Ron Dunham does an intimidating job but he's not an intimidating man.
One of the first things he did as Lakes District Health Board chief executive was work a shift in the Rotorua Hospital emergency department, six years ago.
Lakes District Health Board chief executive Ron Dunham at Rotorua Hospital in 2013. Photo / File
"I found out my stomach isn't as strong as it used to be," he told the Rotorua Daily Post shortly after.
Ask him about his colleague and interim replacement, Nick Saville-Wood, and he'll tell you he is "great, well respected by all the staff, and he takes my jokes as well".
Nick Saville-Wood will replace Ron Dunham until a new permanent person is found. Photo / Supplied
Dunham started as a young male nurse from Mangakino, the first in New Zealand to train in obstetrics.
On December 31 he will walk away from half a century spent working in the health system, with a tally of 18 years in chief executive roles in DHBs in Australasia.
He also spent the last three years as the national chair of the DHBs' chief executive group, "corralling them all".
"It's sort of a bit like kindergarten cop really. You get one being naughty in the corner and another one yelling over here... but we achieved a lot."
Lakes District Health Board chief executive Ron Dunham is finishing up this month. Photo / Stephen Parker
The first controversial question in our interview is about the series of strikes from junior doctors, nurses, and midwives in Dunham's last few years in the job.
"Do you think any of these groups deserve better...?"
Dunham butts in before I can say "working conditions".
"They all do," he says.
"Health sector staff, they're all dedicated to their job. The money isn't the reason they come to work, so we've got to make sure that they are well kept and they're earning enough money to keep them here."
He says "the challenges are always going to be not enough resources, not enough funding to do the things you know are going to make a difference".
"We do what we have to do to be effective, it's essential, but there's a whole lot more we could do. Particularly trying to get into the prevention and health promotion, rather than just always taking people who are sick."
From left, former health minister Dr Jonathan Coleman, Lakes DHB chairman Deryck Shaw, Rotorua MP Todd McClay and chief executive Ron Dunham in 2014. Photo / File
We then move to last year's decision to stop the Hunga Manaaki service.
The end of Rotorua Hospital support service Hunga Manaaki in 2017. Photo / File
For 20 years it provided advocacy and cultural support for Māori during their time in hospital in the Lakes DHB, but it was replaced by a wider community-focused service across the hospitals and mental health services.
Rotorua Hospital support service Hunga Manaaki is farewelled in 2017. Photo / File
Despite iwi strongly opposing the changes, Dunham says they are "working well".
"We are now able to follow the consumer if you like, back into their homes... so it was getting away from just being a hospital service to a whole community provider service."
Dunham says mental health staff are the ones that keep him "awake at night the most".
"It is a very difficult area, that's growing in demand. It's getting more and more stressful for our staff... It's almost like they can't see a horizon because there's so much going through the door."
Dunham says people that are "highly deprived economically" need the most care from the Lakes DHB.
"Those that can't get the right food, can't afford to put the warm clothes on their kids or stop the dampness etc."
He says, therefore, the biggest challenge our health system will continue to face is connecting social care and health care.
One approach that has proven a success in Rotorua in the last year, is the Te Aka Mauri Library and Children's Health Hub that opened in February.
Rotorua's Te Aka Mauri Library and Children's Health Hub. Photo / File
"It's the only one in the world" Dunham adds.
He later tells me he's really proud of it, but that was already clear.
Te Aka Mauri Library and Children's Health Hub opening. Photo / File
"When we have a child in there, we don't actually just think of them as a broken arm or a hearing problem or whatever, we start to make sure they've got immunisations and how many times a year do they come in with a respiratory tract illness?
Rotorua's Te Aka Mauri Library and Children's Health Hub. Photo / File
"And what's housing like or what are those bruises, you know, we are looking after the whole child not just its hand or eyes. So there's a lot more opportunity and we work closely with education and social services, and we find that we share families."
He says the children's clinics are seeing "much better attendance" at the hub.
Te Aka Mauri Library and Children's Health Hub open day. Photo / File
After a career of careful decision making using data, research and scientific evidence, Dunham's decision to retire is based on intuition.
"There comes a time when it feels right."
When he cleans out his office at the top of the north-eastern hospital block, he will be looking forward to enjoying more family time.
Dunham has spent 50 years helping save lives, but he can now focus on enjoying his own.
Ron Dunham's career 1968 – 1971 student nurse Tauranga Hospital 1971 – 1972 staff nurse, accident and emergency Tauranga Hospital 1973 – 1978 living in UK and Canada, accident and emergency psychiatric nursing, a pharmaceutical representative 1978 – 1985 national sales manager Wellcome NZ 1985 – 1987 organisation development manager Wellcome NZ 1987 – 1990 marketing manager Wellcome NZ 1990 – 1993 general manager clinical support services Central Auckland Health District 1993 - 1996 New Zealand general manager Glaxo Pharmaceuticals 1996 – 2005 chief executive Bay of Plenty District Health Board 2005 – 2010 chief operating officer Counties Manukau District Health Board 2011-2012 chief executive Western NSW Local Health District, Australia 2012 -2018 chief executive Lakes District Health Board
