Barriers to change at hospital do a disservice to vulnerable people

Residents at Wakari Hospital’s Ward 10A deserve better, writes Fay McDonald.

In his recent report to the Southern District Health Board, following his unannounced visit to Wakari Hospital’s Ward 10A last May, Chief Ombudsman Judge Peter Boshier criticised the unsuitability of the building and the conditions of the ward.

It is home for up to 12 people — for at least one of them, for nearly 15 years. A few never leave there. Ward 10A has been unsuitable for its purpose since the day it opened, then at its fresh and smartest best. It was built in the 1950s as a floor of the nurses’ home for the new Wakari Hospital. That design is still recognisable there today.

The SDHB said that to spend money on refurbishments of this ward would be "putting good money after bad", and would not be happening. That is little consolation for the people who continue to live there during the drawn-out time it takes for any major project to be designed, approved, consented and built. The newer Helensburgh Cottage is modern, purpose-built and infinitely more acceptable for those who are making the transition to freer lives.

The people who live at Ward 10A are among those in our society who have been born with or acquired some of the most difficult disabilities, and combinations of disabilities, that life can deal to anyone.

Few people know that some of those difficulties exist and many who do are likely to want to know only that they are safe from such people, and that they themselves are out of harm’s way. They are a disparate group for whom we have not found solutions, and each one of them needs a different solution.

Because there are relatively few of them the needs imposed by group living and by staffing must always overcome an individual’s needs and rights and for minimum restraints on the way individuals live. Some of the legal requirements placed on the forensic residents automatically limit the lives of everyone else. So, for example, all of them are locked in, whether it is required and necessary or not.

Judge Boshier called for independent consumer advocates to be available to the residents of Ward 10A and others throughout the country.

The health and disability advocates employed under the Health and Disability Commissioner Act are exactly that and they have always visited Ward 10A and acted on their clients’ requests.

The staff have always enabled and encouraged advocates to make contact with the residents, and the advocates are reliant on the staff’s concern for their residents to help initiate possibilities for change.

As one of those advocates in Dunedin for 15 years until I retired in 2007, I visited Ward 10A whenever asked to, and was known to the residents and recognised by them to varying degrees as able to assist them to achieve small changes, sometimes.

Current advocates continue to do that today, though rarely. These advocates have the statutory power to support people using health and disability services of all sorts and who are unhappy with the service they receive. But the complaints must come under the provision of the Code of Health and Disability Services Consumers’ Rights if they are to act. Many of the things Judge Boshier mentioned fall outside the boundaries of the code and so these advocates are then not able to act.

In addition, these advocates cannot raise their personal concerns and few of the residents could articulate the extent and certainly the complexity of any of Ward 10A’s shortcomings.

Individual consumer advocates or groups acting without statutory backing have little chance of achieving more than the simplest change. If Judge Boshier, as Chief Ombudsman, has had his earlier recommendations ignored, then what chance have individual advocates to achieve significant change for the residents? This really seems to be one of the "too hard basket" issues.

The people who are living at Ward 10A are unknown to almost everyone; their difficulties are unfamiliar to most of us, and so it is easy for them to remain hidden, locked away and absent from the thoughts of virtually everybody else.

They receive few visitors.

Their disabilities are not the sort we wish to read about on the front page of the newspaper, where they might attract our admiration or our sympathy, and we have no solutions to offer them; there are only a few of them and their plight is easily pushed aside.

Some have burnt out the family members who have earlier cared for them, or are too difficult for others to contemplate living with them. Perhaps they have no family.

In this world full of other demanding people, their needs and their rights become insignificant and lost from sight.

Unless a group of influential, noisy, determined and dogged people, each with a genuine concern, takes up this situation, nothing will change for a long time.

A few years of delay waiting for better facilities may not be long for large bureaucracies and this is representative of the normal way things happen in health provision. But for the people living in Ward 10A each long day is yet another one now shaved off their sad lives.

You and I would want something done if it were our life. They do too.

-- Fay McDonald, of Outram, is a former health and disability advocate.


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