So too have plans to replace them: deep disquiet continues to rumble in the South over the trimming and hedging in the services and spaces which will initially be available upon the opening of the much anticipated and desperately needed new Dunedin hospital.
The focus, not to mention the enormous expense, of building a new facility for residents of the lower South has caused many, including this newspaper, to question whether the equally as neglected Wakari Hospital would ever receive a much-needed upgrade.
Hence, the announcement last week by the government that a contract had been signed to complete a much needed and appallingly overdue refurbishment of Ward 10A at Wakari was welcome good news.
Ward 10A is a secure hospital facility which treats patients with intellectual disabilities who have been convicted of criminal offences or who have been assessed as being a risk to themselves or others.
However, the building was not constructed for that purpose, a fact which the many reports into its many failings have highlighted as problematic.
Ward layout and design is not conducive to contemporary therapeutic or safe care, patients cannot separate themselves from others or avoid unintended contact with other patients or staff, and the ward lacks dedicated spaces for therapeutic programmes, quiet spaces, gender separation, or clinical and interview spaces.
An ombudsman’s inspection in 2014 brought many of these issues to the public’s attention, although clinicians and patient’s families had been well aware of them long before then.
The sub-standard nature of Dunedin’s mental health services was highlighted again in 2019 after a report into them commissioned by the former Southern District Health Board was leaked to the Otago Daily Times.
Consultants who surveyed Wakari found that almost all of Wakari Hospital’s mental health facilities were not fit for purpose, posed safety risks to patients and staff, and hindered appropriate treatment of patients.
The also noted that despite 10A having lower occupancy rates, the ward had the highest rate of incidents in the DHB and also the highest staff injury rate — clearly demonstrating that something needed to be done.
"I consider the poor state of repair of this ward to be unacceptable," the Ombudsman said.
"It is unsafe for both patients and staff, and severely compromises the dignity and independence of patients.
"I am further disappointed that action has not been taken since my predecessor’s inspection and I strongly urge the DHB to take immediate action to prioritise a rebuild or redevelopment of this ward."
It will be five years since those words were written before the work —to be carried out by local firm Naylor Love — is complete but at least, finally, some discernible progress can be pointed to and praised.
Before work on 10A can start improvements will be made to another problematic area of the hospital, Ward 9A, a medium secure forensic unit which has issues with blind spots, lack of space and natural light, an insecure entry and other safety issues.
Once that work is done, which is expected to be by mid next year, the residents of 10A will temporarily move to 9A while up to 12 months is spent on refurbishments.
This work is not the solution to Wakari’s woes, which have been well documented but only slowly acted on.
It is, however, a start to addressing long-standing problems which have been shamefully left unaddressed on the backburner for years.
However, much more work will need to be done if a facility which, largely, was not built for the purpose it now serves, is going to be able to adequately care for some of the South’s most troubled patients appropriately, and ensure the safety of both the residents and the dedicated staff who work there.
