Action needed on recommendations

PHOTO: Gregor Richardson
PHOTO: Gregor Richardson
We hope the Southern District Health Board and the Ministry of Health are paying attention.

Chief Ombudsman Judge Peter Boshier says an inpatient unit at Dunedin’s Wakari Hospital has given him possibly the most concern of any facility his office has looked at.

The record of the DHB and ministry to date on this has not been impressive.

Some vital recommendations remain unheeded despite being made following a 2014 inspection.

Judge Boshier’s report issued last week concerned an unannounced inspection of Wakari Hospital’s Ward 10A and Helensburgh Cottage last May under the Crimes of Torture Act 1989.

He has not minced words about it, reported elsewhere as saying the ministry was ‘ missing in action" and the situation was "Third World".

There is not room here to itemise all the issues found with 10A, but lumping male and female patients with complex needs with some who were criminal mental health patients in a woefully inadequate facility was described as unsafe and a "volatile" environment.

Judge Boshier wants immediate action to prioritise a rebuild or redevelopment of the ward.

It is no surprise that Ward 10A is unfit for purpose.

Multiple reports have described it thus, including the Office of the Ombudsman in its report following the 2014 visit.

The ward, which opened in 1992, was developed on the ground floor of Helensburgh House at Wakari Hospital, occupying what had been a nurses’ home.

Changes made since then have not been enough to ensure it is adequate.

Judge Boshier also drew attention to the frustration of those working there, saying staff describing their own facility as a disgrace was something he had never encountered before.

"Staff expressed frustration and disappointment at the ongoing poor state and design
of the ward and described the negative impact the environment had on patient care, recovery and rehabilitation.

"Senior management told my inspectors that they had repeatedly raised their concerns with the DHB regarding the physical environment," Judge Boshier said.

The ward was described as stark and unwelcoming, poorly furnished, badly maintained and lacking cleanliness.

Judge Boshier found the poor state of repair unacceptable in a hospital environment, unsafe for both patients and staff and severely compromising the dignity and independence of patients.

"All patients are entitled, and should expect, to receive healthcare in a clean, safe and well-maintained setting."

We can understand how demoralising it is for staff, clearly trying to do their best, when their frequent requests for improvements are ignored (and the DHB can have no excuse for poor cleanliness).

Planning for a replacement for the facilities at Wakari Hospital has been far too slow and we are still some way from knowing what will happen and when.

In the meantime, Ward 10A cannot be allowed to limp dangerously along in the same way for who knows how many more years.

Recognising that these facilities reflect the decades of paucity of proper planning for hospital buildings throughout the country will be no comfort to patients or those working with them.

It is not a triumph of our democratic system when a watchdog with the status of
the ombudsman is ignored following inspections of facilities caring for people who are vulnerable for one reason or another.

In the past, Judge Boshier has spoken out about the Corrections Department’s failure to respond to repeated calls for improvements.

In the Wakari Hospital instance, he said it was extremely frustrating his office was given powers to inspect
and comment and that it made recommendations which were accepted and then nothing changed.

We agree with his view that it is compromising the integrity of his office.

Those responsible for the management and governance of the DHB and the Ministry

of Health need to urgently address such inertia.

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