Dunedin Hospital #despair

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Initially, it was hoped the $11 million upgrade would not get bogged down in a drawn-out approval process.

### ODT Online Fri, 30 Oct 2015
ICU upgrade approval not before March
By Eileen Goodwin
Approval for the long-awaited Dunedin Hospital intensive care unit upgrade has been pushed back to March at the earliest, it has been confirmed. […] The upgrade was considered urgent last year, when the unit lost its accreditation to train specialists, and it was initially hoped building work would start by mid-2015 or sooner.
Read more

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Posted by Elizabeth Kerr

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35 Comments

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35 responses to “Dunedin Hospital #despair

  1. Elizabeth

    This week I said I’d been removed from a waiting list for a cataract operation at Dunedin Hospital – this is nothing compared to what patients are experiencing at Opthalmology further south.

    Carole Heatly doesn’t appear to be earning her self-aggrandising salary.

    An Official Information Act response shows one patient lost sight in one eye, and the other had reduced sight in both eyes.

    ### ODT Online Sat, 12 Dec 2015
    Patients’ vision loss: ‘serious situation’
    By Eileen Goodwin
    Partial eyesight loss in some ophthalmology patients at Southland Hospital has been blamed on a lack of available appointments in a department “overwhelmed” by patients. “The service was just overwhelmed with numbers of patients,” acting Southern District Health Board chief medical officer Richard Bunton said.
    Read more

  2. Elizabeth

    Officials recommend a fund of $7.3million, less than half the $15.4million required to fix all of the “significant and high-risk items”.

    ### ODT Online Mon, 14 Dec 2015
    Ministers told of risk at hospital
    By Eileen Goodwin
    Government ministers were told an urgent maintenance fund was needed to avoid “critical service failures” at Dunedin Hospital. “There is a high risk to the sustainability of key clinical services due to the physical condition of the hospital,” Ministry of Health advice to Health Minister Dr Jonathan Coleman and Finance Minister Bill English released under the Official Information Act says. […] a second document, also released to the Otago Daily Times under the OIA, reveals Treasury warned Mr English and Dr Coleman against speeding up the time frame for the $300 million redevelopment.
    Read more

    ****

    New ICU will likely end up being redundant in about a decade.

    ### ODT Online Mon, 14 Dec 2015
    Intensive care plan revealed
    By Eileen Goodwin
    The fifth floor of Dunedin Hospital’s ward block will be transformed by an expanded and rebuilt intensive care unit and a new high-dependency unit, the project leaders say. The $11 million project will use the entire floor including the existing unit, the former neonatal intensive care unit, and ward 5B, which will shift. It is by far the most complicated project of the package of $22.5 million for special interim works approved this year by the Government.
    Read more

  3. Elizabeth

    ### Stuff.co.nz Last updated 16:52, December 14 2015
    Southern District Health Board budget cuts dangerous – Annette King
    By Phil McCarthy
    The Southern District Health Board is making progress in driving down a forecast $42 million budget blowout in 2015-16, but Labour Party health spokeswoman Annette King says staff cutbacks could lead to a potentially dangerous loss of services. […] “Despite Minister Jonathan Coleman’s continued denial that $1.7 billion has been wiped from health in six years, there’s no disputing the fact that our health boards are short 158 doctors. These are medical professionals that have been budgeted for, but are not being hired because of the massive financial constraints the sector is facing. The pinch is also being felt among the wider health workforce, with a shortfall of 162 allied sector personnel, such as radiographers and physiotherapists.” King says that with a growing and ageing population reducing headcounts and not filling vacancies could only lead to one thing, a significant and potentially dangerous loss of services.
    Read more

  4. Elizabeth

    ### ODT Online Sat, 6 Feb 2016
    No word on using lifts
    By Eileen Goodwin
    The Southern District Health Board cannot say when these Dunedin Hospital lifts, closed in October because of the asbestos scare, will reopen. Chief executive Carole Heatly said the decontamination was a “really big job”, and had been put out to tender.
    Read more

