The Southern District Health Board has been ranked the
poorest-performing DHB in an assessment of doctors' and nurses'
involvement in decision-making.
Led by the University of Otago's Centre for Health Systems in
Dunedin, the national survey released in Wellington on
Thursday is believed to be the largest carried out in the
Southern was ranked 49% for ''clinical governance'' behind
other low-ranked boards, Whanganui, Bay of Plenty and West
Best-performing were North Island boards Counties Manukau
(highest-ranked, 65%), Wairarapa, Tairawhiti (Gisborne),
Hawkes Bay, Northland, and Taranaki.
Southern health workers were least likely to say they
involved patients and families in care; least likely to say
their DHB supported clinical leadership; least likely to
agree the DHB had established partnerships between managers
and clinicians. Speaking at the national survey's release,
Health Minister Tony Ryall said the Government had directed
boards to restore clinical staff to positions of influence.
''Cast your mind back four years, and there was significant
disengagement between clinicians and managers. You read it in
the newspapers almost every day.''
Commissioned by the National Health Board (NHB) and the
Health Quality and Safety Commission, the project gauged
progress since the In Good Hands clinical leadership report
There had been progress, but more work was needed, Mr Ryall
Association of Salaried Medical Specialists executive
director Ian Powell was disappointed, but not surprised, to
see the southern board ranked lowest.
Significant changes called for in last year's systems review
of Dunedin Hospital had not eventuated, he said.
The board placed its faith in restructuring to effect a
change in culture, which had not worked.
''There's a big disconnect,'' Mr Powell said.
Southern board chief medical officer Dr David Tulloch said in
a statement recent restructuring to merge Dunedin and
Invercargill clinical departments increased clinicians'
A new decision-making model put them on an equal footing with
managers, and ''once they are properly in place, I would
expect a vastly improved response''.
NHB national director Chai Chuah said boards had made
considerable progress developing clinical leadership: ''DHBs
need to accelerate and increase these activities. The
challenges of the health sector can be met as clinicians are
fully engaged, lead changes, and provide clinical governance
over the triple aims of quality, access, and remaining within
The survey drew 10,303 responses - a 25% response rate. The
survey targeted doctors, nurses, midwives and allied health
The quakes-affected Canterbury DHB was left out.