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This has been the unfortunate situation for years.
We wonder if the latest review, commissioned by the Ministry of Health, pointing this out and calling for an overhaul of governance and management structure will be any more successful than any previous attempts to address myriad board issues.
In recent years we have had changes in top management, a succession of crown monitors, the sacking of the board and the installation of commissioners, and the return to an elected board.
When the commissioners left at the end of 2019, they were adamant they were beginning to turn the rudder on the good ship SDHB.
Among the successes hailed by the departing commissioners were a new primary and community strategy, a revamp of the Dunedin Hospital Intensive Care Unit and a much better relationship between the DHB and the local primary health organisation WellSouth.
But the ICU project is still not completed, and we wonder about the success of the primary and community strategy when the leaked draft of the ministry-commissioned report from external consultant Leena Singh says there is a dysfunctional relationship between the board and WellSouth.
Ms Singh has described her report as confrontational and designed to start an honest conversation.
But how many of these conversations have there been over the years? How often have we heard the refrain about departments operating in silos rather than collaboratively? The notion that short-term fixes which cause problems elsewhere later is not new either.
The report draws attention to the need to improve governance. It was encouraging to see chairman Pete Hodgson acknowledge the board needed a much more structured approach to its decision-making, holding people to account but also giving people the freedom ‘‘and sometimes the budget’’ to get on with the job.
It will not be helpful that Ms Singh’s review, and indeed the board’s own staff satisfaction survey, noted a concerning level of low staff morale with staff saying they were unaware of the direction of the DHB.
The stress of working in outmoded facilities, such as those at Dunedin Hospital, will be playing a major part in some of that low morale, and the difficulty of keeping nearly 5000 employees working over multiple sites in a complex organisation happy and well-informed should not be underestimated.
The next year will be a difficult one for all district health boards as they count down to their official end, as part of the health reforms, on July 1, 2022.
There will be considerable uncertainty about what is to come next and no doubt some jockeying for position among those in senior leadership roles across the country as the new set-up takes shape.
With half of the SDHB staff surveyed saying they do not believe the organisation implements change effectively, there will have to be a major improvement in that situation if the board is to effectively transition to whatever comes next.
We look forward to the final report from Ms Singh, which we hope will not be white-washed, and how the board plans to change so it is ready for the challenges ahead under the new system.
We agree with National list MP Michael Woodhouse when he says the board needs to improve its performance rather than just rearrange the deckchairs.