  5. Elizabeth

    39 Dunedin News Fri, 1 Apr 2016
    Local demand for surgery exceeds capacity
    New research shows joint replacement surgery in Otago is getting harder to schedule, with demand outstripping capacity. Hundreds of people referred for hip and knee replacements have been sent back to their GPs, only to be re-referred for surgery at a later date. The problem’s been highlighted in a report by a Dunedin Hospital orthopaedic surgeon and a researcher at the University of Otago. They say local demand for joint replacements has been increasing over the last four years, but capacity has not. That means patients waiting to qualify for surgery are experiencing more problems. Many people are being told they should consider private care, at their own cost.
    Ch39 Video

    ****

    Otago appeared to be “several years ahead” of the rest of New Zealand because it had a higher proportion of older people.

    Fri, 1 Apr 2016
    ODT: Surgery shortfall worsens
    The “explicit rationing” of joint-replacement surgery in Otago is worsening, and patients should look to other ways of funding their surgery, a research paper published today in the New Zealand Medical Journal says. Written by Dunedin Hospital orthopaedic surgeon Associate Prof David Gwynne-Jones and Dr Ella Iosua, a biostatistician in the Department of Preventive and Social Medicine, University of Otago, the paper analyses hip and knee patients from November 2013 to October 2014 in Otago (excluding Queenstown).

  6. Elizabeth

    Fri, 8 Apr 2016
    ODT: Antibiotic-resistant bacteria found in five patients
    Five patients recently admitted to Dunedin Hospital have screened positive for an antibiotic-resistant bacteria, the Southern District Health Board announced this afternoon. The patients were colonised with vancomycin-resistant enterococcus (VRE). The bacteria was in or on the patient’s body, however they were not sick because of it.

  7. Elizabeth

    More

    Sat, 9 Apr 2016
    ODT: Hospital ‘shock’ as super bug discovered
    Five Dunedin Hospital patients have screened positive for an antibiotic-resistant bacteria, a reminder of the importance of infection control, chief medical officer Dr Nigel Millar says. The bacteria is vancomycin-resistant enterococcus (VRE). […] Southern DHB takes any positive results for antibiotic-resistant bacteria very seriously, and we are screening patients who have come in close contact, or shared a room with the patients identified as being colonised with VRE. “We are getting in touch with contacts who have left hospital and providing information to their general practice teams and other relevant healthcare providers, though the risk to them is very low,” Dr Millar said.

  8. Elizabeth

    Received from Gurglars
    Sat, 9 Apr 2016 at 8:29 p.m.

    The solution to the SDHB financial worries
    This Sydney orthopaedic surgeon suggests that many operations (which he has conducted) including arthroscopy, back fusion, floating livers*, and many others should be scrapped until there is real scientific evidence that such procedures are significantly better than placebo operations.

    Makes a lot of sense to me and would free up surgeons to actually do surgery which works such as hip replacement. The benefits lower waiting lists, less surgeons, lower costs of running the SDHB. Very radical, but intelligent analysis.

    RNZ: LISTEN to Professor Ian Harris in conversation with Simon Morton.
    Audio | Downloads: OggMP3 (19′03″)

    “Patients have to ask for the evidence. They should be saying to their surgeon ‘What evidence do you have that this operation is better than any non-operative alternative?” –Ian Harris

    Liver [thefreedictionary]

    *Floating liver means an easily displaced liver. Hepatoptosis is a rare entity in medical practice. It is also known as wandering liver and hepatocolonic vagrancy. It describes the unusual finding of, usually through radiology, the alternate appearance of the liver on the right and left side, respectively.

  9. Elizabeth

    Caution needed interpreting results at regional level, but it appears the situation is worsening in the South. –HFANZ chief executive Roger Styles

    Tue, 12 Apr 2016
    ODT: Tens of thousands await surgery in South
    About 40,000 people in the Southern District Health Board area may require elective surgery, a survey released yesterday suggests. The research, by TNS New Zealand, commissioned by Health Funds Association New Zealand (HFANZ) and the Private Surgical Hospitals Association, found 110,000 New Zealanders were on official waiting lists, and a further 170,000 had not been placed on waiting lists despite being told they required elective surgery.

