Dialogue: Reprieved hospital ready for a clean break from the past

By ELEANOR BLACK

It was the sort of scene Gisborne people have come to dread - a gaggle of media types armed with cameras, notepads and microphones gathered to hear the latest instalment in their healthcare saga.

But this time there was good news. Health and Disabilities Commissioner Ron Paterson's report into patient care and quality assurance systems at Gisborne Hospital, released this week, found that while the hospital was responsible for several serious breaches of the patients' code of rights, the future was rosier than most people in the East Coast community might have expected.

The hospital was not going to produce a disaster on the scale of Gisborne pathologist Dr Michael Bottrill's cervical cancer mistakes, which led to a lengthy inquiry from which disturbing revelations spewed like hot lava.

The rumours about a cowboy anaesthetist who threw needles around the operating theatre and got kicks from touching patients were untrue.

Lady Luck had smiled on 117 patients whose prostate cancer tests were misread and 134 others whose anaesthesia was delivered via reused needles. The health professionals responsible for these highly public breaches had moved on.

Finally, after years of speculation, rumour and misery in the halls of medicine and in the wider community, Gisborne Hospital has been given the all-clear.

Unfortunately, restoring staff morale is going to take a lot longer than it took Mr Paterson to establish that the hospital is a safe place for patients.

The most fascinating aspect of the commissioner's surprisingly readable 185-page report is the description of the almighty clash of personalities which led to a distinctly unhealthy atmosphere at the hospital in 1999 and last year.

The unhappy organisation described by Mr Paterson was a place where "endemic distrust" had developed between clinicians and managers with budget priorities. Devastated staff confessed that they felt powerless against the charge of bureaucracy and believed patients were at risk. When something went wrong in the operating theatre or on the ward, they were afraid to report it because they felt they would be blamed.

The battle between senior managers and clinical staff got so bad that doctors and nurses were diverted from focusing on patients and burst into tears when speaking to the commissioner's investigation team.

Dr Brian Lucas, the locum anaesthetist who was accused of ripping gowns off patients and rubbing ice on them suggestively, was described as an experienced but aggressive man who got offside with colleagues. Nurses said he talked down to them and got snippy with patients. One woman, who went into hospital for a vaginal hysterectomy, said the doctor did not respect her choice of anaesthetic method and made her feel like "a little schoolgirl."

Hospital group manager Mike Grant emerges as a deeply unpopular man whose drive to change the structure of the hospital and its "provincial town thinking" was met with strong resistance.

When clinical staff learned the priority which had been placed - necessarily - on budget concerns, they refused to cooperate with senior managers, or even communicate with them in a meaningful way.

Former chief executive Sheryl Smail, who resigned in October, admits her style of leadership was "more top down than is ideal" and that she did not spend as much time with staff as she would have liked.

Problems brewed but were not addressed and discontent rose from a quiet murmur to bellowing that hit headlines throughout the country.

Mr Paterson says the level of media interest in the hospital was disproportionate to what was actually happening there. But how could we resist the titillation, the gossip, the drama that was unfolding?

People were talking about it at cafes, in shop queues and on bar stools throughout Gisborne. We were simply listening. Hopefully, though, there will be no more headlines concerning Gisborne Hospital for a while. The people who work there and the community that relies on it deserve a break from the spotlight.

If Ron Paterson is right, this is a time of hope and goodwill at the hospital. Lessons reaped from its period of crisis are now available in print for us all.