A new NHB initiative coming

Today we noticed some articles in the paper (NZ Herald article and Stuff article) about the plan (as far as I can see) to consolidate all the district health boards into one to become a National Health Board and this means that things like IT, payroll and Admin will be centralised. I'm not quite sure what I think about it because as it is I don't know that much about the actual running and purpose of each individual district health board. I didn't even know we actually had 21 district health boards which sounds quite significant for this small country with its small population.

My only experience is really just with the CCDHB in Wellington, the one in Christchurch that we briefly dealt with and now the Auckland one. Of all of them I think the Auckland one (from our experience) seems the be the most efficient, but I'm only speaking from our experience. Well mostly efficient, there is one specialist that I can't handle because said person must be one of the rudest and most impatient people I've ever dealt with and I'm not the only one not happy with this person (who shall not be named) and no amount of formal and informal complaints have ever made a difference. Certainly my complaints resulted in them defending this person. But anyway. These things are long gone and as far as I'm concerned this particular specialist does not exist and if I have to deal with this person, then I'll tolerate this person, but I will not ask questions and I will seek a second opinion. But for most of it we've been very happy with Auckland District Health Board.

I was happy with the nursing staff and when we had our oncologists in Wellington, I was not happy with CCDHB at that point in time. I really felt they could have done more and do better to retain staff. But I understand the new CEO is trying very hard and so is meeting with a parent focus group or something. That is a good thing. Of course prior to us coming to Auckland we had Christchurch running the show for a bit and I must say I never felt it worked very well. For one I never got the feeling the specialist knew Bianca or the details in her file. I was shocked when she was in with shingles he saw her and then 3 weeks later he asked me "so is her face better or worse than I last saw her?" and then he asked "so how far along in her maintenance is she?" I felt a bit shocked because I assumed that as the specialist in charge of my daughter's file he would know a little bit more and at least have read her files and the notes one would imagine he would have made, and it didn't feel very safe that he could make the best decisions when he seemed to have known so little about her.

I will also never forget the day Christchurch decided that they would suddenly do all scripts and we needed to fit in with their processes and protocols. There I sat waiting to hear what time we would get Bianca's chemo script and even though the Wellington staff left like 3 messages, nobody answered. I think it eventually came through after 4pm. That is despite the specialists knowing that the local pharmacies couldn't supply chemo as it needed to be ordered by a certain time, that is despite knowing that Wellington hospital didn't have a pharmacy on site and that we would have to take the script to the pharmacy up the road where you struggle with parking, you would have to hand it in and then wait and what if they were about to close by the time you get there or worse was closed? Thankfully it got sorted out, but it was so frustrating realising that there was a real possiblity my child might not get her chemo script to use that night still all because of them implementing a new system with very little notice and real thinking behind it and that what worked in Christchurch (with an onsite pharmacy) might not work in Wellington. I really felt that their admin process could have potentially put Bianca at risk and it was as if they just did not care. But anyway, also long gone.

I think what is good about district health boards is that they are run locally and can cater for the local people. But I guess having a central system means that perhaps they will all adopt the same processes and protocols throughout, so that regardless of which hospital you go to for treatment, you will get the same service levels and if they can avoid duplication and cut costs this way then that is also a good thing - why do you need 21 different people doing the same thing that 1 or 2 or maybe 5 can do? Perhaps also if things are a bit more centralised and doctors do give bad service like with our experience, we can really take it further rather than letting local people shove it away and pretend it never happened just because they don't want to deal with it.

Of course the sad thing is that so many will lose their jobs to implement the process and unfortunately with the new initiative they won't be able to avoid that. So I'm not quite sure what to make of this new initiative.

What do you think?

1 comment:

Anonymous said...

I loved your rant about "she who may not be named". It's the same oncologist who has just raised Pete's chemo for no reason at all. Obviously she hasn't looked at his file at all. And if Pete's counts crash I will not be happy.
Hope that you guys have a great day today.