  10. Elizabeth

    Has to be some Good news emanating from Dunedin Hospital most days but all we seem to get from ODT is accounts of gangrenous rot and toe losses. A sure sign of poor management and declining funds for complete medical care – the common ailment for southern dwellers. ODT is unapologetically morbid and depressive —effective Hospital staff don’t deserve the constant barrage.

    Fri, 22 Apr 2016
    ODT: SDHB at financial risk from asbestos
    Asbestos poses a financial risk at the Southern District Health Board, which is under pressure from the health minister and Wellington officials to “accelerate” cost-cutting, a document released under the Official Information Act shows. It is hoped the board will post a smaller deficit than the $35.9million forecast, but this was at risk because of the discovery of asbestos at Dunedin Hospital last year, the document says.

  11. Calvin Oaten

    I wonder if asbestos could be ground to make a gruel? Add a bit of flavouring (not to much) and Compass could be part of the solution. Wouldn’t do their profits any harm either.

  12. Elizabeth

    GREAT NEWS – new ICU

    ### dunedintv.co.nz Wed, 27 Apr 2016
    Hospital upgrade imminent
    A major upgrade of critical care facilities at Dunedin Hospital is waiting in the wings. Staff are expecting the planned redevelopment to be approved for funding on a national level. And changes could begin as soon as July.
    Ch39 Video

  13. Elizabeth

    DISTURBING

    PSA’s concerns include corroded state of some surgical equipment manufactured in-house.

    Sat, 30 Apr 2016
    ODT: ‘Lack of respect’ for sterile practice, association says
    Patients who have been exposed to unsafe practices in Dunedin Hospital may feel they have been placed at risk and they should have been told, the New Zealand Sterile Services Association (NZSSA) says. The professional body issued a statement yesterday backing up Public Service Association concerns about sterilisation practices at Dunedin Hospital.

  14. Elizabeth

    Significant Progress

    ### dunedintv.co.nz Tue, May 3, 2016
    Orthopaedic training reinstated at Dunedin Hospital
    Orthopaedic training can once again be undertaken at Dunedin Hospital. The Southern District Health Board lost the right to host orthopaedic training at the Hospital last year. That decision was made by the New Zealand Orthopaedic Association. But it was appealed by the board, and the Royal Australasian College of Surgeons ordered another inspection of local facilities. That was done at the end of last month and now the board’s announced training can be reinstated. Orthopaedic trainee surgeons are expected to be allocated to the hospital from next year.
    Ch39 Video

  15. Elizabeth

    Tue, 10 May 2016
    ODT: Hospital asbestos clean-up cheaper
    The Dunedin Hospital asbestos clean-up has now cost more than $1.3 million, it has been confirmed. The new figure was released yesterday after the Southern District Health Board released documents under the Official Information Act showing an estimate last November put the potential cost at $14.6 million.

  16. Elizabeth

    ### dunedintv.co.nz Tue, 10 May 10 2016 at 6:37 pm
    Hospital asbestos clean-up tops $1.3m
    The cost of dealing with asbestos at Dunedin Hospital has topped $1.3m and is still rising.
    Ch39 Video

  17. Elizabeth

    PREPARE FOR SLASH AND BURN AT SDHB FACILITIES
    Thanks for shafting everyone, You on the big salaries and stipends: Yes You…. Carole, Kathy, Richard and Graham

    Sat, 4 Jun 2016
    Two HR managers lost to board
    The loss of two highly regarded human resources managers at the Southern District Health Board has left staff and unions reeling. HR manager (strategic) Alan Clarke resigned amid major restructuring at the department, and his last day was yesterday. […] Another manager is understood to have been unsuccessful in applying for a new HR role, but will stay on for a time in a different role.

