Clark David: Ministerial Statements — Southern District Health Board—Replacement of BoardText is incorporated into the Bound VolumeClark David: Ministerial Statements — Southern District Health Board—Replacement of Board[Sitting date: 17 June 2015. Volume:706;Page:4470. Text is incorporated into the Bound Volume.]Dr DAVID CLARK (Labour—Dunedin North): Given years of deficits and months of adverse publicity perhaps the most surprising thing about the Minister’s announcement today that he is considering replacing the board is that it has taken him so long to reach a decision. I think the politics have dictated the timing. Until now the Government has maintained a facade of arms-length operation despite appointing five out of 12 board members including the chair and despite having a Crown monitor on the board for nearly 6 years. That Government watchdog has been reporting to the Minister the whole time and has a direct line to the Minister. Any remaining impression of ministerial distance from decision making is sacrificed with the appointment of this commissioner—perhaps it was becoming a little implausible anyway.I cautiously welcome the appointment of Kathy Grant and Graham Crombie and Richard Thomson respectively. They are well respected locally and I hope that they can succeed where the Minister has failed until now. The odds of course will be stacked against them. Fixing the district health board will not be easy. The cultural challenges are well canvassed. Some departments have worked well together since the merger; others have not. But of course one of the big elephants in the room is funding. The Minister can wish that away but the inquiry that he has launched into the funding model is so narrow that it is clearly there only to dismiss media interest and nothing more.The funding issues will not go away. The Southern District Health Board trains a health workforce for the rest of the country and that appears to be inadequately compensated for. It takes longer to treat patients when teaching students at the same time. It has the largest geographic area of any district health board and yet it does not have the largest funding component. It also has older buildings and that forces older less-efficient styles of operation that involve more staff time. The Minister must address concerns about the funding model. It was introduced by Labour about 10 years ago. It is time that it was fully and properly reviewed.The glacial progress towards a hospital rebuild should bother us all. The Minister needs to commit to a full tertiary hospital with level 6 status. So far he has ducked for cover on that one. Already the hospital has lost accreditation for the training of intensive care unit specialists. A Beca Group report late last year said that Dunedin Hospital’s outdated ward and operating theatre layouts were in need of replacement. That means that a refit will not do it. It is prohibitively expensive to do that. There is asbestos in the buildings. The layout is no longer suitable for modern operating and refitting the old building would not be a wise use of capital.Urgency is needed. The Minister has let time frames slip. The previous Minister said a business case would be at Cabinet this year; the Minister has said the end of this year. The district health board has said the background will not be doneeven by the end of this year. There will be no comfort in the South until the Minister commits—and has a sod turned before his term of Government is out—to rebuilding that full tertiary hospital at level 6 standard.People in the South like people across New Zealand deserve affordable access to decent health-care. It is something that every Kiwi should be able to count on. This Government has continued to fund health care below the rate of inflation. Our health care services are suffering. This Minister no longer has anywhere to hide. With the appointment of this commissioner the fate of the Southern District Health Board is tied tightly to his success in his portfolio.