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Health Minister David Cunliffe is poised to sack Hawke's Bay District Health Board and appoint a commissioner.
Mr Cunliffe today wrote to the board giving it a deadline of six days to provide written reasons why he shouldn't appoint a commissioner in their place.
He said his action was prompted by a "deteriorating situation" in the board's governance.
The board has suffered several recent setbacks.
Its financial position has moved seven months ago from a forecast of breaking even at the end of June to a revised forecast of a $7.7 million deficit.
The board's chief executive has recently gone on sick leave and chief operating officer Ray Lind was reported to have secretly recorded meetings with board members.
Mr Cunliffe has also this week rebuked board chair Kevin Atkinson for public comments on the problems.
"I am concerned at both the deteriorating financial situation at the Hawke's Bay board and the board's failure to discharge its responsibilities," Mr Cunliffe said today.
"My first responsibility is to people of the Bay and I must preserve their access to first class public health care."
Mr Cunliffe said the board had until Tuesday to reply to his list of concerns which included:
* Its rapidly deteriorating financial performance;
* his increasing lack of confidence in the board's integrity and members publicly challenging him as health minister;
* using the media to advance the personal agenda of board members;
* dysfunctional relationships between the board, the minister, and management;
* a critical report into the DHB from the auditor-general last month.
In his list of reasons Mr Cunliffe singled out Mr Atkinson's comment last week that "It was never a realistic goal to cut $5 million from the board's costs, but it had factored that expectation into its budget to simply get the sign off from the health minister".
Mr Cunliffe said he was also concerned with Mr Atkinson's comments to The Dominion Post this week that Mr Cunliffe was "trying to set the scene to bag the district health board".
Mr Cunliffe said he would make his decision on Wednesday.
He had not yet made a final decision, but said it was reasonable to assume he had someone lined up to play the role of commissioner if he decided to take that step.
Giving the board a chance to convince him a commissioner was not necessary was part of a process of "natural justice", but he would not meet with the board or grant any extension.
He also warned the board against making further public comments before he made his decision.
"If there is any further deterioration of the situation that compounds my concerns, I reserve the right to move earlier than Wednesday," his letter to the board states.
Mr Cunliffe said the issues at the board were different from those that forced him to intervene at Capital and Coast last year.
The Government appointed a new chair and crown monitor to that troubled district health board (DHB) in December after it was hit with a cluster of problems including budget deficits, difficulties between management and staff and concerns over patient care.
But Mr Cunliffe said Capital and Coast's issues were related to its systems, whereas Hawke's Bay's problems were largely due to "board level dysfunction".
In July last year the Ministry of Health ordered a governance report on the DHB following a conflict of interest crisis involving board member Peter Hausmann and other issues.
Mr Cunliffe said he was yet to receive that report, but he had received a range of correspondence from concerned clinicians and members of the public calling on him to take action.
He acknowledged, however, there were a range of views in the region on whether the board was to blame for the problems.
This week several clinicians came out in support of the board and its chair Kevin Atkinson.
- NZPA
