is exploring some innovative new services it certainly is having difficulty, because even though there is low unemployment, that is a sector that is certainly low in morale, as well.

Another pane of glass in the window to the health system is the 2,500 patients who were referred back to primary care in this financial year, when the revised booking system came into effect. As the Health Committee, we had to recommend that the district health board carefully monitor the patients who were referred to primary care, to make sure they had adequate support—that is, that they were not left high and dry with no options other than to continue to suffer in pain. There was some suggestion that their referral visit to their general practitioner would be paid for. But that is not enough; these people had an expectation that they were going to get their surgery. They know that many billions of dollars are being put into the health service, and they are wondering why on earth they are suddenly being left high and dry without either their first specialist appointment or their surgery.

Like other hospital boards, Capital and Coast District Health Board has suffered its share of adverse events. Unfortunately, included in those adverse events was one that hit the headlines—that is, the care and treatment received by a 50-year-old man who died 40 hours after being admitted to Wellington Hospital. The post-mortem found that he died of respiratory failure and pneumonia. The really tragic thing is that he had received very poor care from both medical and nursing staff, as reported by Health and Disability Commissioner Ron Paterson, who advised that the case was not an isolated one. In fact, the gentleman had an X-ray taken that showed he had the early stages of, or was developing, pneumonia, but the X-ray was not read. Staff shortages were no excuse for the failures by Wellington Hospital to care for that man properly, according to Mr Paterson; I have to agree with that view. The hospital took it on the chin, but that case is yet another pane of glass in the window to the health system.

Hospital-acquired infections, generally considered to be adverse events, were reported by this district health board, as by other boards, and also medication-related errors. In fact, there were approximately 320 medication-related errors. This, indeed, is another symptom of an ailing health system.

Work is happening within this district health board in oral health, which is another interest of mine, but the board has found it extremely difficult to attract practitioners from oral health services in the community to look after the oral health of adolescents. This is a country-wide problem and certainly cannot be attributed to this district health board being rural, because in the main it is not. But it does highlight the effect that this Government is having on relationships within the health sector. I have spoken already about anaesthetists, but the issue relates to dentists as well.

Report noted.

Counties Manukau District Health Board