Neil Kirton: Ruby Princess 'Dad's Army' fiasco

Neil Kirton (inset) says the Ruby Princess posed a "clear and present danger". Photo File

Hats off to Hawke's Bay Today for the exceptional story, One Last Normal Day. Reporter Blair Voorend's detailed investigation into the arrival of the cruise ship Ruby Princess, is breathtaking in exposing the structural deficits of our national public health response capability.

The events leading up to the Ruby Princess berthing in Napier would be Dad's Army comical if the impacts on the Hawke's Bay community were not so dire.

The chronology shows a Hawke's Bay Medical Officer of Health had clear concerns about the ship's arrival in Napier and sought clarification of the health status of passengers. Alarm bells were ringing with Chernobyl intensity.

With a high level alert already in place and complete border lockdown only a day away, our medical officer quite correctly asked for Covid virus testing. The negative result is inexplicable and deserves further scrutiny.

However, even without the wisdom of hindsight, it is obvious that there was clear and present danger. What part did our centralised Wellington public health bureaucracy or other influences play in allowing the ship's commercial interests to override public safety?

There was no apparent Ministry of Health urgency to the pandemic devastating Wuhan in late December and early January. This is despite the almost forgotten experiences of bird flu and SARS in the previous two decades.

At the regional level, DHB pandemic preparation and resourcing look to have been a low priority. Our public health specialists and skilled workforce, such as public health nurses and health promoters, appear to have been under-resourced and under-valued.

While nationally co-ordinated communication and strong collaboration are important, the public health specialists in the field must be given autonomy to act, in the face of what is in front of them.

At the local level, it is my view that structural faults in crises management are now apparent. There is a question mark over whether the DHB has sufficient resources and a good intelligence structure to monitor the health status of the region's population, track contacts and respond to a Covid-19 outbreak.

Medical practices should have a standing contract in place for a health crisis response. Medical practitioners should have been recruited to provide early intelligence about the health of their patients, testing and monitoring the progress of the virus and following up contacts.

Instead there is centralised referral and assessment of patients with symptoms. Outcomes and follow-up information remains illusive to the primary carer most vested in their patients.

The decision allowing people returning from overseas to skip quarantine is a Dad's Army episode all on its own. Once again, our primary practitioners should have been brought into play. They should have been given the names of people returning to Hawke's Bay for follow-up and to monitor their lockdown.

In the spirit of kindness, reporting of the performance of our critical institutions is somewhat muted. Back-slapping admiration has replaced objective scrutiny, when things have clearly gone wrong and mistakes made.

Although better than many other countries, our level of preparedness is and still remains at least two weeks behind Covid-19. We should be doing much better.

It is my belief that the centralised, command and control structure gets in the way of good decision making at the local level and needs radical reform post Covid-19. The Ruby Princess saga is stark evidence of this.

* Neil Kirton is a Hawke's Bay regional councillor and former associate minister of health and manager responsible for public health services in the 1990s.