The review, commissioned from Hamilton consultant Leena Singh by the Ministry of Health, was described by its author as confrontational and designed to start an honest conversation.
The review, a copy of which was supplied anonymously to the Otago Daily Times, said it was difficult to determine if the board was meeting the health needs of the region as no one person was responsible for determining that.
Planning and funding models present in other health boards were not used at the SDHB, departments operated in silos rather than collaboratively, there was little accountability, and the board made short-term fixes which caused problems elsewhere in the organisation later.
The current system could not continue or it would create unnecessary stress and burn people out, the review said.
Other sections of the southern health system also came in for criticism, and the review said there was a dysfunctional relationship between the SDHB and the WellSouth primary health organisation.
Resources were allocated to departments which demanded them rather than areas which needed them and there had to be a concentrated effort to improve governance, the review said.
The board was prepared to accept that projects would go over time and over budget and not meet all their objectives, and had commissioned a range of strategies which had not been implemented and did not seem likely to be.
The board’s performance has previously been criticised by Health Minister Andrew Little, who cited overcrowding issues in Dunedin Hospital as an example of why reform of the health system was necessary.
Those reforms include the scrapping of the DHB system, due to occur in July next year.
The review said the next 12 months would be a test for the SDHB, which needed to have frameworks in place so the move to the new system could be made easily.
SDHB chairman Pete Hodgson - appointed to the position in December after former chairman, the late Dave Cull, was diagnosed with cancer - said the review raised a lot of important issues and the board was likely to implement many of its recommendations.
"There is no shortage of dramatic language in there and no lack of basis for it," Mr Hodgson said.
"I think it’s fair enough to say the board has had a history of lurching from crisis to crisis ... but the more important part of the report is that there is the opportunity for organisational redesign which should address some of those issues."
The SDHB was now, coincidentally working on a "strategic refresh" and Mr Hodgson said while it was a different piece of work, it would address some similar issues to those in the review.
"We need to have a much more structured approach to our decision-making, we need to hold people to account and we need to give people the freedom and sometimes the budget to get on with their job."
Mr Hodgson said the report was in an early draft stage and the SDHB was meeting the author next week for further discussion.
"We will make it public eventually ... but it is simply too early because some of the issues raised will probably be contested so it is probably not in its final form.
"We hope to give a considered response in weeks rather than in months."
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Still more talk, still waiting for action. Same old story from this DHB. In the mean time, patients, such as I, face longer than acceptable waiting lists, and in my case at least a far shorter time left on this earth.
It's beyond time for talk - action, now, to help others who, like me, are suffering from unmet need.
Oh for heaven's sake. Another review? We know what the problems are and we know what has to be done to fix them. It just seems the government doesn't want to put more money into health so it keeps reviewing to avoid actually doing anything. Meanwhile people are getting sicker, waiting longer, and getting very varied care, at best.