KEY POINTS:
I've been chairing boards for 15 years, and this month had more lows than the rest put together." No self-pity, and certainly no defeat in Wayne Brown's voice. Just frustration, weariness. And bristling resolve.
It's the first meeting of the Auckland District Health Board since the High Court
struck out a controversial new $560 million, eight-year contract for laboratory testing. Justice Raynor Asher ruled Auckland's three health boards wrongly allowed one of their board members, pathologist Tony Bierre, to sit in on discussions about the laboratory testing tender when his consortium Labtests Auckland was preparing a bid, and that Bierre used inside knowledge to help the new consortium win the tender. He also found the boards failed to consult properly with doctors.
The ruling drew calls for heads to roll - Brown's tanned, balding, clipped-grey-bearded, as the Auckland board's chair, and Ross Keenan's white-haired and professionally affable, as the government-appointed deputy chair on all three boards.
Brown quickly became a football in the political storm that blew up. National's health spokesman Tony Ryall blamed him for not picking up on Bierre's conflict of interest earlier, slating him as one of Labour's "handpicked flunkies".
Then, last week, another potential PR catastrophe hit when it was revealed 43 patients may have been exposed to the deadly Creutzfeldt-Jakob disease through contaminated surgical instruments.
And this week, health boards around the country are bracing for a two-day strike by medical laboratory workers looking for better pay and conditions. Another major union, the Association of Salaried Medical Specialists, is warning the health system could become "bogged down in industrial strife by the middle of the year" because of health boards' "adversarial, rigid and dogmatic negotiating position".
To top it all off, Brown had a flood at home, in picturesque Mangonui, Northland, where he lives with his wife Toni (they have two adult children).
Last week he was sitting on a beach with his friend and neighbour Eddie Aickin wondering if it was all worthwhile.
Says Aickin: "We were sitting on a beach in the Far North after a nice after-storm surf, weighing-up whether it is really worth his while taking all of this crap for the modest remuneration he gets. We agreed that the current political furore has nothing to do with better health outcomes or reduced costs: it's all about political Brownie points."
Why does Brown keep at it?
According to Aickin, Brown simply wants to make a difference.
"He's interested in improving health for disadvantaged and powerless people. And in doing things right: less waste, more health."
And, as he faced his board and executives on Friday, Wayne Brown didn't look like a beaten man.
His springy body and short-sleeved shirt seemed out of place in the wood-panelled library. Like a schoolboy stuck in class, his foot tapped the pink carpet as the morning session drew to a close.
"Eat lunch quickly and get back. I've got much more important things to do than to be here."
The mood was coolly defiant. The board stands behind Brown and its tendering process, and the court judgement "is likely to be appealed", board member and semi-retired GP Di Nash told me between sessions. She added Asher said the board acted in good faith and without bias.
Said another elected member and surfing buddy of Brown's, Maori businessman Harry Burkhardt: "You take any of our meetings and take out all those people who have interests in the health sector, and the only people left in those meetings would be Wayne, Ross and me."
This became a running joke in the afternoon meeting. Burkhardt: "That's one of the issues that Maori face continually. If you take it to the Nth degree, everything in the Pakeha world should be mooted through Maori processes."
Brown put a resolutely positive spin on things: he praised the hospital's quick tracking of patients possibly exposed to CJD and honesty with the public - "People shouldn't be surprised at how well things work here. It's a good place."
He praised the interim laboratory contract, hurriedly struck with the original provider Diagnostic Medlab: it had widespread support, meant better coverage for low-income areas and savings of $10 million.
"It's a wonderful story of success," he told me over a briskly eaten lunch. "The lab test fiasco, if there has been one, has been the withdrawal of [the] labour of people doing the tests. If our politicians - the ones picking on me, who've become obsessed with this - if they cared about health they'd get into that. No person in Auckland is going to miss a community lab test and no person would have."
Refreshingly frank and up front is Brown, a necessarily acerbic antidote to the egos, patch politics and spendthrift ways of health professionals? Or a rude, arrogant, hard-nosed moneyman who puts savings above patients and refuses to listen to those at the coalface?
Scourge or saviour? Brown's a self-made millionaire through engineering and property developing. He's served on boards as diverse as the Maori Television Service, New Zealand Rail, power company Vector and the Land Transport Safety Authority. He once stood for Parliament in Bob Jones' New Zealand Party.
And he has 15 years' experience as a Mr Fix-it in health. National appointed him to the board of the financially ailing Northland Crown Health Enterprise in 1992. He managed to turn it around, achieving a $3 million surplus in 1998. But the specialists' union said the surplus was down to funding not Brown, and communities fought the closure of rural hospitals.
Labour was impressed enough, though, to make him health commissioner in Gisborne in 2000 after dismissing the board. When district health boards were set up the following year, he stood for election, even though he didn't have to as a Government appointee, to ensure he had public backing. A mark of his integrity, according to current Tairawhiti District Health Board Chair, Ingrid Collins. And in Gisborne, she says: "He had a good rapport with the staff". He's been nothing but friendly to her, helping her with advice when she took over the chair, she says.
"Even though his manner can be brash, he also makes a lot of sense."
But his relations with doctors have been rocky since he was shifted to Auckland in 2001.
He's overseen a massive fiscal recovery - from a projected deficit of $80 million in the 2002 financial year to being on track for a targeted $20 million deficit this year, and aiming to break even next year. But doctors have vehemently argued the cost to patient's care has been too high.
Association of Salaried Specialists executive Ian Powell is a longtime critic of Brown's management. The association, embroiled in floundering negotiations with the board, last week demanded Brown and Keenan jump or get a "good solid shove" from health minister Pete Hogdson.
"He really is a contradiction," says Powell of his nemesis. "On the one hand, he's intelligent and able... on the other hand, he comes across as a troglodyte. He has the advantage of cutting to the chase and being direct, but he invariably does it in such a way that it comes across as devaluing what other people do and being coarse and rude."
Powell believes Brown's contributions - encouraging more clinicians on the board, improved the calibre of senior management - are overshadowed by his arrogance.
He's particularly aggrieved by what he sees as Brown's token consultation with doctors.
In Brown's corner, board member Barry de Groot says Brown's up-front style was what inspired him to stand for election. De Groot, who runs a disability support service, says, "The medical staff are used to getting their way.
"You've got so many different departments in the hospital all vying for funding. Wayne came along and said 'here's the money we've got, you've got to make a case for it'."
He says Brown does understand health, and is simply trying to "get the best quality for the best price".
Friend and Northland Labour MP Shane Jones tells the story of Brown single-handedly devising a wastewater treatment system for Northland maraes, for a "modest charge", when no one else was interested because of the limited market.
"It's wrong to describe him as hard-headed, money-obsessed, and unwilling to advance the interests of patients, when the reverse is true...Wayne with his forthright manner, ability to stir and being anti-stuffed shirt brigade, he'd strike [doctors] as a barbarian at the clinician's ball."
