Gisborne Hospital Report - Health and Disability Commissioner

Gisborne Hospital 1999 – 2000
Introduction and Environment
The report
1.18 This report is based primarily on information gathered between July and
September 2000, and refers principally to events that took place in 1999 and
2000. The employees of Tairawhiti Healthcare referred to are those employed
as of that time, not as at the publication of this report. For example, the
references to the Chief Executive relate to Ms Sheryl Smail and not to the new
Chief Executive, Mr Jim Green.
1.19 For the most part, events in this report are described referring to the positions
held by people, rather than by their names. There is a Glossary of positions,
names and dates of tenure, and of abbreviations, at the end of the report.
1.20 The allegations made are contained in the Appendix. It is important to
understand the environment out of which these allegations arose. A
description of the environment at Gisborne Hospital in 1999-2000 follows.
2. ENVIRONMENT
Financial pressures
2.1 In 1998-99 THL faced challenges similar to most smaller New Zealand public
hospitals. There was a need to rationalise physical and human resources,
provide safe care in a region isolated geographically, and meet financial
imperatives. THL had a budget of $40 million and was faced with an
overspend of 20% ($8 million). There were clear signals from Wellington that
THL needed to work itself out of financial difficulties, as a priority. The
shareholders and the Board embarked on a process of reform to ensure that
spiralling costs were halted and that it kept within budget. To this end,
Business Plans and company objectives were developed and endorsed by the
Board. It is difficult to over estimate the impact of the changes that ensued.
2.2 The Chief Executive explained:
“The organisation was in major difficulty financially, not only making a
major loss but also vastly over spent against budget by 31 December
1995. Both medical and nursing staff expressed strong dissatisfaction to
me with the status quo. There was no nursing position above that of
charge nurse, nor medical director. While there was a high level of
consensus processes among the service managers, this did not extend
into the organisation and the processes used did not result in actions to
achieve Business Plan commitments nor to resolve the difficulties that
the organisation had.”
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