Christchurch hospital funding debacle

Nine to ten years after the Christchurch earthquakes things are looking dire for Christchurch and Canterbury health care.

Stuff: Staff shortage at $525 million dollar yet-to-open Christchurch hospital

A decision not to open parts of Christchurch Hospital’s new emergency department (ED) due to financial constraints has been labelled “beyond embarrassing”.

Stuff: New Christchurch Hospital car park expected to be 1000 short of what is needed

A new car park being planned for Christchurch Hospital is expected to provide a further 450 spaces – still almost 1000 short of what experts feel is needed.

Years of inadequate facilities around the central city hospital have seen staff threatened with fines for parking on nearby Hagley Park, medics camping out in their cars to secure spots and nursing staff attacked at night during lengthy walks back to where they have parked.

RNZ: Christchurch hospital staff upset by delays to opening of children’s units

Dr Clare Doocey is upset that hospital emergency care for children in Christchurch will not be moving into a brand new, purpose-built facility.

The new $500m Hagley hospital block has been built with dedicated units for children within the emergency department and intensive care.

But financial troubles at the DHB mean children will still in most cases have to be treated alongside adults, with three units at the block set to be mostly unstaffed.

RNZ: Warning Christchurch Hospital funding woes will put pressure on ICU and elective surgery

The head of intensive care at Christchurch Hospital is warning some surgery for children and adults will have to be put off because of funding woes.

The Canterbury District Health Board says it is not reducing any services.

However, it has run out of money to fully operate three units at its brand new Hagley block.

One of the three services being curtailed is Canterbury’s first-ever dedicated children’s intensive care unit (ICU) (in addition, a specialised children’s unit in the Emergency Department, and an Emergency Observation unit for all ages also face unexpected constraints).

ODT/RNZ: Management exodus: What’s going on at the Canterbury DHB?

There have been five shock resignations from the top levels at the Canterbury and West Coast DHB in just one month.

The Detail talks to former Press reporter Oliver Lewis about the reasons behind the executive management resignations and why the rest of New Zealand should care.

The first to go was the chief people officer Michael Frampton in July, but this month the exodus really started.

In three consecutive days from August 3, the DHB’s planning, funding and decision support executive director Carolyn Gullery, chief executive David Meates and the chief financial officer Justine White, all resigned.

Last Friday the chief medical officer Sue Nightingale – who’s the leader of the region’s Covid-19 response – quit.

“I don’t really know if you can look at that and say that is a coincidence,” says Lewis.

“As the senior doctor’s union has pointed out, it looks more like an implosion and there has been…serious concerns about the relationship between the board and the executive management team.”

ODT: Departing CDHB boss given guard of honour outside hospital

Outgoing Canterbury and West Coast district health board boss David Meates was given a guard of honour by Christchurch Hospital staff today.

Meates resigned as chief executive last month, triggering an outpouring of tributes. Staff applauded him again today as he walked out of the CDHB offices.

He has been chief executive of the CDHB since 2009, and led the region’s health response to both the earthquakes and the March 15 terrorist attack.

He has also clashed with Ministry of Health officials to advocate over funding and facilities. It is a tumultuous period for the CDHB, which is under pressure to address its mounting deficit that reached roughly $180 million in 2019-20.

Dunedin hospital rebuild delayed further, another Labour commitment failure

Before the last election Labour criticised the then National Government for delays in building a new hospital, and committed to starting the rebuild of in their first term. But the Labour Government has kept pushing out a decision and the rebuild to further than National had indicated, and have just announced they won’t even make a final decision until next year.

Before the 2017 election Labour stated: Rebuilding Dunedin Hospital

All New Zealanders should be able to get the healthcare they need, when they need it. Dunedin Hospital serves 300,000 people in the city and the surrounding regions, but it is no longer fit for delivering modern healthcare to a population with increasing health needs.

For years, Dunedin Hospital has needed to be rebuilt.

The current Government has finally committed to making a decision on the rebuild but Cabinet won’t consider the details until sometime next year and it plans for the new hospital to be up to 10 years away.

Up to ten years away then was up to 2027.

With Labour’s approach, Dunedin will have a new hospital as soon as possible, and the taxpayer will get the best value for money. Avoiding further delay will minimise costs and mean patients get better care more quickly.

Labour will: commit to beginning construction of the new Dunedin Hospital within our first term

This project is expected to cost $1.4 billion, and will deliver the most modern hospital in New Zealand, ready to serve Dunedin and the Lower South Island for decades to come.

But the Labour Government hasn’t avoided further delays. While land has been purchased and buildings are being demolished, there is no sign of a start on the outpatients block let alone the new hospital.

