Ministerial Statements — Capital and Coast District Health Board—Appointment of Crown Monitor 
Ministerial Statements — Capital and Coast District Health Board—Appointment of Crown Monitor 
[Volume:644;Page:13951] 
Ministerial Statements 
Capital and Coast District Health Board—Appointment of Crown Monitor 
Hon Dr MICHAEL CULLEN (Deputy Prime Minister) 
: 
 I wish to make a ministerial statement under Standing Order 348 relating to the appointment of a Crown monitor for Capital and Coast District Health Board. Over recent months a number of issues relating to the management of Capital and Coast District Health Board have become significant concerns for the Government and for the Wellington community. Without at this time rehashing points that have already been made and fairly widely debated within this House I will say that the quality of health services is a major priority for the Labour-led Government that we invest heavily in it and that we have achieved real and measurable improvements right across New Zealand.  
The priority we place on improving health services for our families also means that when our standards are not met and when the public has a right to feel that their expectations are not being met then the Government must act. At the Cabinet committee this week Ministers discussed the problems facing the board and a range of proposals to address them. We endeavoured not to make a decision in haste. We knew we had to get this decision right. The Government has just announced—the Hon David Cunliffe being in Auckland today—that a new chair and a Crown monitor will be appointed to Capital and Coast District Health Board. The Crown monitor who will report directly to the Minister is Dr Ian Brown an obstetrician and gynaecologist who is the current Director of Medical Services at the Northland District Health Board. He is also the former chair of the national Chief Medical Officers’ Forum and has been a member of the National Medical Strategy Workforce Group. I acknowledge that Dr Hutchison who of course was a practitioner in this area recognises Dr Brown’s expertise and value.  
The new chair is Sir John Anderson the current chairman of Television New Zealand and of course one of New Zealand’s pre-eminent business leaders with a proven record in governance. Ken Douglas will remain as deputy chair to provide continuity.  
Of course the Government at this point is appointing new board members in any case to all district health boards around the country and therefore of course the fact is that appointing a new chair is by itself not necessarily a matter of particular note but in the case of Wellington it obviously bears some relationship to other matters.  
The first priority for the new board and the Crown monitor will include consulting with clinical staff on the creation of a forward plan for the district health board. As well as appointing the Crown monitor the discussion on providing deficit support to Capital and Coast District Health Board will continue. Discussions with the board will focus on deficit support in order to relieve some of the financial pressure currently experienced by the board. This does not mean that it has an open cheque book. It means that this district health board is expected to resolve the issues it has and that the Government will be working with them to ensure that all solutions are sustainable.  
In closing I think it is important to stress that the vast majority of Wellingtonians who rely on Capital and Coast District Health Board get a very high standard of service. The doctors nurses and other staff at the region’s public health facilities are committed and hard-working. They deserve praise not the ridicule that some members of this House have expressed.  
Hon TONY RYALL (National—Bay of Plenty) 
: 
 I wonder whether the Minister of Health could clarify whether the Peter Douglas being appointed is the same Peter Douglas who is currently on the board. The Minister is standing in the House today and saying that a new board will be expected to deal with the problems facing Wellington Hospital when half of its members were on the old board. I do not think the people of Wellington will buy that.  
The culture change required at Wellington Hospital will be harder to achieve now that the Government has baulked at appointing a commissioner. What is needed at Wellington Hospital is a culture change and that is no easy task considering the climate of mistrust that exists between the management the board and the doctors nurses and other front-line heath staff.  
Government briefing papers have revealed that the Labour Government has had Wellington Hospital under intensive management or intensive monitoring since May. I cannot see how the idea of a Crown monitor will mean much as the Government has been actively monitoring Wellington Hospital for the last 6 months and all the while has been watching this crisis unfold at the Capital and Coast District Health Board. For half a year while the Government has been intensively monitoring Wellington Hospital public health services in our capital city have been allowed to suffer. I think Wellingtonians will trust Sir John Anderson and look to him for action but we believe that a commissioner would have had a more immediate impact on turning this hospital round. This turn-round could have been achieved more effectively by a commissioner. Creating culture change will be very challenging from the chairman’s seat and even more challenging when Sir John is also trying to turn round Television New Zealand.  
Sir John is left with a lot of baggage from the old board. Not only were four people re-elected by the people of Wellington on false pretences because they were part of a board that suppressed damning reports on the quality of that hospital but also Sir John is left with a lot of baggage from that district health board. There are four members whom the people of Wellington re-elected plus two more board members whom the Government is reappointing. Can we really expect Sir John to turn round Wellington Hospital when more than half of his board are the same failed people who as we have seen brought the Wellington health services to its knees?  
The most important message that the Opposition can give the Government is that front-line personnel must be part of the solution. They have been treated as though they are the problem. That is ridiculous. We have detailed previously a number of proposals that will re-engage the clinical workforce in improving the quality and productivity of services at Wellington Hospital.  
It is simply bizarre that since the Government changed Wellington Hospital has hired more managers and administrators than doctors. It has taken a crisis in maternity drastic problems with community services a damning audit report and papers showing one serious mishap after another for this Government to do anything about the state of public health services in the capital city of New Zealand. This is a Government that has dithered and dithered over saving our capital city’s health services.  
