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New Health Minister David Cunliffe is facing more headaches with the release of a private briefing paper showing at least three more district health boards are in serious financial strife.
Cunliffe is expected to take options to Cabinet tomorrow to address "wide-ranging systemic issues" at the crisis-stricken Capital and Coast District Health Board.
Several political parties are demanding the board be sacked and a commissioner appointed after a series of damning reports about medical mishaps, patient deaths and chaotic management problems.
Cunliffe has not ruled out sacking the board, but other options include appointing an independent commissioner or enforcing a short period of close monitoring "to see whether a new board can stabilise the situation at Capital Coast health".
Now it has emerged at least three other district health boards are facing similar issues to Capital and Coast.
A Ministry of Health briefing paper to Cunliffe highlights a series of financial and clinical issues at the Southland, West Coast and Whanganui District Health Boards.
This comes on the back of chronic staff shortages at Waitakere and Christchurch Hospitals and concerns over dealings by Otago District Health Board former chief information officer Michael Swann with an IT company contracted by Dunedin Hospital. The board dismissed Swann last month for gross mismanagement, and the Serious Fraud Office is investigating.
According to the briefing paper, the most critical issues are facing the Southland District Health Board, which is under intensive ministry monitoring as it grapples with the "deteriorating financial and non-financial performance of the board".
During discussions over the 2007/08 annual plan, a raft of concerns were raised about the board's ability to "function in a sustainable manner" and provide a level of service that the public could rely upon.
Similarly, at the West Coast District Health Board, there were concerns about the board's ballooning financial deficit - forecast to be $4.6 million for the current financial year. The board has been given a year to identify cost pressures and put in place measures to achieve "sustainable financial and service performance".
The problems facing the Whanganui District Health Board have been well publicised. This year an independent review - carried out after three episodes of patient injury and public allegations of unsafe clinical practices - found there was "room for improvement" with the way the board ran health services.
The second review, a joint effort with the Ministry of Health, contained more than 50 recommendations.
Several, aimed at improving services and helping the hospital run more efficiently, were included in the board's annual plan.
The ministry's briefing paper to Cunliffe highlighted a series of serious financial problems, which had culminated in massive annual deficits.
At one stage, the board had predicted a break even financial position, only to report a deficit of $5.6 million a few months later.
The board is finalising an action plan to deal with issues raised in the two recent reviews, which will then go to the ministry for comment.
Board 'interference' behind crisis
Capital and Coast District Health Board deputy chairman Ken Douglas is blaming interference by board members "in issues they had no role in" as one reason for the crisis facing the board.
Ken Douglas told the Herald on Sunday management was upset at board members interfering with its work, and warned next year's opening of the new regional hospital, which is understood to have fewer beds than the current one, was likely to plunge the board into more chaos.
Douglas acknowledged there were financial and staffing problems, as well as tension between management and some board members.
That followed interference by some board members in issues they had no role in, he said. "Our function is to identify priorities on the basis of recommendations from the management team."
He said management had a "growing lack of confidence" because they felt their professional advice was being ignored. He said a Government cash injection, expected to be announced tomorrow, could help the crisis, but was not expected to solve it long-term. Douglas said moving into the new $364 million regional hospital next year was likely to blow the budget out even further and present new capacity issues.