  18. Elizabeth

    Documents confirm a “strategic assessment” will be combined with an “indicative business case”, which will save six months. […] Rebuild proceeding through established Treasury process for large projects.

    Thu, 7 Jul 2016
    ODT: December 2019 start for hospital
    A tentative construction start of December 2019 for the Dunedin Hospital redevelopment has been revealed in new documents released by Health Minister Dr Jonathan Coleman under the Official Information Act. The documents also show officials are pursuing a “potential” faster timeframe for the delay-ridden $300million redevelopment.

    ****

    ### dunedintv.co.nz Tue, 5 July 2016
    Plans for critical care unit released
    Health Minister Jonathan Coleman has announced plans for an $11m critical care unit for Dunedin Hospital. The Minister says it’s part of an extra $194m regional health package over the past eight years. The critical care unit is to be part of the urgent interim work already scheduled at the hospital. The Minister says two High Dependency Units and the region’s Intensive Care Unit will be in the same area. Work on the project is expected to start next month, and be completed by 2018.
    Ch39 Link

    ****

    Thu, 7 Jul 2016
    ODT: Date set for start on new ICU
    Construction of the new Dunedin Hospital intensive care unit will start in August, after a delay of more than a year, it has been confirmed. The $11million facility will be completed in early 2018, Health Minister Dr Jonathan Coleman announced this week. […] The planned facility is a “critical care unit” that includes two high dependency units. The HDUs are to be “co-located” with the ICU. The unit will house eight ICU beds and 10 HDU beds. There was potential to add four extra beds over the next 10 years, Dr Coleman said. The unit will be built on ICU’s existing space, ward 5A, and the adjacent ward 5B.

  19. Elizabeth

    “Everything is up for consideration.” –Blair

    Thu, 21 Jul 2016
    ODT: ‘General’ hospital possible
    Dunedin Hospital might switch to a “generalist” medical model with less focus on individual specialist services when it is rebuilt. Southern Partnership Group chairman Andrew Blair, of Hawke’s Bay, stressed no decision had been made on the critical question over the hospital’s future.

  20. Hype O'Thermia

    Isn’t this like what Hilary Calvert was talking about, re Council? “No decisions” nothing to see, nothing to report… then by the time the people outside the “Magic Circle” get it brought forward for “discussion” there’s nothing left to discuss. Some time wasted on the charade of community input, then the decision made without official record (i.e. not obtainable under LGOIA) is made official by a chorus of Ayes. The ayes have it, democracy has been done: like a dinner.
    Feeling burnt? Me too.

  21. Elizabeth

    Sat, 23 Jul 2016
    ODT: ‘Loath’ to repeat ‘wrangle’
    The redevelopment of Dunedin Hospital is “highly unlikely” to adversely affect neurosurgery, Health Minister Jonathan Coleman says. The qualified assurance, conveyed by a spokeswoman, follows the release of a Dunedin Hospital rebuild plan that says the new hospital should be physically configured to focus on generalist rather than highly specialised care.

    ● Dunedin is the national centre for stereotactic radiosurgery, a radiation procedure that involves a neurosurgeon’s input.

    ****

    Dunedin should not be treated like just any provincial centre. –Gerrard

    Sat, 23 Jul 2016
    ODT: Hospital report alarms medical school staff
    A special relationship of more than 130 years between the Dunedin School of Medicine and Dunedin Hospital must not be “disregarded with the stroke of a pen”, Emeritus Prof David Gerrard tells health reporter Eileen Goodwin. A report prepared for the rebuild of Dunedin Hospital has caused alarm at the Dunedin School of Medicine because it suggests research is a financial burden and ties up too many resources in Dunedin.

  22. Elizabeth

    That Dr Coleman has not seen fit to appoint a southern doctor to the Southern Partnership Group that controls the rebuild is telling.

