Health provider: Why we failed

Lyvia Marsden, general manager of Te Puna. Photo / David White

An Auckland's primary health organisation that performed poorly on child immunisation rates in a national league table says it was going through a bad patch and has rectified its failings.

Te Puna, serving North Shore and Rodney, is one of eight Auckland region PHOs named among the worst five performers on one or more health indicators on the national table.

The Health Ministry table shows Te Puna performed cardiovascular disease screening on none of its high-health-need patients.

This was said to be an administrative error, but it made Te Puna worst-equal on this indicator with Hauraki PHO and Partnership Health in Canterbury.

The table, released this week, is the first of its kind to be made public and is dated last June. PHOs contract with health clinics and channel money from district health boards.

Those which meet targets set with the ministry receive a share of a $25 million performance fund, of which usually about $20 million is paid out.

Te Puna was also in the bottom five performers for full immunisation of its neediest 2-year-olds (51 per cent), and vaccination of its high-need elderly against the flu (44 per cent).

Full immunisation of all its 2-year-olds was only slightly better, at 55 per cent; the national target is 85 per cent.

General manager Lyvia Marsden yesterday acknowledged that Te Puna's performance had fallen short.

She blamed the swine flu epidemic, an influx of 300 new patients and staffing shortages.

But its performance had picked up dramatically since September, because of changes in the way cardiovascular risk assessments were done and increased staffing.

"September should not be zero for cardiovascular disease [assessment]. There were problems with the way the data was being captured. We discovered that a number of our clients were not going to the lab and the lab test was crucial to complete the path for the statistics."

Nurses were now drawing the screening patients' blood and sending it to the testing laboratory.

Total Healthcare Otara's executive officer, Mark Vella, rejected what he said was the table's faulty figure on his PHO's child immunisation rate, and demanded an apology by today from the ministry.

The table said 32 per cent of the PHO's 2-year-olds were fully immunised. Mr Vella said the correct figure 76 per cent last year.

"I am extremely disappointed with the news releases that have slandered Total Healthcare Otara as the worst performing PHO regarding immunisation ... Last year THO was the lead PHO for the Counties Manukau district supporting the other PHOs ... to get the immunisation rates up."

But there was also an accolade for his PHO - it was top for cardiovascular risk assessment.

The Tongan Health Society's clinical spokeswoman, Dr Glennis Mafi, said it had done a lot of work to increase its women's low uptake of cervical screening.

Women from Tonga were unfamiliar with cervical screening because the country did not have a screening programme.

The ministry accepts some data in the table is weak, but says its reliability is increasing.