District Health board member Richard Thomson protests too much with his adoption of a disdainful, holier-than-though attitude dismissive of those who view things differently from him (ODT , 29.3.14).
I am not going to replicate his style by observing the Health Ministry report which revealed serious systemic failures at Dunedin Hospital largely referred to the period when the DHB was under his leadership.
Instead, let's stick to the issues without distraction.
There are several areas where he is wrong or does not give a full picture of the decision to contract out the breast-screening service.
First, he blames Counties Manukau for telling them they would no longer provide the back-up second-reads service they had provided.
I'm sure Mr Thomson genuinely believes this.
I did myself for a while, because Southern chief executive Carole Heatly told us this also (and I'm confident she genuinely believed it, too).
But it turned out to be false.
We were all misinformed.
Subsequently, I read an article in the fortnightly NZ Doctor publication reporting Counties Manukau disputed this claim.
Stunned, I rang the Counties Manukau chief executive.
I was advised the NZ Doctor report was correct.
In fact, noting their contract to provide second reads was coming to an end, Counties Manukau not only offered to continue it but also to provide more support if it was wanted.
However, they found it impossible to get clarification over what precisely Southern wanted.
Southern management's inability to provide the necessary clarification over what support they wanted left Counties Manukau with no option but to withdraw.
This outcome was not due to Counties Manukau and was avoidable.
This is reinforced by the fact the Southern DHB's initial consultation paper highlighted the so-called Counties Manukau decision to discontinue support as the pretext for contracting out breast-screening.
But in their final decision document this is ignored as the reason or even as being important.
Second, those working in the breast-screening service, including its clinical leader general surgeon Stephen Packer, were marginalised over the decision to contract the service out, as has been previously reported in the Otago Daily Times.
At best they had a reactive role.
They should have been in the engine room of decision-making but effectively were disengaged.
They believe the contracting-out decision was wrong and they are right.
Third, while Mr Thomson may be correct that they knew there was a ''potential'' flow-on consequence for breast diagnostic services in the DHB, this is a major underestimation.
It is much more than this and had management properly engaged with their staff providing the service they would have known that what they called ''potential'' was real and definite as much as night follows day.
Breast-screening and breast diagnosis are joined at the hip like Siamese twins.
Where one goes, the other goes.
It was Stephen Packer and his colleagues who, despite being critical of the flawed decision to contract out the former, had then to persuade management to contract out the latter because there was no clinical choice.
This has been confirmed to us from within management.
They underestimated the flow-up and consequently misinformed Mr Thomson and his fellow board members.
• Ian Powell is the executive director of the Association of Medical Specialists.
