The issue of public health services in the South — including the state of our main hospital in Dunedin — has dominated discussions and headlines of late. It is clear this will be high in the minds of voters in next month’s general election.
Southerners have voiced concerns over democratic representation, outsourcing, retaining services (and have fought to do so in the case of neurosurgery), have endured delays and often their life-changing ramifications, and agonised over the state of our crumbling hospital buildings.
The prospect of a new Dunedin Hospital has certainly lifted spirits, but not allayed many of the concerns.
It is of some sad comfort (solidarity, not schadenfreude) to note the similar problems faced by the nearest district health board, Canterbury.
That district health board is facing similar financial pressures (namely a $54million projected deficit) as those experienced by the Southern District Health Board, which resulted in it being replaced by government-appointed commissioners in June 2015. (The SDHB had been projecting a deficit of between $30million and $42million for 2015-16.)
The comments from major players echo those made relating to the SDHB.
Health Minister Jonathan Coleman says the Canterbury board is adequately funded and quotes substantially increased health funding under National’s watch.
Opposition parties and critics say funding has not kept pace with what is required.
Dr Coleman says savings can be made without any impact on services.
Clinicians, managers and board members say that is simply impossible or walk around the edges trying not to offend lest they put their relationship with the ministry further at risk.
Dr Coleman and others make comments which rankle, offence is taken at the implication bad management is at fault.
The words being used — among them ‘‘challenges’’, ‘‘complex issues’’ ‘‘finding savings’’, ‘‘financially sustainable’’, ‘‘targets’’ — are all too familiar to Southerners.
Meanwhile, the public looks on aghast at some of the mud-slinging.
Miraculously, given the levels of dissatisfaction all round, it seems most are pleased with the high level of service they receive (when they finally get it) and with the professionalism of hospital staff.
With so much public money involved, and people’s health — and indeed lives — at stake, it can be difficult to balance facts with emotion, difficult to know where the truth of the matter lies.
Are our health services adequately funded or underfunded?
Are multimillion dollar penalties for failing to deliver services a motivator or unfair?
Is it possible or impossible to meet the constantly increasing demands given all the other pulls on the public purse?
Is free and accessible healthcare a right or a luxury?
Is the public too demanding?
Are our systems efficient?
Are our elected boards mismanaged?
Is that democratic model still valid or would a centralised government approach be better?
That question is relevant given the SDHB (and Environment Canterbury) commissioner takeover.
Is it paranoid or realistic to be wondering whether boards are being driven to fail so a central government model becomes the new norm?
It must be noted Canterbury is paying the price for its new buildings (high depreciation levels are a significant factor in its projected deficit).
A new Dunedin Hospital will bring the same financial ‘‘challenges’’ to the SDHB.
As the Government opens the books to disclose a $3.7billion surplus, and makes all sorts of funding announcements, another healthy question to ask is whether it is possible to get what the public is begging for when it is not election time.
