Optimism as West Coast DHB rides off into the sunset

I’m genuinely optimistic that having a streamlined structure, administration will improve the delivery and the efficiencies of health

Ahead of health system changes next month, West Coast DHB is leaving “the shop tidy” and the district is “very well set up” for the future, according to outgoing health chiefs.

But they warn the new central governing structure will have to deal with the workforce crisis throughout the sector if the reforms are to work.

DHBs officially pass the baton to Health New Zealand and the Māori Health Authority on 1 July, and the West Coast is among nine districts chosen to become a pilot locality under the health reforms.

Among concerns raised at last week’s final meeting of West Coast DHB were the future of Reefton Hospital, recruitment and retention of nursing and medical staff, elective surgery waiting times, a “precarious” aged care sector and “fragile” ambulance services.

But chief executive Peter Bramley, chair Rick Barker and general manager Philip Wheble were mainly positive about the state of healthcare on the West Coast and optimistic about its future.

Dr Bramley, who is also the chief executive of Canterbury DHB, will become the interim regional director of Te Wai Pounamu – the South Island region, one of the four created in the health reforms.

He told the meeting: “As DHBs come to a close, I think you can actually be incredibly encouraged and incredibly proud of both the people and the facilities that you have to support this community.

“And I think that is recognised in part by being one of the first nine pilots that have been selected under Health NZ.

“Access and equity are the big drivers in Health NZ and I genuinely believe you are very well set up to keep strengthening both elements as you go into Health NZ.”

Dr Bramley says care of communities will increasingly be led by the nursing and allied health workforce.

According to Mr Wheble, West Coast locality services are only at the beginning of the planning stage.

A plan will be submitted to Health NZ for approval after consultation with stakeholders – including the PHO, iwi, regional commissioner of public services and councils – over the next “number of months”, he said.

Mr Wheble says the locality approach is an opportunity for the whole community to work together to keep people well in their homes and to provide healthcare “in a way that is best for our community and in particular our rural community”.

Mr Barker says health services will not be affected by the initial “change of leadership at the top” but will evolve “slowly and subtly”.

“I’m genuinely optimistic that having a streamlined structure, administration will improve the delivery and the efficiencies of health, but by and large, everything else should tick along as per normal,” he says.

“It’s always going to be difficult to provide services in a geographically challenged area. There’s nowhere in New Zealand that is like this.

“But I think the area has risen to the occasion and I think it provides an outstanding service given all the circumstances.”

Signing off, Mr Barker said: “Well, board, I think we are leaving the shop tidy, which is one of the things we were determined to do.”

The board heard that the DHB’s finances for the year to May were only $128,000 in the red, despite flood costs of just over $800,000.

Mr Barker says the DHB’s infrastructure are also in “pretty good shape”, but is concerned about recruitment and retention of staff and a lack of accommodation for them.

“If we don’t get that right, we aren’t going to do things well here.”