This week: Government confirms new Dunedin Hospital design

The Government has agreed on a preferred design for the new Dunedin Hospital featuring two separate buildings, and has provided funding for the next stages of work.

Minister of Health Chris Hipkins says Cabinet has approved in principle the detailed business case for the new hospital, giving people in the Southern region certainty and confidence in the design and ongoing progress.

But there is no certainty, still.

“Cabinet agreed the detailed business case in principle as it’s important the project maintains momentum and demolition and design milestones are reached. We’ve released $127 million to progress design, demolition, piling, project management and early contractor engagement.

“It’s expected the total budget for the project will now exceed $1.4 billion. This will be confirmed once concept design is finished and costings can be finalised. The final details of the business case are expected go to Cabinet for approval by February 2021.

While it looks probably that Labour will be back in Government next year and hopefully the Cabinet will approve proceeding with the rebuild they promised a start in their first term, so have failed to deliver.

Outpatients (at almost 15,000 sqm) is due to be complete by early 2025, with Inpatients (at around 73,500 sqm) due to be finished in the first quarter of 2028.

‘Inpatients’ is code for ‘hospital’. The small outpatients block will be built before the actual hospital is started, possibly in 2025 but that’s far from certain.

And the planned completion date is after what the previous Government had projected. If National had stayed on in Government there’s no guarantee they would have delivered either, but Labour has been no better.

Implementation Business Cases for each building – Outpatients in mid-2021 and Inpatients by the end of 2021, will be considered by joint Ministers of Health and Finance, prior to confirming the main contractor for each building.

Having committed to commencing a rebuild “in our first term” (which ends next month) they now say they will only consider the Implementation Business Case for the hospital building “by the end of 2021”.

The Labour Government is throwing billions of dollars at infrastructure and ‘shovel ready’ projects all over the country, but Dunedin, and Otago and Southland, are a long way from getting a replacement regional hospital for what three years ago Labour described as “no longer fit for delivering modern healthcare“.

This re-emphasises the reality that election campaign pledges, promises and commitments (from any party) are often deliberate delusions aimed at gullible voters.

RNZ three years ago: Ardern raises stakes over Dunedin hospital

Ms Ardern was confident her party could build the hospital faster than the National Party’s seven to 10 year estimation.

“The hospital at present is dangerous and unsafe for staff and patients. Most of the existing buildings would not survive a severe earthquake.

“Things are so bad that at the moment operations have to be delayed because of the leaks when it rains. Dunedin Hospital is no longer fit for purpose,” she said.

Serious problems with the current buildings are ongoing.

Last month: Progress on ICU air conditioning

New air-conditioning machinery will be installed in a bid to get Dunedin Hospital’s multimillion-dollar new intensive care department fully functional.

Ventilation issues delayed the opening of stage one of the project for four months in 2018-19; the second stage was meant to open at the start of this year, but its 10 critical care beds remain unused.

The project has been bedevilled by the hospital building’s old air-conditioning machinery, which has proven inadequate to meet the demands of a modern critical care unit.

A new critical care unit can’t be used because of problems with the building.

The new ICU was commissioned by the SDHB to tide it over until the new Dunedin Hospital is built.

It replaces a dark, cramped ward that has poor facilities for patients, their families and staff with bright, spacious rooms and modern equipment, an upgrade staff have been eagerly awaiting.

They could be waiting another ten years.

Earlier this week Prime Minister Jacinda Ardern spoke to the Otago Daily Times:

…Ms Ardern said Labour remained ‘‘absolutely’’ committed to the rebuild of Dunedin Hospital, and also wanted to continue investment on upgrading Otago and Southland school buildings.

‘‘I remember very early on visiting Dunedin Hospital and it was just so clear what was needed there,’’ she said.

But it’s still far from clear what Labour’s ‘absolute’ commitment to the rebuild of the Dunedin Hospital amounts to. Niceness doesn’t provide adequate modern hospitals, nor does it save lives.

Largest health building project ever

The Government announced plans today that confirmed the largest health building project ever in New Zealand, a new regional and teaching hospital in Dunedin.

Building will begin ‘before the next election’, it will employ 1000 workers at it’s peak, and is set to be completed by 2026.

Importantly it will be built in downtown Dunedin, on separate land to the existing hospital buildings, ensuring minimal disruption during construction.

The now closed Cadbury chocolate factory site will be used, as well as another whole block. A down side for some will be the closure of the Cadbury World tourist attraction.

ODT has maps and details – Dunedin Hospital announcement: What you need to know

This is big news as well as very good news for Dunedin.

