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Posted at 10:45AM on 17 Mar 08. Permalink.

Intellectual analysis, great commentary, wit, and sense of community.... and free beer!! Damn I love Public Address.....

Posted at 11:09AM on 17 Mar 08. Permalink.

Missed out on the free beer as all gone @ 11:05 am.
But did get a 2 for price of 1 offer as consolation...

Posted at 11:17AM on 17 Mar 08. Permalink.

I got two for one as well! Can't complain about that.

As a born and bred Hawkes Boy (hell, my great great gandmother was Hawkes Bay born and bred) I'll tell you what the HB DHB row is all about: An insular, born-to-rule local squatocracy is immensely resentful of an outsider coming along and upsetting the crony applecart that is business as usual in many an isolated provincial town.

The extra twist of bitterness comes from an extraordinarily poisoned right wing exceptionalism that has seeped into every nook and cranny of this particular sleepy hollow, if you don't believe me just check the editorials in the back issues of Hawkes Bay Today.

Posted at 11:18AM on 17 Mar 08. Permalink.

Hmmm....email received at 10:54am....beer all gone at 11:02am...call me a sceptik but did 100 people really receive a free dozen beer today??!! Regardless - the 2 for 1 offer was nice, cheers for that Russell! :)

Posted at 11:20AM on 17 Mar 08. Permalink.

I used to work with Hausmann (not in the health sector) but it gives you a slightly different view on things. Thats said NZ is a VERY small place with limited skillsets in some areas. Conflict of interest is going to happen and just has to be managed properly. I don't know but it is highly likely if you appoint really skilled people who have the business accumen and particular sector knowledge, to a board position, they will also be involved in the business/private sector side.

Posted at 11:21AM on 17 Mar 08. Permalink.

Curses - too slow. Waiting on the two for one... hooray!

Posted at 11:23AM on 17 Mar 08. Permalink.

if you don't believe me just check the editorials in the back issues of Hawkes Bay Today.

Oh yes -- I'm familiar with that particular oeuvre.

Posted at 11:24AM on 17 Mar 08. Permalink.

There might be some free beer left at Spare Room - same deal.

Posted at 11:24AM on 17 Mar 08. Permalink.

Hmmm....email received at 10:54am....beer all gone at 11:02am...call me a sceptik but did 100 people really receive a free dozen beer today??!!

Yep. The last successful text seems to have been sent at 11.02am, exactly 25 minutes after I hit "save" on the post.

Posted at 11:25AM on 17 Mar 08. Permalink.

There might be some free beer left at Spare Room - same deal.

Oh you slutty readers -- always off to anywhere with free beer ...

Posted at 11:29AM on 17 Mar 08. Permalink.

The extra twist of bitterness comes from an extraordinarily poisoned right wing exceptionalism that has seeped into every nook and cranny of this particular sleepy hollow, if you don't believe me just check the editorials in the back issues of Hawkes Bay Today.

Tom: Perhaps we could forget its election year for a moment, and consider that vote health chews though an eye-watering amount of public money, and we might all have an interest in making sure that it's not a trough for cronyism and outright corruption. I'll tell you this from experience, Tom, when your partner is on an operating table with his chest open the politics of health can go get fucked.

Posted at 11:32AM on 17 Mar 08. Permalink.

Tom: Perhaps we could forget its election year for a moment,

To be fair, I hardly think that it's Tom who has made this dispute into a political issue ...

Posted at 11:33AM on 17 Mar 08. Permalink.

Oh you slutty readers -- always off to anywhere with free beer ...

Theirs was posted before 5:00am, so it'd be a miracle in the Feeding Five Thousand league if there was any left now!

Posted at 11:38AM on 17 Mar 08. Permalink.

It seemed unlikely to me that a man as ambitious as David Cunliffe would hitch his ministerial career to a brutal act of "utu" (as Ralston had it) if he knew there was an independent review of disputes around the board coming that would leave him thoroughly exposed only weeks later.

You seem to be operating under the misconception that politicians always operate on the basis of rational self-interest. :) A smart political operator might just come to the conclusion that any report would be complex enough - and cast enough criticism in all directions -- that you could cherry pick the best bits to spin, and most people would get bored and move on before any real damage is done. Seems to work well enough, enough of the time to be a viable strategy. Especially in health where the media isn't all that interested unless there's a corpse or two surrounded by particularly photogenic mourners.