    Sat, 23 Jul 2016
    ODT Editorial: Perils of Dunedin Hospital rebuild
    OPINION If the public has all but given up on the prospect of a major redevelopment of Dunedin Hospital, it is now time to start paying attention. After years of dithering and empty promises, Health Minister Jonathan Coleman has told bureaucrats to hurry up and get on with it.

    █ Dunedin List MP Michael Woodhouse’s apparent lack of interest in the project is unfortunate.

  23. Elizabeth

    Mon, 25 Jul 2016
    ODT: Hospital rebuild ‘exciting opportunity’
    The rebuild of Dunedin Hospital is an “exciting opportunity” for changing health services but for now it is “business as usual”, Southern District Health Board commissioner Kathy Grant says. […] The public is not being consulted on the plan. […] The planned hospital would be “smallish” or medium-size, and the area’s population meant “we don’t expect massive growth in bed requirements”.

    ****

    Comment at ODT Online:

    Dunedin Hospital
    Submitted by fields-nz on Sun, 24/07/2016 – 6:27pm.

    I was disappointed to find several misinformed comments and misunderstandings about the current situation with regard to specialist surgical services in Dunedin Hospital. I first worked in Dunedin Hospital in 1987 and was appointed as an ENT Specialist in 1995. The Neurosurgical service has never had it’s own stand alone ward in that time. The current ward used by Neurosurgery is 5B and is shared with the ENT, Ophthalmology, Maxillofacial (Oral) Surgeons and Neurology. There is a good reason why these specialties are placed together – we are all focused on the neck up. This means that we often have cases that overlap and require each other’s skills and working as a team. This also applies to the Nursing staff, who provide valuable additional skills when looking after head injured patients, or those with airway and swallowing issues for example.

    This group of Specialties are about to move to the 3rd floor as 5B is required for the new ICU. At the planning stage for the move – we were very concerned that this skilled group could be split up to the detriment of our patients. We were relieved to find that SDHB management listened to our concerns and every effort has been made to keep this group together on a shared ward.

    On occasions when our ward is full, some of our acute admissions have to be admitted to other wards and in turn our ward often takes others “outliers”. It is always preferable to get our patients back to our base ward under the care of our specialist nurses, especially those with airway concerns. If I had an orthopaedic problem – I know I would prefer to be on an orthopaedic ward for the same reasons. The idea of having a whole mixture of patients on a “generalist” ward does not make sense and will increase the risk of complications.

    Hospitals are for patients requiring acute specialist care / investigations. If they have a “generalist” problem that could be managed by a non specialist – then they could / should be in a nursing home or GP run hospital or managed at home.

    Finally – don’t underestimate how important the Medical School is to the quality of care provided and the ability to retain skilled and experienced specialists. Downgrade the hospital or move the Medical school out of Dunedin – then many medical staff would have to leave if they wished to continue with research and teaching (which is why many are here).

    Although the Otago / Southland catchment is small by world standards – the Christchurch earthquake was a good reminder that too much centralisation of services carries risk. Maintaining the Medical school and a tertiary hospital in Dunedin should be considered essential by politicians and the public.

  24. Elizabeth

    Tue, 26 Jul 2016
    ODT: Risk seen in hospital plan
    Having too wide a mix of patients in a hospital ward will increase the risk of complications, Dunedin Hospital ear, nose and throat specialist Martyn Fields says. Mr Fields is opposed to the idea of managing complex patients in generalist wards. The idea has been suggested in a Dunedin Hospital rebuild strategic plan. […] The Otago Daily Times understands it is possible the “neck up” specialties might be cared for in a generalist ward, depending on the outcome of the process.

    • Hype O'Thermia

      What would specialists – or nurses or patients or indeed anyone in Otago – know what’s best for us? That’s what we have politicians and hand-picked commissioners and consultants for, isn’t it? And the further away from Otago they’re based (and where their loyalty lies) the more they know what’s good (enough) for us. Right?
      Roll on general election, let’s choose better next time.

