New DHB chief executive Carole Heatly is embarking on
restructuring. Photo by Peter McIntosh.
The Southern District Health Board will be restructured
to create regional clinical service groupings, rather than
duplications, in Dunedin and Invercargill.
New chief executive Carole Heatly, a Scotswoman who started
last month, said yesterday she had spent much of the past six
weeks on the "shop floor" gaining an understanding of the
"It's fair to say the organisations, Southland and Otago,
merged [in 2010] ... but we've got a number of things we need
to do to make that merger real for the people who work for
Her first step was restructuring the roles of 11 executives
who reported directly to her.
That could see two fewer members in the top team, but
redeployments were highly likely.
Details go to staff for feedback next week, but the proposal
included a single chief medical officer, rather than one in
Dunedin and one in Invercargill.
"There's going to be some big changes, but only if they're
supported by the staff."
When a reorganised executive team was in place, hopefully by
June, it would look to merge eight Southland and Otago
clinical groupings, known as "directorates", into four.
Merging them would take "a bit of sorting out", because they
were not identical, in terms of where clinical services
fitted within them.
Established recently, a Maori health directorate was
unaffected because it already operated across the whole
Leadership roles in the new directorates would involve
considerable travel between Dunedin and Invercargill.
Under Ms Heatly's proposal, the two main sites were equal,
and directorate heads would not necessarily be based in
Staff should have fewer bosses once restructuring was
complete in about six months.
"I think it's really important that if you are a charge nurse
or a departmental head, you shouldn't be more than four or
five levels away from the chief executive."
Ms Heatly expected to be successful where her predecessor
Brian Rousseau failed in 2010, because staff were now ready
for change two years on from the merger, she said.
Mr Rousseau proposed a similar restructuring but backed off
after opposition from staff.
Dubbed by one Southland senior doctor as a plan for a
"travelling circus", the proposal attracted criticism from
staff, many of whom feared the regional directorates were too
Ms Heatly said her proposal would improve patient safety,
increase leadership opportunities for clinicians, create more
convenient services for patients, and cut decision-making
A "streamlined" structure helped move the DHB towards single
This could result in Southland patients being treated at
Dunedin Hospital or vice versa when there was available
space, and more convenient arrangements for patients in
Central Otago and the Wakatipu.
Asked what had surprised her most in her first six weeks at
the DHB, she cited the extent to which Otago and Southland
worked as though separate DHBs.
She hoped restructuring saved money, but cost-cutting was not
the primary motivation.
An intense focus on the DHB's deficit problems had bred
feelings of "negativity" among staff, which she was keen to
address. She wanted to find ways of saving money that
In a letter to staff proposing changes, Ms Heatly said:
"Southern DHB has financial challenges and we can't ignore
our responsibility to live within our means, but it is clear
that this has had an effect on our organisational culture and
the way we do things here."
She told the Otago Daily Times she had been greatly impressed
by the enthusiasm and goodwill of staff.
"Six weeks in, I'm still loving every minute [of the job]."