Hard News by Russell Brown

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Hard News: A business most feral

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  • Russell Brown,

    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.

    Auckland • Since Nov 2006 • 17941 posts Report Reply

  • Jono Baddiley,

    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...

    Wellytron • Since Mar 2008 • 11 posts Report Reply

  • Craig Ranapia,

    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.

    North Shore, Auckland • Since Nov 2006 • 11614 posts Report Reply

  • Idiot Savant,

    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)

    Palmerston North • Since Nov 2006 • 1591 posts Report Reply

  • Idiot Savant,

    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.

    Palmerston North • Since Nov 2006 • 1591 posts Report Reply

  • merc,

    Apparently justice costs more for some than others,

    Former Hawke's Bay DHB chairman Kevin Atkinson expects to ask questions over whether Hausmann and his legal team had preferential access to the panel over himself and other former board members. But Atkinson notes that their hands are tied to some extent as they are no longer allowed access to the files held at the board's legal office since Cunliffe sacked the board. Any resultant legal action would have to be funded from board members' own pockets.

    From Fran's herald piece, what a world lies in those few sentences.

    Since Dec 2006 • 2468 posts Report Reply

  • Idiot Savant,

    I would suspect having local district health boards, with elected officials, would be more likely that things like this would get local attention.

    It would, if they had control of their budgets. But they don't. The services they provide are contracted by Ministyr of Health, and if MoH doesn't think a region needs a psychologist, or so many hip ops, then they don't get them, EOFS. I'm not even sure if the DHB can legally run a cake stall to raise additional money to pursue local priorities.

    This is why I hate the system. Democracy implies accountability, and we can indeed "hold DHBs accountable" by de-electing them. but when you look at it, there's actually not much they're really accountable for. Given this, it would be far more hinest just to appoint regional managers and be done with it; DHB elections simply exist solely to distract us from where true responsibility for our health system lies: with people in Wellington.

    (Of course, there's another option: give DHBs real authority to set their own budgets, so those elections and accountability are meaningful. but I can't imagine any NZ government doing that).

    Palmerston North • Since Nov 2006 • 1591 posts Report Reply

  • InternationalObserver,

    heh heh - me so greedy - me see text for free beer so me text for free beer - me so stupid not even read the very next bit:

    (UPDATE: All gone in 25 minutes! But it looks like you'll still get a two-for-the-price-of-one offer if you text in UPDATE 2: There are still a few of the twofer deals going, but they'll probably be exhausted by 12.30pm.)

    me learn alot for only 20ยข

    Since Jun 2007 • 909 posts Report Reply

  • Rich of Observationz,

    Of course, there's another option: give DHBs real authority to set their own budgets, so those elections and accountability are meaningful. but I can't imagine any NZ government doing that

    Dunno, if you had a local income tax paying for health it'd reduce the headline rate for national income tax. It'd make IRDs job harder though.

    Back in Wellington • Since Nov 2006 • 4210 posts Report Reply

  • Rob Stowell,

    I/S- the "more honest" approach of appointing regional managers does appear to be underway!
    Who's next!

    Whakaraupo • Since Nov 2006 • 1353 posts Report Reply

  • Shep Cheyenne,

    I make an echo stand and throw away my cell phone & now I miss out on beer.

    Since Oct 2007 • 927 posts Report Reply

  • Shep Cheyenne,

    thr4ow away read recycled

    Since Oct 2007 • 927 posts Report Reply

  • Shep Cheyenne,

    Annette King and sex scandle - You had to offer free booze after that Russell ;p

    Since Oct 2007 • 927 posts Report Reply

  • Craig Ranapia,

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

    Exactly my point, I/S, and you'd think O'Sullivan would be aware of the distinction. Then again, I do grind my teeth whenever she uses 'refute' as an synonym for deny.

    North Shore, Auckland • Since Nov 2006 • 11614 posts Report Reply

  • Steve Withers,

    Elected health boards were abolished by Bill Birch and National, who created the CHE's that appeared to be a precursor for ultimately selling off hospitals. Otherwise they made no sense. Labour restored some measure of democracy to the renamed DHBs, but forgot to give them back any real power. If I have this wrong, I'm sure someone will "help" me out. :-)

    Auckland • Since Mar 2008 • 279 posts Report Reply

  • Leigh Kennaway,

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

    Happy Birthday Sam - you can have half of mine!!

    sunny Pt Chevalier • Since Mar 2008 • 40 posts Report Reply

  • Sam F,

    Thanks for the thought, Leigh, but you're welcome to hang onto the beer!

    Auckland • Since Nov 2006 • 1549 posts Report Reply

  • Lyndon Hood,

    Wellington • Since Nov 2006 • 1091 posts Report Reply

  • Russell Brown,

    It's out. From Stuff

    A conflict of interest inquiry into Hawke's Bay District Health Board has slammed it for failing "the most simple test of good governance", but also criticised Government appointee Peter Hausmann for not making full diclosures about work sought by his company.

