Repeated reports have slammed Wakari Hospital for its dilapidated ward conditions, but little has been done. Photo / Stephen Jaquiery
Wakari Hospital has repeatedly been the subject of damning reports but there appears to be little certainty around its future. PIJF Court Reporter Tina Grumball reports on a case that has further exposed its shortcomings.
Four nurses prepared to enter a seclusion room at Wakari Hospital unsure of what they might find.
There had been no time for a handover and the woman inside had covered windows to obscure their view.
They were to open the door, enter the room, and remove the paper.
"First time I was made aware of it was the needle going into my thigh," said Douglas when she testified at the Dunedin District Court trial last month.
She said it was"just like getting an injection".
Donna Jane Murray, 35, was the patient charged with assault with a weapon.
The police case was that Murray had snuck it in and used it deliberately.
Volatile environment
However, defence counsel Brendon Stephenson argued it was the panicked circumstances of the restraint that caused the accidental use of the needle.
Once the nurses had pried it from Murray's hand, they exited the room and threw it in their sharp objects bin. "Anything sharp or dangerous we don't have on the ward ... to the best of our ability we try to make sure they are not available," Fitzsimmons testified.
So how was an unstable patient able to smuggle a needle in and use it against a staff member?
Acting general manager of mental health, addictions, and intellectual disability Steve Bayne said part of the investigation into the incident was a review of the protocols surrounding searching incoming patients and property.
The episode only added to the woes surrounding Wakari Hospital.
Ward 9B is a locked unit that aims to assist recovery by "providing a safe and therapeutic environment".
However, after several reviews since 2019, Wakari Hospital has been evaluated as "unfit for purpose".
A damning report previously obtained by the Otago Daily Times revealed "the majority of the mental health facilities located on the Wakari site in Dunedin are in a poor state and not fit-for-purpose".
It also revealed 9B was one of the four wards that required "urgent attention".
Built in the early 1990s, the ward "remain[ed] in [its] original condition", as do many others on the site.
Among the problems found were: Institutional setting; insufficient space to meet the needs of patients; no specific rehabilitation area or quiet space; insufficient heating and ventilation; inaccessible for patients in wheelchairs; not welcoming or culturally sensitive; limited access to the outdoors which was underutilised.
Underneath the cultural problems were also physical ones.
Insulation repairs were required, seismic restraints put in place, and the original electrics needed repairing as they were "nearing the end of life".
Based on a 2017 report by engineering consultant Beca for the Southern District Health Board, it was estimated the cost to rehabilitate the hospital would be $40million.
The options presented were to either renovate four of the six buildings on the site or redevelop the hospital entirely.
In 2020, Southern District Health Board chief executive Chris Fleming said "this a complex issue, with no easy or quick solutions".
Chief Ombudsman Peter Boshier recently released a report into Wakari Hospital ward 10A — an inpatient facility — in which he highlighted the "volatile environment".
Bayne said, "any decision to use seclusion requires a robust rationale".
"The threshold is an imminent risk of physical harm to others".
Seclusion rooms had always stirred controversy.
In 2015, the United Nations Committee against Torture revealed they were "greatly" concerned about the use of seclusion rooms for punishment and discipline in New Zealand.
The Health and Quality Safety Commission subsequently sent a letter to District Health boards around the country announcing a plan to eliminate the use of these rooms by 2020. However, they acknowledged it was "an ambitious goal".
SDHB would not comment on whether they were being phased out.
The health board was preparing a proposal to put to the Ministry of Health about the future of the hospital, but they have not said publicly what changes would be made or when.
Bayne said the nurse who was assaulted had been given support following the incident.
"Southern DHB has zero-tolerance for any kind of violence, abuse, or threatening behaviour, whether it be physical or verbal, towards our staff or other patients."