Posted at 11:38AM on 17 Mar 08. Permalink.

The sort of local cronyism/exceptionalism being exhibited by the local ruling class in Hawkes Bay has always been present.

But when I was a lad, information wasn't controlled by the local caudillo's like it is now. Newspaper wise we had the old-school Labourish Napier Daily Telegraph and the voice of the farmers, the Hasting's Herald Tribune. They were tempered by a local ZB station that had local reporters and covered local news. Now the only source of local information the vile Hawkes bay today, a paper that now exists (in my view) purely as a vehicle for the fundalmentalist religious views of its editors.

Posted at 11:45AM on 17 Mar 08. Permalink.

To be fair, I hardly think that it's Tom who has made this dispute into a political issue ...

No, but I don't think nutting off about some filthy "right wing exceptionalism" is much use either. As I said earlier, the public health system runs through vast amounts of public money every year, and I'd like to know that no DHB is handing out multi-million dollar contracts on the basis of cronyism and patronage, and that all conflicts of interest (which may well be inevitable in a country as small as New Zealand) are properly disclosed and managed.

Posted at 11:46AM on 17 Mar 08. Permalink.

Too bad about the beer, back to the Health Bored.
Can someone tell me why, in a country of 4 million people, we need so many DHBs?? Does Sydney have this many managerial units to oversee health delivery?

I don't see that our health needs or ability to meet them varies that greatly from one district to another. Isn't it unnecessary duplication and creating opportunities for just this sort of palava?

It also distracts from the more important issues - in manawatu, wanganui, rangitikei areas, we have no adolescent/teen specialist psychologist and rely on a locum from Auckland visiting. Naturally, only the most serious cases are seen - too bad about the rest of the troubled teens. Same with obstetric/gyno care and the nine house surgeons they're short of.

Posted at 11:51AM on 17 Mar 08. Permalink.

DHBs. Why do we have them?

We get a vote on the members, but it's pretty hard to pick out who they are, even if you read the candidate book cover-to-cover. They have no control over funding allocation (it's not as if they had a health rate or something to set) and little control over big aspects of policy, such as which drugs to fund.

Are they just there to give the government someone to blame when things go wrong?

Posted at 11:53AM on 17 Mar 08. Permalink.

I wonder how many of the free beers went to Public Address regulars and how many went to lucky friends and workmates of PA regulars who were suddenly ordered to "OMG! Text this to get free beer! Free beer! Do it! Now! Right now!!!"

Posted at 11:56AM on 17 Mar 08. Permalink.

Missed this beer but got 6-pack of Amstel Premium through exactly the same mechanism last week. This 393 is presumedly a DB thing then - being a number of their brands and redeemed through their stores. Pretty smart brand marketing, but gets a little diluted when you have a few different brands all doing the same thing.

Re the HB DHB, must admit I haven't followed incredibly closely but I got the feeling that everyone is going to come out a bit murky - i.e. the board were entirely mismanaging the place, the "whisteblower" in Hausmann wasn't so clean himself with his conflicts, and King placed someone in there who was a little too closely linked for comfort. So each of them are furiously pointing fingers at each other, when in reality they were all failing - and frankly the relativity of thos failings doesn't really matter.

Posted at 11:58AM on 17 Mar 08. Permalink.

Hausmann, like the other parties to the dispute, had the opportunity to review the draft, claimed it was "factually incorrect in several key areas" and had it peer-reviewed by a QC.

And just to get nit-picky, Russell, I wonder if 'peer-review' (a term which bears connotations of disinterested academic scrutiny) was the best choice of words.

Here's how Fran O'Sullivan used the term:

The Herald on Sunday understands that Hausmann and Healthcare NZ strongly contested the initial draft, claiming that it was factually incorrect in several key areas.

Hausmann's legal firm, Russell McVeagh, had the initial report peer reviewed by Wellington Queen's Counsel Hugh Rennie.

In the context of a drug trial, I think any academic journal would not publish on the basis of a peer review commissioned either by a pharmaceutical company with a very direct interest in publication.