Dunedin hospital rebuild

Last week National announced a schedule for rebuilding the Dunedin Hospital, parts of which are in a very poor state. Rain leaks into the operating theatre, and asbestos in ceilings of the clinical services block means that new cabling can’t be run.

Dr Coleman made the announcement with Prime Minister Bill English at Dunedin Hospital today.

“The Government is committed to ensuring the people of Dunedin and the wider Southern community receive quality hospital care,” Dr Coleman says.

“We have been assessing the options around refurbishing the existing site and building a new hospital. The decision has been made to rebuild.

“This would maximise the opportunity of having a purpose-built, state-of-the-art facility, while also minimising disruption to patients and staff.

“Given the scale of the project it is estimated to cost between $1.2 billion – $1.4 billion, making it the largest hospital rebuild in New Zealand history.

“The original plan was to simply rebuild the services block, but the indicative business case has determined that the ward block also needs replacing and that has increased the cost significantly from the original $300 million estimate.

“The Ministry of Health is working to secure an appropriate site for the new hospital, with a strong preference for a central city location. Depending on the location the new hospital will be opened in 7 – 10 years.

Promises of rebuilding had been staggering along for years, and this announcement says it will be 7-10 years before a new hospital is finished – unless there are further delays.

“Given the size of the project the Government will consider all funding options including a Private Public Partnership model.

“We are also taking steps to support the existing Dunedin Hospital while the rebuild takes place with an extra $4.7 million being invested into the Interim Works programme, taking the fund to $27.2 million.

The Indicative Business Case for Dunedin Hospital can be accessed here.

There were protests at the hospital for this announcement, and some of those protesting came back yesterday to cheer Jacinda Ardern for a Labour pledge.

Dunedin Hospital to start in Labour’s first term

Labour will start construction on a new Dunedin Hospital in the city centre in Labour’s first term, says the Leader of the Opposition Jacinda Ardern.

“We will build the new hospital without a Public Private Partnership (PPP) and it will be rebuilt within existing funds.

“This is a project that is long overdue for Dunedin. The hospital at present is dangerous and unsafe for staff and patients. Most of the existing buildings would not survive a severe earthquake.

Dunedin is one of the lowest risk areas for earthquakes in the country.

“Things are so bad that at the moment operations have to be delayed because of the leaks when it rains. Dunedin Hospital is no longer fit for purpose.

“There is enough money in the Government’s capital spending allowance to build the hospital without a PPP.

Good for Dunedin, but that must mean $1-1.5 Billion of the capital spending allowance won’t be available for other things.

“Labour will not build on the Wakari site but we want a central city site for the new hospital.

That’s good, Wakari is too far away from downtown Dunedin, but stating this means the price of available land may go up.

“With Labour’s approach we will have a new hospital as soon as possible and we will immediately form a group around the Southern DHB, the Ministry of Health, the Dunedin City Council, the Otago Regional Council and the University of Otago to agree on a vision for this hospital.

Another working group!

“We pledge that Dunedin Hospital will be rebuilt so that the people of Otago can get the healthcare they deserve,” says Jacinda Ardern.

National have sort of pledged the same. But Labour are significantly in front on this. The hospital rebuild, and standards of health care, and food supplied from Auckland, have all been contentious issues in Dunedin.

Labour should hold both their seats – especially with a sampaign like this:

It won’t be rebuilt ‘now’ by either Labour or National. It will take years to get started – they don’t even know where they will build the new hospital yet.

But Labour are very much on the front foot here, and National really don’t seem to put much priority on Dunedin.

The Nation: state care abuse

On The Nation this morning:

Mike Wesley-Smith investigates what could be one of the worst cases of abuse in state care in New Zealand’s history. Alison spent 40 years in psychiatric hospitals, suffered sexual and physical abuse – and she didn’t have a mental illness.

A major stain on New Zealand’s recent past.

The Nation – prisons or hospitals?

In the third in a series on mental health, crime and justice:

Prisons or hospitals?

This weekend we bring you the final part of Mike Wesley-Smith’s investigation into treatment of mental illness in the justice system.

In this episode we look at conditions behind the wire for inmates with mental health issues.

A ormer prisoner talks about there was yoga and belly dancing offered to her when she was inside but not counselling.

@TheNationNZ

Since 2007, 53 inmates in NZ prisons have taken their own lives and are 4x more likely to attempt suicide

The chief Ombudsman Peter Boshier says the number of suicides in prisons is a real concern to him.

Demands on the forensic services within prisons are growing as the muster increases.

Corrections deals with more people with mental health issues than any other institution and the Ombudsman has raised concerns about training.

