Battle for openness ahead

Southern District Health Board chairman Pete Hodgson (centre) heads the board’s final meeting...
Southern District Health Board chairman Pete Hodgson (centre) heads the board’s final meeting held earlier this month. PHOTO: PETER MCINTOSH
The cat was unimpressed by the last meeting of the Southern District Health Board, preferring to hunker down under the duvet to avoid seeing it on my laptop.

She would not be the only one to be less than enthusiastic about such meetings, but as a reporter I have always appreciated them.

That is not strictly true. In my early reporting days, I sometimes fell asleep in Gore Borough Council meetings (thankfully, without snoring and dribbling). I doubt I missed anything important, because when councillors were getting passionate about something, the noise level would rise and so would my eyelids. My trusty pen would be at the ready to capture the debate.

I am not particularly sad about the end of the DHB system. While voters might have believed elected board members represented community interests, legally, all board members’ first responsibility was to the minister of health.

Ministry pressure on boards was not always sensible. This was highlighted by retiring DHB chief executive Chris Fleming’s revelation at this month’s meeting that when senior leadership signed off the Southland Hospital redevelopment in 2002, they said "we agree to this, but we note it won’t suit in winter".

Pressure had also been applied over the redevelopment of Dunedin’s intensive care unit to accept something which would never work to fit a budget, something the board’s then commissioners had to address.

How much pressure will apply under new arrangements is unknown, but Mr Fleming urged staff involved with site planning not to succumb to it.

Something DHBs offered, absent in the new set-up, was a regular public opportunity to peruse some of their reports and attend or view their public meetings.

Public meetings, particularly those where bodies must provide agendas and reports in advance, can be a treasure trove for journalists if they have the time to read and understand and attend meetings. Reports can provide stories in themselves or spark curiosity about an issue, and give valuable background information about how an organisation works.

(In a report to the board’s April meeting, for instance, I noticed reference to the auditing of acute colorectal cancers checking patients had not been declined a colonoscopy or other treatment. In May, after I asked how long this had been going on and what was revealed, I was told it started in April last year. It showed none of the nine cases found had been declined colonoscopy or other appropriate service.

This information was greeted warmly at the board’s final meeting. It is good news, although it does not make up for the board’s reluctance to carry out similar analysis of acute colorectal surgery from 2013 to 2020, the years when access to colonoscopy was more restricted. I wonder if there are more instances of poor management of cases from that time yet to emerge from complaints to the Health and Disability Commissioner.)

Under the health reforms, there is reference to the three-year health plans for localities (a particular geographic area) becoming public once they have been agreed, but what opportunity there will be to peruse draft documents or witness input into such plans is not spelled out. What our locality will be and when it will be introduced is still unknown.

Call me cynical, but I expect anything done in public will be highly stage-managed.

Up until now the Ministry of Health has not been great at proactively releasing documents and I would be surprised if any of the new bodies has enthusiasm for openness at its core. I am sure we might have heard about it by now if that were the case.

Where will that leave reporters trying to shed some light on what is going on in their backyard?

There will be issues which experienced reporters already know about and can presumably pursue through Official Information Act requests, as frustrating and time-consuming as that might be. They will be able to put questions through communications staff, but if they turn out to be situated outside our area, how readily will they know who to go to for a quick response? How often will reporters be allowed to speak to anyone in a local leadership position?

My experience of communications staff in a variety of organisations suggests they vary considerably in their ability to get sensible answers quickly, and some seem to see their main role is to impart as little information as possible.

And what about the issues we do not know about already which may be bubbling away in the background or being shoved under the nearest tatty old bit of carpet?

If reporters are reduced to lodging wide-ranging fishing Official Information Act requests for material which would once have shown up as a matter of course through DHB meetings, that does not seem like progress.

 - Elspeth McLean is a Dunedin writer.

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