The Herald continues its three-part series on the boards that run the region's healthcare system. Today, Waitemata DHB.
Waitemata's health services have attracted attention for all the wrong reasons in the past decade. Now it has come to prominence for attracting 33 election candidates, the greatest number for any district health board in next month's polls.
This is arguably positive as it indicates huge public interest in the running of health services; but also potentially negative since candidates' campaigns inevitably focus largely on the undeniable problems they plan to fix.
Prominent among these is the failure to provide Waitakere City with a truly 24-hour acute hospital, despite earlier promises to the West Auckland community.
At present, the emergency department closes to new patients at 10pm, although that is an improvement on last year's hours. The latest promise from the current board is that the ED will be open 24/7 by December.
"There are services that are lacking - 24/7 at Waitakere Hospital," said Waitemata hopeful Sandra Coney, Auckland Regional Council member, Super City candidate and a campaigner for health consumers.
Rival Christine Rankin is zooming in on Waitakere Hospital too. "I don't know how an area like that is supposed to survive without that kind of service," she said.
Board chairman Lester Levy, a Government appointee, said that while the opening hours of the emergency department had been a problem, it was now all but fixed.
"A candidate whose platform is to meet that 24/7 [has] kind of missed the boat."
Ms Coney, 65, said changes she would push for included better services in Waitemata's northern area.
"[Around] the Hibiscus Coast, there's a need in particular, which I would support, for more community-based day-patient clinics so people don't have to travel all the way to North Shore Hospital, particularly a lot of retired people in that area."
When asked if standing for the DHB was a back-stop in case her Super City bid failed, Ms Coney said, "Health has been one of my great commitments since 1970."
She was critical of the current board, which she claimed had a tendency to rubber-stamp staff recommendations "rather than making real decisions".
Dr Levy objected to this.
"I think that's an appalling thing to say. The Waitemata board, at least in the time I have been there, has made significant progress. It's an ill-informed comment.
"Maybe she should have taken the time to come and sit in a board meeting and see the pretty serious discussion that goes on."
If Ms Coney is to win a board seat, she will have to displace 81-year-old Pat Booth or one of the other six elected members of the current board, who are all offering themselves for another three-year term.
Others vying for a seat include North Shore Mayor Andrew Williams, former Labour Party president Mike Williams, former regional councillor Ian Bradley, former board appointee Mary Lythe and financial journalist Graeme Hunt, a running mate of Mrs Rankin's on the centre-right North Now ticket.
Mrs Rankin, 56 - who, like Mr Bradley, Mr Hunt and the mayor, is seeking a Super City seat - denied that the DHB was a second choice. "I'm really interested in health services and I have been for a long time," she said.
She was concerned that North Shore Hospital seemed to be "plagued with problems".
"I have been contacted by so many people who went into North Shore and while one or two have told me about the fantastic emergency service, [a lot] are frustrated."
Mr Bradley, 73, said there was nothing in particular he wanted to change at the DHB. "I think health has probably had enough changes."
Mrs Lythe, a nurse and the clinical services manager of Alzheimer's Auckland, was appointed to the board by the last Labour Government, but was manoeuvred off by National Party Health Minister Tony Ryall.
Mr Williams, 60, is standing primarily to further his anti-drug campaign.
"My main reason is that I want to see more focus on the problem of methamphetamine, which is rife on the North Shore and in West Auckland."
Dr Levy said the board had vigorously addressed big issues since he was appointed last year.
Top items were emergency services at both hospitals, elective surgery and the big outflow of money - nearly $273 million in the last financial year - to have patients treated at other DHBs, mainly Auckland.
He said the answers largely lay in increasing capacity and smarter hospital processes. Twenty-five beds were added at North Shore before winter and more might be needed.
The new emergency department and assessment and observation unit were due to open in about a year and a dedicated elective surgery building, intended to have four theatres and 40 beds, was being planned.
Waitakere was having beds added, a never-used operating theatre was being fitted out for surgery and new, experimental ways of organising elective surgery were proving cheaper and had increased throughput.
Waitemata's profile
Population: More than 525,000.
Annual turnover: $1.2 billion.
Staff: Around 6000.
Emergency departments: 79,344 patients at North Shore and Waitakere hospitals in 2008/9.
Board member annual pay: $25,000 base rate for ordinary members, up to $32,800 including committee fees.
Health Boards
Yesterday: Auckland.
Today: Waitemata.
Tomorrow: Counties Manukau.
