In light of the most recent episode in the life of Michael Laws, it is even harder to understand why Health Minister Tony Ryall tipped Katie Joblin out of the Whanganui District Health Board chair when she had consistently demonstrated her skill in leading the board through tough times.
Mr Ryall may be noting the latest example of immaturity by Mr Laws and pondering whether he got rid of the right person.
Regardless of the actual basis of the disagreement between Mr Laws and Keith Maynard, parent to a Down syndrome child, to explain your behaviour by saying "he insulted me, so I insulted him back" is worse than childish - it is boorish and lacks wisdom.
The DHB needs all the wisdom it can get with the pressure across regional health services to deliver to ever-growing demand.
Mr Ryall's actions are a reminder that although most health board members are elected by the community, once in the role they are actually accountable to the Minister of Health. The election process is something of a farce - a placebo rather than a real dose of democracy.
Children's Commissioner Russell Wills' report on the level of child poverty, as evidenced by the rising number of admissions for respiratory illnesses and infectious diseases that have their roots in crowded, cold, damp housing, poor nutrition and lack of warm clothing, is putting hospitals and community health services under huge pressure.
It is not of their making but of policy decisions made remotely from the consequences. It is a situation that requires all government ministries to put children and adolescent well-being into the policy balance sheet so the consequences of decisions made in one sector are assessed for their wider impact.
To make this happen requires all the political parties to put aside their posturing and bickering and tackle the child welfare urgently. Inequality is dividing the country into two separate islands - The Isle of Haves and the Isle of the Have Nots - and it is possible to travel between them in most cities and towns by simply crossing suburbs.
The long-term outcomes for children growing up in relative poverty are now being banked for future reckoning, and when the bills come in they will include costs to justice, education, welfare, health and economic stability. We already have inter-generational markers of the failure to address child poverty and there appears to be no cohesive response.
The Health Minister should convene an inter-departmental group that can bring a collective approach to policy design that considers the consequences of political decisions on the lives of children that works across ministries to ensure the resulting planning makes policy "hold hands" around the needs of children.
The current approach is more "hands off", with the right hand often having no idea what the left hand is doing.
A crucial step towards getting political traction would be to make all such policy decisions a conscience rather than a party vote. This would result in accountability, and we would know where MPs stand on issues relating to child and adolescent well-being, allowing democracy to bring its power to the process.
A concerned conscience can be a great motivator for creating change and all our elected representatives need to think hard about their responsibilities in the light of the child poverty report.
Terry Sarten is a writer, social worker and musician. Feedbacke: tsg@inspire.net.nz or www.telsarten.com/