The Southern District Health Board (SDHB) released an independent report last Friday, of an external review of their performance in maternal health, conducted by Ernst and Young. The verdict was not good.
The report said, the Hub “would have been more effective if there was a commonly shared definition of the purpose of a Hub within the communities they operate. Confusion as to the definition and purpose of the Hubs was evident…”
This is indeed true as many locals are still scratching their heads about what the Hub is supposed to do. It is located a long way from the helipad and there is no details of what equipment will be supplied. The neonatal resuscitaire and a cardiotocography are both stored in a corridor in the Wānaka Lakes Health Centre (WLHC), which midwives have 24/7 access too, but there is no room in the WLHC that they can access to use this equipment out of hours except the clinic room but this is not accessible directly from the medical centre. Despite over a year in planning, no one is the wiser about where this equipment will go and whether the hub is the primary point of emergency care, or the WLHC.
Local midwife Deb Harvey said the Ernst and Young audit on SDHB’s maternity services was accurate. “The strategy is poorly thought through and even more poorly executed, I think the report highlights a lack of strategic planning, poor communication with communities it is supposed to help and a lack of leadership. The hub concept is an unproven and unevaluated strategy that has been poorly implemented.”
That said, the report did state that the teleclinic service “has demonstrated success in key areas.” However, it is now a victim of its own success as it is oversubscribed.
Waitaki MP Jacqui Dean says she fears for the future of maternity services in Wanaka and Central Otago in the wake of the report. “I welcome this report because at last some light has been shone on what has been a truly lacklustre performance by the Southern DHB. Its trail of broken promises and ineffective management has left mothers and midwives in this area feeling unhappy and insecure.”
In response, Southern DHB said they will be establishing stronger project management structures, reshaping midwifery leadership roles and looking at opportunities to expand telemedicine and optimise payments to LMC midwives.
CEO Chris Fleming said, “The system needed to change. LMC midwifery was facing a crisis and services were concentrated in some parts of the district, and missing from others… We accept the findings however that we did not adequately anticipate or plan for the scope of changes required, by ensuring we had sufficiently robust project management structures in place.”