  25. Elizabeth

    ODT 25.7.16 (page 8)

    ODT 25.7.16 Letters to editor Tordoff Harman Calvert Angelo Poole p8

  26. Elizabeth

    Thu, 28 Jul 2016
    ODT: MP hits back at health changes claim
    A legal requirement to consult the public on major health changes in their area has been fulfilled, Southern Partnership Group chairman Andrew Blair says. However, Dunedin North MP David Clark disagrees, saying the New Zealand Public Health and Disability Act’s clear requirement for public consultation on strategic planning might have been breached.

    Dr Clark also disputes Mr Blair’s assertion, reported last week in the Otago Daily Times, that most people prefer to leave health planning to “experts”.

  27. Hype O'Thermia

    A half-truth: “most people prefer to leave health planning to “experts”.”

    Experts in health, in the health needs of that particular area and knowledge of the best ways to deliver the best value for money to the most patients possible. This necessitates keeping the best health practitioners of all levels from most senior consultants to the most recently graduated nurses and physiotherapists etc. Keeping them means they have to be able to work to a standard that does not compromise their integrity. They have to be busy and challenged but not overworked and exploited. They need their minds stimulated, they need time and space to give appropriate attention to patients. There is no need for “planners” to put patients first: health practitioners do that given half a chance to do their best work consistently without obstruction from “experts” and managerialism cultists with their weird rituals of disruption and humiliation.

    Not preferred: experts in political expediency, spin, diverting money from necessities to pet projects and personal advancement etc etc.

  28. Elizabeth

    Better final result without unexpected bill of $3million to clean up asbestos.

    Thu, 28 Jul 2016
    ODT: Deficit better than expected
    The commissioner team at the Southern District Health Board is celebrating a better-than-expected deficit figure. At its monthly public meeting yesterday, chief financial officer Clive Smith said the 2015-16 deficit was $1.7million better than expected. The board had expected to post a $35.9million deficit. The figure will be subject to final adjustments.

    • Calvin Oaten

      So, the deficit is lowered from $35.9m to $34.2m! Big ups all round says Richard Thomson, “we should celebrate these joys as they come along”. Richard of course is redundant as he was on the committee to assess the ‘rebuilding programme’. That will of course be superceded by the latest appointment of a consortium of Australian consultants, won’t it? His honest response would be to submit his resignation, wouldn’t it? We should see his notice published in the ODT anytime now.. Oh, I forgot, that would not be considered as news would it? Oh well, I guess the utterances of this ‘fool’ will be heard for some considerable time yet. Still at least we won’t have to suffer his ‘pearls of wisdom’ at council table.

  29. Elizabeth

    Thu, 4 Aug 2016
    ODT: Consultants appointed
    The Australasian consulting firm whose controversial report upset senior Dunedin research clinicians recently has been chosen to run the next big stage of the Dunedin Hospital redevelopment project. Sapere Research Group will write the “indicative business case” for the $300million project. […]A second contract, for hospital services and architecture planning, has been awarded to a consortium of three companies – Jacobs, CCM Architects, and Johnstaff.

    █ Johnstaff is an Australian project advisory firm, CCM Architects is a Wellington-based architecture firm, and Jacobs is a multinational engineering consulting firm.

  30. Elizabeth

    At Facebook:

    ****

    Wed, 5 Apr 2017
    ODT: Unhappy nurses to meet managers
    By Eileen Goodwin
    Nurses at Dunedin Hospital are unhappy with staffing numbers and will raise the problem with management. The New Zealand Nurses Organisation has set up a meeting between some of its emergency department members and management to be held later this week. Last night, nursing union delegates met in Dunedin to discuss other possible actions. The NZNO president, Grant Brookes, of Wellington, said he visited Dunedin Hospital on Sunday to listen to nurses. “The nurses aren’t able to provide the standard of care they feel people deserve and need.” He said some nurses were saying the situation was as bad as 2014, when 300 nurses attended a stopwork meeting to complain to management about low staff numbers. Cont/

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