    Director-General of Health Stephen McKernan has just released a long-awaited inquiry into conflicts of interest at the troubled board - sacked by Health Minister David Cunliffe last month - which exposes systemic failures to follow good practice.

    And:

    "The review panel found a culture of mistrust and dysfunction between the board and senior management and that is a significant roadblock to good performance."

    Dysfunction, along with a burgeoning budget blowout, was a major factor cited by Mr Cunliffe when he sacked the board and appointed Sir John Anderson as commissioner last month.

    Though the review did not examine the boards sacking, the review panel said the problems it uncovered would have led it to recommend a monitor for the troubled DHB.

    It looks like no one comes out completely clean, except perhaps for Cunliffe. I look forward to Ralston's next column.

    Auckland • Since Nov 2006 • 17941 posts Report Reply

  • Angus Robertson,

    Is NZ Lager really worth 20c?

    I/S

    Democracy implies accountability, and we can indeed "hold DHBs accountable" by de-electing them. but when you look at it, there's actually not much they're really accountable for.

    They are accountable for ensuring that contracts are awarded in a fair way and carried out in an efficient manner.

    In the Hausmann case the contention is that he (a government appointee) colluded with management for privileges to several $million in business. A faction of the Board found this out and have attempted to censure him. If the board did not exist the chances of him being found out are neglible. The fact that Board members are not of the same political bent as each other is beneficial to them fufilling their role, irrespective of who is in government.

    Can only endorse the call for removal of the elected Boards if there is an apolitical authority erected to investigate and prosecute the type of corruption that is alleged in this instance and apparent in the Medlab/Labtests fiasco.

    Auckland • Since May 2007 • 984 posts Report Reply

  • Russell Brown,

    Also Scoop has the Q&A for the media (which emphasises the authors' view that they would "have recommended that at the very least, a monitor was needed to help address the issues found if the review had not been overtaken by events") and a link to the full report.

    Auckland • Since Nov 2006 • 17941 posts Report Reply

  • Gareth Ward,

    Well it certainly seems to back up the view that it was a mess in there, and that the conflict of interest wasn't sinister but just botched in terms of it's handling.
    I think you're right - Cunliffe looks like he made a fairly good call getting rid of them.

    Auckland, NZ • Since Mar 2007 • 1712 posts Report Reply

  • Russell Brown,

    Can only endorse the call for removal of the elected Boards if there is an apolitical authority erected to investigate and prosecute the type of corruption that is alleged in this instance and apparent in the Medlab/Labtests fiasco.

    The Labtests debacle was much worse than what Hausmann did. He didn't participate in discussions, did eventually declare an interest (but didn't say he'd had an early look at the RFP) and ultimately the bid was cancelled.

    In Auckland, Tony Bierre was a CitRat board member in a position to gather comprehensive information about the contract and MedLab's position, who left the board and used that information to make a successful bid. Unlike Hausmann, who owns a respected service delivery company, Bierre had no track record and no staff when he won the bid, which threatened to dangerously disrupt the whole region's lab testing services.

    Auckland • Since Nov 2006 • 17941 posts Report Reply

  • Ben Thomas,

    The Labtests debacle was much worse than what Hausmann did.

    I haven't read the HBDHB report yet, but I covered the Medlabs case pretty closely.

    Bierre and the ADHBs got a bit of a bum rap on that case. Justice Asher, in the High Court, effectively invented a new form of conflict of interest in order to overturn the decision: the argument was not that Bierre abused his position to win the tender, but that by being on the board (__before__ the tender) he instinctively had a better understanding of what the board was looking for from a proposal on community labtesting (a far cry from actually seeing the RFP ahead of time).

    Bierre didn't know about Medlabs' position - that's because it was utterly opaque about its cost structure under the contract with the DHBs. That was one of the big points of contention when it again submitted a highball tender. Asher J basically overturned the contract with Bierre saying that in order to be fair to Medlabs the board should have formally pointed out its expectations from Medlabs to reduce costs etc even though these issues had already been broached at a senior level with (company) management.

    And he said that, having been on the board at the time it had formed opinions on community lab testing (again, before the RFP was put out) there was nothing - nothing - Bierre could have done to manage that conflict. Most lawyers in the area say this was an impossibly high standard to put on Bierre and the DHBs, and I'm not sure how Hausman (or many other DHB members) would fare if measured against it.

    Auckland • Since Nov 2006 • 20 posts Report Reply

  • Russell Brown,

    Wow -- the Checkpoint interview with the director-general of health was fairly interesting.

    He repeatedly made the point that even within the narrow terms of reference the review was given, its authors found sufficient dysfunction that they'd have essentially recommended something similar to what the minister did -- implying, as he did so, that they'd have gone up to 11 out of 10 if they'd been in a position to address broader issues.

    This very clearly was not a good board. Tom S's comments upthread about the local media's performance seem quite relevant.

    Auckland • Since Nov 2006 • 17941 posts Report Reply

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