Posted at 11:58AM on 17 Mar 08. Permalink.

I wonder how many of the free beers went to Public Address regulars and how many went to lucky friends and workmates of PA regulars who were suddenly ordered to "OMG! Text this to get free beer! Free beer! Do it! Now! Right now!!!"

Cross my heart, it was 100% to readers.

Posted at 12:01PM on 17 Mar 08. Permalink.

It also distracts from the more important issues - in manawatu, wanganui, rangitikei areas, we have no adolescent/teen specialist psychologist and rely on a locum from Auckland visiting.

I would suspect having local district health boards, with elected officials, would be more likely that things like this would get local attention. If things were decided in Wellington, it'd be more modelled and costed and efficiencies. If the DHB in those areas decided that an adolescent psychologist was a priority, they'd be able to do it.

Does this unit not have any psychologists at all?:

http://www.midcentraldhb.govt.nz/HealthDisability/HospitalAndAssoc/MentalHealth/ChildAdolecentFamily/default.htm

Posted at 12:07PM on 17 Mar 08. Permalink.

Missed this beer but got 6-pack of Amstel Premium through exactly the same mechanism last week.

And you didn't tell us??!!

Posted at 12:12PM on 17 Mar 08. Permalink.

Missed this beer but got 6-pack of Amstel Premium through exactly the same mechanism last week.

And you didn't tell us??!!

I wash totally *hic* going to menshion it *hic* but shumone got me intoxshicated *hic*

Posted at 12:13PM on 17 Mar 08. Permalink.

In the context of a drug trial, I think any academic journal would not publish on the basis of a peer review commissioned either by a pharmaceutical company with a very direct interest in publication.

Sure. Let's just say he exercised his right to have the report reviewed by a a QC, then. I hold no brief for Hausmann -- he might be a right royal bastard for all I know -- and it doesn't really alter my point.

I just get annoyed at all the screeching and cries of corruption by a great many people who have only seen selectively leaked parts of a draft report, knowing full well those parts had been subject to challenge; and who have, in one case, used Parliamentary privilege to table those selective leaks in the House. I don't see much of a desire for natural justice there.

Posted at 12:17PM on 17 Mar 08. Permalink.

Can someone tell me why, in a country of 4 million people, we need so many DHBs?? Does Sydney have this many managerial units to oversee health delivery?

I was wondering on this last night. Local accountability would be the one answer - and then sydney isn't 1800km across.

I wondered if the approach would be to have good A&E/critical care units locally, but then set up national specialist centres for different things.

Of course, it would mean that if you have an ailment that isn't your local speciality, you'll be away from family though.

I think that situations like this is why I'm happy that I don't work in the health sector...

Posted at 12:26PM on 17 Mar 08. Permalink.

Sure. Let's just say he exercised his right to have the report reviewed by a a QC, then. I hold no brief for Hausmann -- he might be a right royal bastard for all I know -- and it doesn't really alter my point.

And a reasonable one it was too. But I'd like to think someone who's been around as long as O'Sullivan would have a slightly better ear for the connotations of a phrase like 'peer review'. God knows in Hausmann's position, I wouldn't be retaining a high profile legal beagle like Hugh Rennie to do anything less than turn his keen legal mind to poking every hole in the damn report he could find, and making those holes as large as possible.

In the end, I think there's a lot of spin, counter-spin, pre-emptive strikes and (from gossip I've heard) personal shit between all the players in this that leaves nobody with their dignity intact.

Posted at 12:31PM on 17 Mar 08. Permalink.

Are they just there to give the government someone to blame when things go wrong?

Yes.

(And yes, while I'd be happy enough to do away with this parody of democratic accountability, I'm not under any illusions it would save us money. Sure, we'd save on the board-members salaries, but the rest of the staff - the people who pay salaries, predict demand, sort out contracts etc - all do stuff that needs doing. Their jobs would just be folded into MoH or local hospitals)

Posted at 12:32PM on 17 Mar 08. Permalink.

In the context of a drug trial, I think any academic journal would not publish on the basis of a peer review commissioned either by a pharmaceutical company with a very direct interest in publication.

Academic journals use blind peer reviews. But they're interested in academic quality, not natural justice.