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Home / New Zealand

Under fire health chief quits, board faces sack

By Mike Houlahan
5 Dec, 2007 03:40 AM6 mins to read

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David Cunliffe. Photo / Paul Estcourt

David Cunliffe. Photo / Paul Estcourt

KEY POINTS:

Politicians are calling on the Capital and Coast District Health Board to follow its chief executive and resign - or face the sack.

National, ACT and United Future have called on the DHB to be replaced by a commissioner.

The move follows the departure of under-seige chief executive
Margot Mains this morning, over the release of a report detailing a list of serious and fatal incidents at Wellington Hospital.

The under siege Mains said in November that she planned to resign in February next year but then brought that forward to December 21. Now she is going immediately.

Internal DHB reports obtained by media under the Official Information Act today revealed 23 serious or fatal incidents between 2003 and 2005.

One patient died after doctors realised halfway through surgery that equipment was not available in the right size, forcing staff to contact a company representative for advice.

Another patient died after surgery had been postponed three times, and system failures led to another fatality because of allergic reaction, the reports in the Dominion Post and Radio New Zealand said.

The hospital had 86,000 admissions and treated a total 420,000 patients during that time.

Mr Cunliffe has expressed concern about the "wide-ranging systemic issues" revealed by the cases, but refused to immediately comment on Ms Mains' resignation.

He was considering options including sacking the board, appointing a commissioner or enforcing strict monitoring for a period to see whether the DHB can "stabilise" the situation.

His spokesman said a decision was likely in the next two days but this afternoon Mr Cunliffe said it could be next week.

"It's important to get it right as well as immediately and we are doing our best to do both."

Mr Cunliffe said it was important that health professionals felt able to report mistakes and said the cases highlighted today were a small overall percentage.

"What I have to consider as a minister is, are there underlying issues here that are affecting the performance of the board and the DHB? ... I think there definitely are and some of them are worth very serious consideration which is what we are urgently doing."

He said by law the board would be held accountable. He would not express confidence in the board.

Ms Mains apologised for the deaths at Wellington Hospital and said most patients received outstanding care.

"It is a national and international reality of medicine that sometimes things do go wrong," she said.

Publication of the internal reports follow the death of a baby girl after her mother was discharged just five hours after delivery last Thursday.

United Future leader Peter Dunne said today the latest revelations showed the board was "irreparably dysfunctional" and should be sacked.

"Clinicians, nurses, management and the board are all engaged in what appears to be civil war - a war that can only be ended by outside intervention," he said.

Mr Dunne said he had watched the situation get worse and worse over the last two years and it was time a commissioner was appointed to sort it out.

ACT's deputy leader, Heather Roy, said the DHB should be stood down and an independent commissioner appointed to resolve the "terminal crisis".

Ms Roy said there was a "serious disconnection" between management and clinical staff - a split that meant neither had confidence in the other.

"Wellington Hospital is a very unhappy place to work, with staff morale detrimentally affected by tensions within departments and between staff and management," she said.

Ms Roy also urged Health Minister David Cunliffe to appoint a commissioner.

"Ministerial namby-pamby tinkering will solve nothing," she said.

The board has seldom been out of the headlines in recent weeks, with its health bosses having to defend its maternity and paediatric oncology services from strong criticism.

Last week it was forced to scrap a scheme in which a woman having her second or subsequent baby would receive a $100 supermarket voucher if she left hospital six hours after giving birth.

Yesterday Prime Minister Helen Clark said Mr Cunliffe and the entire Government deplored the way the board had behaved.

Last month Mr Cunliffe said he had serious concerns about the board. Yesterday, after it was revealed the baby had died at her home just hours after being born, he said it was clear the board had wide-ranging systemic issues it needed to address.

"It has become increasingly clear that it is important for me to act, which is why I have asked for further urgent advice on the full range of options available."

Some or all board members could face losing their positions, a commissioner could also be appointed to take over the board's affairs, or a Crown monitor could be brought in to oversee the board.

"Another option, given the timing of an incoming board's arrival, would be to provide a short, closely monitored period to see if a new board could stabilise the situation at CCDHB, and I am actively considering that option as well," Mr Cunliffe said.

National Party health spokesman Tony Ryall said the report shows one patient a month has been the victim of a serious or fatal mistake and the report, now two years old, needs to be updated.

"Wellington Hospital has been subject to damning report, after damning report. The CEO's resignation today is not some magic bullet that will resolve all the problems," Mr Ryall said.

The baby girl whose brief life has brought the Health Minister's wrath down on the board was born in Wellington Hospital last Thursday, after a 20-hour labour. She was born around 5am, and the infant and her family left the hospital for home at 10.30am.

The hospital says it was the independent midwife's decision for the woman to go home, and the baby's parents say they were unaware they could have stayed longer at the hospital if they had wanted to.

The baby died in the early hours of Friday morning.

Stillbirth and Newborn Death Support Services co-ordinator Joan Curle said the family was pleased Mr Cunliffe was taking action. They had told their story to prevent a similar fate befalling other families.

"We don't know if there was anything wrong with the baby, we don't know whether the baby would have lived or died, but irrespective of that she shouldn't have left [hospital] ... no one told her she couldn't stay, they just didn't say she could stay," Ms Curle said.

"She [the midwife] made a bad choice, but I don't think the hospital helped either. There were hospital midwives and doctors there. Someone would have had to have taken the epidural out."

NEXT MOVE

* Health Minister David Cunliffe's options include:

* Sacking some or all of the Capital and Coast District Health Board.

* Appointing a commissioner to take over.

* Closely monitoring the performance of a new board.

- with NZPA

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Opinion

Do you think the Capital and Coast Health Board should resign?

09 Dec 11:55 PM
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