Correspondence between senior managers at both Whanganui and MidCentral boards provides clear evidence of a campaign to diminish Wanganui Hospital's maternity services.
That's the view of Whanganui District Health Board member Michael Laws, who said the documents, released to him under the Official Information Act, showed the campaign had been formulated months ago.
He made the OIA request because he said the board should be able to see what quality of information had led to the creation of the contentious regional women's health service proposal.
If both boards adopt the plan, it could see up to half expectant Wanganui mothers giving birth at Palmerston North.
Mr Laws said the managers and clinicians preparing the review should have gone to their boards from the beginning but instead "they've done exactly the opposite by giving the boards no option".
He also said the documents showed that the proposal was a "highly sophisticated campaign" with specific dates to have decisions reached and the "board to step into line".
He said it was a case of the "tail wagging the dog" and that senior managers were creating the policy and "then intending to pressure the board into agreeing".
He acknowledged that a secondary maternity service based at Palmerston North may ultimately be the only outcome "but at no stage has our board been provided with sufficient research that suggests Wanganui women are disadvantaged by the current system". He said the major argument being used was the service was propped up by locums "but there's nothing to suggest the current service endangers Wanganui women".
Data showed that Wanganui Hospital's record, in terms of live births, was comparable to any other DHB in the country.
"Given the system is working now, you'd expect that evidence to be in here [the documents] that there's a problem. But there is no evidence.
"From earlier than June last year, senior management here and in MidCentral conspired to say 'This is what we're going to do' and the Whanganui chief executive [Julie Patterson] said she would change her board's mind," Mr Laws said.
The first the WDHB members got to see of the plan was in December last year.
Mr Laws said the documents showed "clear proof" that the proposal was being driven by senior managers.
"They have been working to diminish Wanganui's maternity service for many months," he said.
"As early as June last year, chief executive Julie Patterson was telling her colleagues that she could persuade [the Wanganui] board to reverse their 24/7 maternity coverage policy for Wanganui," he said.
Mr Laws said as well as being "stunned" by the extent of planning that had been done, there was nothing in any of the early documents that quantified or qualified any risk to Wanganui mothers and babies under the present system.
"Instead they just decided, very early, that this was going to happen and have been working to that end ever since," he said.
He said the papers were further evidence that the public consultation was a sham.
"There are no alternative proposals, there are no options. It's their way or no way."
He said the management and governance group even had a timeline in place by which the Whanganui and MidCentral board would sign off on the proposal.
The papers, he said, also showed the Whanganui board was kept out of the loop. "The first involvement was at a workshop just prior to Christmas that was always intended as an ambush.
"In all my years of public and political service, this is as obvious as it gets that the bureaucrats wanted to sideline governance from their role. The board's role was simply to be a rubber stamp," Mr Laws said.
"It's about making brownie points with the Minister of Health and all my feelings about consultation being a sham are borne out by these documents," he said. "The remarkable thing is that this proposal got as far as it did without either board knowing anything about it."
What the documents show ...
Documents released to DHB member Michael Laws showed an initial proposal retaining 24/7 maternity services at both hospitals but that position changed.
An undated letter from Mrs Patterson _ but certainly before June, 2011 _ talked about advancing the regional plan.
In it she said: ``We are willing, if we had the support of the governance group, to revisit with our board the issue of 24/7 on the Whanganui site.''
The ``governance group'' includes clinicians and managers but no representatives of either board.
Another document (August 29, 2011) said board support for the plan was critical in ``achieving the milestone of a
single, fully integrated service''. It talked of developing a plan for a single maternity and gynaecology service for the population of both DHBs.
It also talked of ``risk mitigation'' strategies if the boards did not agree to the ``vision'' and said the project steering group needed to have plans in place ``to bring the project back on track'' if milestones were not reached.
A sixth version of the plan was ready on November 18, 2011, and that was followed by the WDHB workshop on