WEEKEND MAGAZINE: Ron Durham

This week, just days after Bay health board chief Ron Dunham announced his resignation, the first sod of dirt was turned at Tauranga Hospital, beginning the $110 million revamp he has spearheaded for three years. He tells Julia Holmes why it's time to move on.
Only a man could compare the health system to being behind the wheel of a car.
"For a number of years the healthcare system was seen as a fix-it shop. It was a bit like the panel beater rather than the road designer, if you like", says Bay of Plenty District Health Board chief executive Ron Dunham.
He is talking about a changing philosophy in heath care, away from purely treating patients towards preventing people from becoming ill in the first place.
"It was there to pick the pieces up and tend to people when they did get sick but now there's a whole lot of emphasis, which is really good, on trying to prevent people from getting sick", he adds.
If we're talking things automotive then Dunham, 54, has worked the whole spectrum, from panel beater, to car salesman, to factory manager - and now he is about to start designing roads.
The man who began his career in the health sector as a nurse and then went on to sell pharmaceuticals, has headed health care in Bay of Plenty for the past 10 years.
He announced his resignation last week and is leaving at the end of September to set up a consultancy, focusing on building healthy communities.
"We've got a lot of healthy individuals who one day will become old and be relatively unhealthy but what determines if they're healthy or not isn't necessarily the health system itself. It's actually a whole lot wider ... the education and information we have about diet and exercise and smoking and alcohol and drugs ... they're far more important to our health status than getting the immediate care that we expect from the hospital", he says.
Dunham has come to that viewpoint after a career spanning more than three decades.
Born in the small rural settlement of Mangakino, he was raised on a farm with two brothers, moving to here in his teens so he could attend Tauranga Boys' College.
Contrary to his masculine upbringing, when he left school he opted to join the female-dominated profession of nursing, becoming the first man in Tauranga to do so.
He was also the first male nurse in New Zealand to do maternity training.
"I had to deliver babies. I think I was quite popular on those wards. I was a bit of a novelty, I think", he beams.
"There are some male midwives in this country now so it's not so unusual but it was certainly unusual then. I probably didn't know what I was letting myself in for really."
It was a year before other male nurses started to appear on the wards at Tauranga Hospital. Now an estimated 10 per cent of nurses in New Zealand are men. Specialising in accident and emergency care, Dunham used his qualifications as a ticket to travel.
"I was always quite interested in medicine but I had a burning desire to travel overseas", he says, adding that he toyed with the idea of going to medical school but decided it was too much of a long, hard slog.
He travelled to London, where he undertook further training in trauma, and was on a bomb squad response team, attending the aftermath of IRA explosions at Kings Cross and Euston train stations.
"It wasn't the sort of thing you got a lot of sleep over afterwards", he says.
"I've still got vivid memories of all that."
London remained his home for seven years and it was while living there that Dunham joined the pharmaceutical industry, working for the multi-national company Wellcome (now Glaxo) as a sales representative.
Returning to Auckland, he worked his way up the ranks to become a general manager for the same company, also completing an MBA.
Dunham says it was a natural progression from nurse to business management.
"The skills you gain as a nurse don't actually go away. Some of the things I learnt in those days I still apply now ... it's about understanding people, not so much what people are saying but why they're saying it and what's behind their behaviour at any particular time. I think it's quite a well-developed skill in many health professionals and it's a valuable management skill."
Fifteen years after leaving the hospital environment, Dunham returned, this time as "factory manager".
Appointed to head health services in Eastern Bay of Plenty, he later became chief executive for the whole Bay of Plenty district when Eastern Bay merged with Western Bay.
"It was the merger of two quite different cultures at that stage, plus adaptation of a changing role under district health boards ... we became both a provider of health services as well as a funder of health services," he recalls.
"There was a tough time for about 12 months. There was quite a negative response from the Tauranga community towards me as a foreigner trying to manage the health system locally."
But within the hospital itself he had - and still does have - many old friends.
"Many of the staff here trained with me. They still give me a hard time. I've got lots of friends in staff, we've all sort of grown up together."
For the past three years, Dunham has been the driving force behind Project Leo, a $110 million revamp of Tauranga Hospital.
With the first sod having been turned this week, he feels now is the right time to leave.
"I've had a fixed term contract and it's coming up for expiry, so ... I decided that 10 years was probably a good time. There are a whole lot of things that are in place now. One is this project," he says tapping the building plans spread across the table in front of him.
"This project is already three years old and the construction's starting this week and its right on track. Its final look is all done and it's a matter of building it now, so I'm quite pleased at this point that its got enough momentum to carry on."
Dunham likes people who are passionate about what they do. It's easy to see that Project Leo is one of his passions.
He is also passionate about Maori health.
"One of the things I get upset about is the criticism of Maori health services, whereas what we're trying to do is tailor and customise a service delivery to meet the need of the customer. It's how you do it, not who you're doing it to," he says.
"I know it actually works," he adds, referring to a successful cervical screening programme that targeted Maori women by using Te Reo and a more informal setting, boosting attendance from 60 to 100 per cent. Criticism of health professionals also fires him up.
"Some of the disappointments I guess are when people get critical of the system and the individuals and not realising that they are working hard and are doing their best with the resources they've got available," he says.
"Sometimes they make mistakes, but so does everybody in any job, it just so happens sometimes these mistakes are a bit more serious and they're dealing with people in their most vulnerable stage - they're grieving, they're angry, they're losing loved ones, they're losing their life, they feel dependent on other people which they've never done before. Health professionals take all that into account and still do their best for them."
The passion he will now pursue is measures to keep people out of hospital.
"They're simple things like more emphasis on asthma education ... the design of roads to prevent accidents or ensuring our rural communities' houses are well-ventilated and not damp, or getting smoke alarms fitted in houses," he espouses.
"There's a lot of opportunity locally to get involved, for instance, between local authorities and the health system ... connect them both so we've got a community that's actively looks after itself."
Dunham practises what he preaches.
"I try and go to the gym three or four times a week and as a family we try and practice good diet management and exercise. One of the best values about family environments is that if you participate as a unit you actually encourage each other to do some of these things like exercise that individually may not be pleasant. I'm lucky I've got a strong family unit."
That family unit consists of his wife Sally, a veterinarian, daughter Morgan, 13, and son Matthew, 10.
Having to leave their Otamarakau lifestyle block at 5:15am every day for work, returning at 6.30pm, is something he will not miss.
"One of the things I'm looking forward to is more family time," he says.
"I love my kids."
Ask him to share one of the most memorable moments in his career to date and his response is equally as simplistic.
Harking back to his nursing days, he says: "I always remember when I worked in casualty here a little kid came in. I think he'd cut his hand or something and I was stitching his hand and his mother said 'do you remember this child' and I said 'ah ... no' and she said 'you delivered him' and that was great, it was quite a buzz I must say."
It's moments like this that will carry him forward on his new venture.
This road designer hasn't forgotten his panel beating roots.