KEY POINTS:
The struggling Hawkes Bay District Health Board appears set to be sacked after Health Minister David Cunliffe gave its members less than a week to explain how they could overcome his "serious" concerns about how they were functioning.
In what is the second example of Mr Cunliffe stepping in to sort out a DHB drama since he was promoted to the health portfolio late last year, the Health Minister yesterday sent a strongly-worded ultimatum to the board.
"I have become seriously dissatisfied with the performance of the board of the Hawkes Bay District Health Board," Mr Cunliffe said in the letter.
"I wish to provide you with an opportunity to respond before I make any final decision," he wrote, issuing a deadline of 1pm on Tuesday for a written reply saying how it would address his concerns.
He will make a decision on Wednesday.
Mr Cunliffe made it clear he was considering sacking the entire board - something done just twice before - and appointing a commissioner.
While he stressed to reporters he had not made a decision, Mr Cunliffe indicated he had already identified a person he might ask to take on the role of commissioner.
The tough stance from Mr Cunliffe comes after several months of acrimony at the Hawkes Bay District Health Board, and not long after he had to deal with systemic problems at Wellington's Capital and Coast DHB.
The Hawkes Bay trouble began publicly in the middle of last year when concerns about a conflict of interest involving a board member and a multi-million dollar tender process hit the headlines, prompting then Health Minister Pete Hodgson to order a review.
Relations within the board have deteriorated as the review report has taken far longer to be finalised than was expected.
Chairman Kevin Atkinson was voted back on to the board in last year's local body elections with strong public support, but Mr Cunliffe has held off re-appointing him as chairman until the review report comes in.
There are additional positions on the board which haven't been filled for the same reason and sources have suggested to the Herald that because of that the board hasn't been able to set up all the committees it needs to in order to function properly.
But Mr Cunliffe appears to have run out of patience with the board's problems and looks set to strike before the report - which has been held up because of legal wrangling - is finally issued.
His tough stance drew criticism from rival MPs yesterday, who claimed the health board had been unable to function properly because of the "holding pattern" circumstances it has been faced with.
Act MP Heather Roy said Mr Cunliffe had not given the board "a fighting chance", and accused him of deliberately discrediting the board.
National MP Chris Tremain - the MP for Napier - said there was actually strong support for the board in the Hawkes Bay region and Mr Cunliffe had it wrong when he suggested there were problems between the board and senior clinicians.
"There is no breakdown, there is no apparent tension," Mr Tremain said in Parliament.
"I personally rang around a significant number of senior consultants on Sunday evening and spoke to them, and my research indicates there is virtually unanimous support for the board."
Mr Cunliffe said he had been contacted by other people with the opposite view.
CUNLIFFE'S WORRIES
* The DHB's financial performance is rapidly deteriorating and it is predicting a year-end deficit of $7.7 million.
* The chairman has been reported as saying it was never realistic to cut $5 million from costs, but the scenario was still factored into a budget to get sign-off from the minister.
* He has an increasing "lack of confidence" in the board's integrity, through it publicly challenging him as minister and by using the media "to advance the personal agenda" of members.
* There are dysfunctional relationships between the board and Mr Cunliffe, and the board and management.
* An Auditor-General's report has reflected poorly on the board.