Mental health, crime, prisons and hospital care combine to make a very difficult issue to deal with.

“Teen in coma for 57 days needs legal access to cannabis oil”

Seven Sharp had an item on Alex Renton, the 19 year old who had a major seizure and has been in a coma in Wellington Hospital for 57 days. So far treatment has been unsuccessful, and his life is at risk.

His family want to be able to try using cannabis oil (CBD) which has been successful in reducing seizures in some cases.

Today, two weeks after a recommendation from Alex’s neurologist that CBD be tried, the Wellington DHB has put in an application with the Minister of Health requesting approval to be able to use it.

TVNZ News only seems to have this available online via this video; “Teen in coma for 57 days needs legal access to cannabis oil”

Mike Hosking: On a day where we found out that the courts weren’t in a position to help Lecretia Seales, what did the judge say, it’s really only Parliament’s job who can do that, we want to introduce you to a young man who has a similar vexed battle on his hands.

Nineteen year old Alex Renton, he’s been in a coma for fifty seven days with a mystery illness.

Nadine: The drugs haven’t fixed him but his family is holding out hope, because they believe Alex’s saviour could be cannabis oil. Problem is it’s illegal. So could a law change in this case save a life?

It’s use is allowed with the approval of the Minister of Health, according to the NZ Drug Foundation:

@PeteDGeorge @metiria The law doesn’t actually need changing. The minister right now could simply give approval… if he/she wishes.

Jehancasinader: (voice over video of his family celebrating Alex’s birthday in hospital):  Alex never expected to celebrate his nineteenth birthday in a coma. The pair of shows a present from Mum, for the day she hopes he’ll walk out of here.

Alex was as fit as a fiddle, until one seizure tipped his life upside down.

Alex’s doctors are stumped, their diagnosis uncertain. Meanwhile his brain is inflamed, and rocked by constant seizures.

Alex’s family believes there’s one last hope.  Cannabis. It’s illegal of course, but advocates say the oil can fire up neurons in the brain.

Rose (Alex’s mother): We’ve been offered the oil from overseas, clinically tested oil.

The oil is extracted from special strains of the cannabis plant that are very low in the intoxicant THC.

Jehancasinader: Last year we showed you how desperate Aussie families have relied on it to save their kids lives. It needs special approval. Rose says hospital officials are dragging the chain.

Rose: They seem to be frightened.

Jehancasinader: Until now Rose says drugs haven’t been a part of Alex’s life.

Rose: This isn’t about recreational marijuana, this is about medicine.

Jehancasinader:  Now Alex is being given Ketamine.

Rose: They choose to pour chemicals into him, but they will not choose a natural herb extract.

Jehancasinader: Rose believes time is running out for her boy.

Rose: A petition of twenty five thousand people have supported this treatment for Alex, and still we wait, he waits, because one hospital thinks they know better.

Mike Hosking: Jeez it’s been a tough day in so many respects hasn’t it Jehan, even to you, you’re with us live, just tell us how is Alex doing and what seems to be the hold up, what seems to be the problem here.

Jehancasinader: Well Mike I visited Alex here at Wellington Hospital late last night with his Mum. It was pretty tough actually seeing him lying in that bed unable to move and unable to talk.

Now you heard Rose saying that story that she believes the hospital has been dragging the chain on this, and we have the proof tonight.

The Ministry of Health says that it still hasn’t even received an application from the hospital for this cannabis treatment to be given to Alex.

Now this is two whole weeks after the neurologist said look we really need to look at this as an option. He is deteriorating.

Now within the past hour I finally heard from the DHB and they’ve confirmed that today they’ve decided to put that application in to the Minister of Health. He will have the final say on whether the cannabis treatment is granted and meanwhile Alex is spending his fifty seventh night in that hospital behind me.

Associate Minister of Health Peter Dunne will now have responsibility for this decision.

Snub hospital grub hubs!

The possible the centralisation of hospital food distribution in hubs is very concerning. Stuff reports in Hospital food could be up to a week old:

A report obtained by TV3 News yesterday showed food would be made in two hubs, in Christchurch and Auckland, and then transported to hospitals across the country, saving $10 million.

Apart from further gutting the regions it has potentially major implications at times of disasters and extreme weather events.

The Christchurch earthquakes caused major disruptions to food distribution around the South Island, and then the roads were still usuable.

I’d be very concerned if hospital food for the South Island was distributed from a Christchurch hub.

A report obtained by TV3 News yesterday showed food would be made in two hubs, in Christchurch and Auckland, and then transported to hospitals across the country, saving $10 million.