I am sure the people of Wellington will be keeping a very close eye on the performance of this board. I think people will be stunned that the Government expects a board made up of most of the people who were involved in causing the problem to be part of the solution. That is a job even a gentleman of the calibre of Sir John Anderson will struggle to meet. 
PETER BROWN (Deputy Leader—NZ First) 
: 
 My contribution will be brief but hopefully to the point. New Zealand First acknowledges what the Government has done and is supportive of it. We also recognise that the medical staff—the doctors and nurses and all involved in that hospital and district health board—do a first-class job and are first-rate people. We believe that something had to be done and we believe that Sir John Anderson is the right person to head the new team—so to speak—with the help and assistance of Ken Douglas. We sincerely wish them well. 
JEANETTE FITZSIMONS (Co-Leader—Green) 
: 
 The Green Party welcomes the step the Government has taken to sort out the appalling mess at Wellington Hospital. Unlike the National Party we think this step will have minimal interference in normal processes yet maximum effect in turning things round compared with completely overturning the board and starting again. We sincerely hope it will work and we express our support for all the medical staff who at last are to be consulted on the way forward for this hospital. 
TARIANA TURIA (Co-Leader—Maori Party) 
: 
 The Maori Party supports the move the Government has made at this time. It is our firm belief that the board actually does have the confidence of the community at large because its members have only just recently been elected. Having used the services at Wellington Hospital myself as have members of my family I commend the people who work at that hospital for the great service they provide. Kia ora. 
HEATHER ROY (Deputy Leader—ACT) 
: 
 On behalf of the ACT party I say that we too felt that a commissioner should have been inserted into position—an independent commissioner with the ability to think outside the square and turn this organisation round. Unfortunately the board has a very familiar look to it. The Government has had 6 years to rectify the situation at Capital and Coast District Health Board. I wish the board well but I suspect we will see very little in the way of change.  
There is a difficulty with the district health board format. Boards are democratically elected but unfortunately democracy ends there. Boards are given the instruction that they are there to implement the Government’s health policy. That will not change. Systemic failure which has been rife I am sad to say at Capital and Coast District Health Board results in medical errors being made. This Minister of Health the Hon David Cunliffe in his very short time has managed to misinterpret very deliberately and cynically criticisms of himself and his health policies as an attack on the clinical staff at Wellington Hospital. That is quite wrong. There is no one in this House I think who does not believe that the doctors nurses and other health professionals working at Capital and Coast District Health Board are very committed professional and provide excellent skills.  
But when systemic failure arises it inevitably results in medical errors. That is exactly what we have seen. It was very distressing to see a report earlier this week about a razor gang—and the proposed cutting of 50 doctors. I can liken that only to cutting muscle rather than fat in an organisation in crisis. We do not believe that this business of dealing with Capital and Coast District Health Board’s woes has been done quickly or boldly enough. I hope things improve at Wellington Hospital but sadly I fear that will not be the case. 
JUDY TURNER (Deputy Leader—United Future) 
: 
 United Future supports what the Government has chosen to announce today. We certainly support the appointment of Sir John Anderson. We think he is a very fine choice to be looking at the very serious matters that face this district health board. We encourage the Government to continue to keep a very watchful eye on and stay in close contact with the Crown monitor as things progress. We would hate to think the Government has completely ruled out the option of appointing a commissioner in the future should the situation prove to be more serious than it looks even now. Having said that it is not because we have any disregard for who has been appointed.  
We also support the comments made by other members of this House regarding their commitment to supporting the very fine staff who work for this district health board. We want to make sure that where there are systemic problems for that district health board they are addressed as such and that this House refrains from attacking people who are delivering a very fine service. 
Hon Dr MICHAEL CULLEN (Deputy Prime Minister) 
: 
 I will respond to one key point raised by both Tony Ryall and Heather Roy which is whether a commissioner should have been appointed. Clearly the Government considered that option. There is a major legal barrier to the appointment of a commissioner. Even though there is substantial continuity in the membership of the Capital and Coast District Health Board as a legal entity in any practice this is a new health board not the old health board. A new health board started only this week. It would therefore be very difficult for the Government to justify under any legal challenge the appointment of a commissioner to replace the current board before that new board had had a chance to show whether it was capable of turning round the situation at that board. Let us not pretend that litigation does not occur in those kinds of circumstances. In other words the advice that I had very clearly as Attorney-General was that we would be exposed to a very serious risk that any such action could be challenged and overturned in court. That was not therefore thought to be the appropriate way to proceed in this case.  
On the second point made by Mr Ryall I fully agree with him that the front-line personnel need to be part of the solution. That is another reason why the Crown monitor who is being sent in is not a person from outside the hospital and medical profession but is in fact a highly experienced person within the hospital system. He has very high credibility and has participated in a range of activities that clearly well suit him to form that crucial bridge between the board and the medical staff and to ensure that proper consultation occurs.  
The Government has every hope that the appointment of a new chair and a Crown monitor will lead to a change in the effectiveness of the governance arrangements at this district health board.