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With the exception of the incumbent, Dave Cull, Dunedin mayoral candidates view the Dunedin Hospital rebuild and the health service as an election issue. Health reporter Eileen Goodwin canvassed their views.
Dunedin Mayor Dave Cull says there is risk in "crying wolf" and leading public campaigns that are either ignored, or back the Government into a corner.
Mr Cull says the Dunedin Hospital rebuild and health services are not local body election issues as they are not council responsibilities.
He tends to advocate for the Government’s approach taken to the controversial rebuild, but says he has ‘‘a position’’ on one issue — the importance of the University of Otago’s relationship with the hospital.
Mr Cull’s views are at odds with the 10 candidates trying to replace him.
They talk up the role as a cheerleader for the health service.
Some view colourful Invercargill Mayor Tim Shadbolt as a role model, and believe pressure needs to be kept on the Government to deliver.
The Dunedin Hospital rebuild is at a critical point, with quiet planning behind the scenes amid fear of a downgrade and a potential threat to the relationship with the Dunedin School of Medicine.
The hospital itself is under pressure day-to-day, and the most recent development is a downgrade of the emergency department’s training accreditation.
Mr Cull believes fears over the rebuild are misguided.
"I think there has been some apprehension that enhancing generalist wards — grouping people by medical needs not clinical ownership — somehow reduces specialist care.
"In fact [it] could produce economies and allow more financial support for specialist care."
Mr Cull believes in lobbying decision-makers "off-line" and recently met Andrew Blair, the political appointee who leads the Southern Partnership Group.
After meeting Mr Blair, Mr Cull felt confident the Dunedin City Council would be involved in the process in due course.
"I appreciate the overarching importance of the hospital to the medical school, the university and through them to the wider Dunedin economy.
"On that score I do have a position. I want those factors and relationship to be carefully appreciated and considered so the redevelopment does not compromise them."
It was important not to be seen "crying wolf all the time and then [you] get ignored".
"And sometimes a quiet word off-line can be more effective.
"Among other things there is usually nothing to be gained from publicly putting the decision-maker in a corner so he or she loses face if they have to back down."
Candidate Lee Vandervis points to the successful 2010 neurosurgery campaign as an instance where public pressure worked and the service was saved.
"People tend to underestimate public pressure."
Because Dunedin was Labour-voting, it was not considered important by either main party.
That meant it missed out on resources.
"We need to be much more proactive in terms of galvanising public pressure and making people aware of what we’ve got to lose."
Candidate Aaron Hawkins pointed out that the South was stripped of its right to elect health board members, meaning local politicians had a bigger role lobbying for the health service.
"The future of health services in Dunedin has been one of the most common concerns raised with me during the campaign so far.
"With the Government removing our right to elect our own health board representatives, it’s incumbent upon the local elected members that are elected to be more active in this area."
Candidate Scout Barbour-Evans said concern over the hospital had been exacerbated by years of delay around the rebuild.
"It’s been delayed to the point where it’s almost negligent by the Ministry of Health; people very naturally are starting to lose trust. I don’t blame people for being anxious."
Candidate Jim O’Malley said both major political parties had been "withdrawing from the city" for years.
His plan was to get southern mayors to speak as a "single voice" for health.
Candidate Athol Bayne said the council’s role in the "complex" debate was one of advocacy and evaluation to ensure it was doing everything possible to support the hospital, the medical school, and the dental school.
Candidate Rachel Elder said she would liaise with politicians from both Labour and National, and she cited Mr Shadbolt as a mayor who "stood for the people".
Candidate Conrad Stedman also cited Mr Shadbolt as a role model, and said Mr Cull was not very vocal.
People were worried about health and needed to see leadership, Mr Stedman said.
Barry Timmings said Dunedin’s problem was a lack of population growth, which had a direct effect on its health service.
The city needed a "growth agenda" to increase population.
The world was changing and Dunedin was becoming more attractive.
"There is demand emerging for people to want to be in Dunedin which will feed the growth agenda that we must pursue," Mr Timmings said.
Andrew Whiley said Dunedin Hospital and the Dunedin School of Medicine were among the city’s biggest drawcards and had an economic "multiplier effect".
The mayor’s role should be one of "active engagement" with all of the relevant parties in the matter, Mr Whiley said.
Abe Gray said he had "unique" abilities as a communicator, and would use them to become an "effective cheerleader" for Dunedin Hospital.