Waitaki District Health Services FAQ

Waitaki District Health Services Group is made up of Waitaki District Health Services Limited and Waitaki District Health Services Trust.

Waitaki District Health Services Limited was established in 1998 during turmoil in the health sector and major changes by Government which threatened the future of health services in the Waitaki district. It is a registered company that owns and operates Oamaru Hospital and provides health services in the Waitaki district.

Waitaki District Health Services Trust was established as a trust from which grants can be made to support Oamaru Hospital and other health services in the Waitaki district. The trust receives and invests donations and bequests from individual donors and community organisations. Funds from the trust cannot be used for operational expenses at the Hospital.

The company is 100% owned by the Waitaki District Council as a Council Controlled Organisation under the Local Government Act. The council appoints the directors to the company after publicly advertising for applications and conducting interviews. The aim is to have a mix of expertise on the board. Directors are appointed annually, retire by rotation but can be reappointed.

Present directors Mr Chris Swann (chair), Mrs Helen Algar (deputy chair), Mr Paul Allison, Mr Ian Hurst and Dr Andrew Wilson.

The trust is an independent trust, established under a trust deed. Its trustees are the directors of Waitaki District Health Services Limited.

WDHSL, is required to report twice a year, unless otherwise requested, to the shareholder, Waitaki District Council. It provides a written report, along with half year and annual accounts.

The Council once a year approves a Statement of Intent under which the directors must operate the company.

Directors through the board appoint the chief executive officer. All other staff are appointed by the chief executive officer. The Southern District Health Board has no powers to appoint staff.

WDHSL provides health service and operates Oamaru Hospital under contract to the SDHB. In the 2017-18 financial year, the SDHB provided funding of almost $10.5 million.

Some income is also received from other sources for services provided, such as ACC.

The contract with the SDHB stipulates what services are to be provided, including at the hospital, and the volumes.

The company then provides those services with whatever resources are required, including staffing and buildings.

The company’s financial statement forms part of the publicly available 2017-18 annual report on the Waitaki DC website.

The latest financial statement records a nett operating deficit of $810,918 for the 2017-18 financial year, compared to a deficit of almost $600,000 the previous financial year.

The company is unable to sustain continued losses.

WDHSL is currently looking at an increased forecasted deficit for 2018/19.

We are currently reviewing both expenses and revenue to confirm what we believe is a work out plan to break even within the next 12-18 months. This will require both efficiencies in how we manage our business and looking towards future revenue opportunities. There is NO plan to reduce health services.

The provision of Food Services for Oamaru Hospital and Meals and Wheels was reviewed as part of the process of gathering data on services. The review included the cost of operating the kitchen. It revealed the kitchen was running at a loss of about $250,000. Taking into account the cost of out sourcing, there will be a saving of about $140,000.

A process started to look at the cost of Food Service, and what alternatives were available. Kitchen staff and their union were consulted as part of that process.

The decision was made to investigate out-sourcing the Food Service to another organisation, resulting in a Memorandum of Understanding with Presbyterian Support Otago to explore provision of food through its Oamaru Iona Enliven Care Home.

That process is still being undertaken and no final decision has yet been made.

WDHSL has directed that any provision of Food Service outside Oamaru Hospital must be done locally, be fresh and provided hot and, where possible, use local suppliers.

It will not be reheated frozen meals and Meals on Wheels will continue.

The option facing the company is to continue a service that is losing money, or explore alternatives that can result in the savings being utilised in health services in the district.

Any savings, if Food Service is outsourced, will not return to the SDHB.

Any changes to the Food Service is not related to a need for space for other uses.

The company already outsources a range of services including accounting (which is being brought back in-house), laundry, property maintenance, garden maintenance and some speech therapy.

In 2016, a joint review was carried out by WDHSL and the SDHB to explore how best to provide sustainable health services for the Waitaki district in the future. The review included consultation and engagement with the community. The review report was accepted by the WDHSL and SDHB in August, 2016.

Full details of the review, including community consultation, has been publicly available at:

https://www.southerndhb.govt.nz/pages/review-of-waitaki-district-health-services/

WDHSL set up the Waitaki Project Review Board which prepared a Model of Care, based on the recommendations arising from the joint review and two others. That was completed in August 2017. The Model of Care is a living document, flexible to meet the changing health needs of the community, along with advances in health care.

It will ensure demands for health services are met with a focus on the individual patient’s needs by utilising all the resources of Oamaru Hospital in conjunction with health providers in the district from general practitioners to community groups.

The Model of Care was developed with staff, community groups, GPs, St John and unions.

All the input was incorporated into drafts for community and staff consultation before the final document was prepared. Clinical and other expertise was provided through representatives on the review board, the SDHB and other sources.

The Model of Care “Shifting the Focus” has been publicly available at:

https://www.oamaruhospital.co.nz/userfiles/file/MoCUltimate14072017.pdf

Since then, the company has been working to implement the Model of Care, focusing on priorities, which has included gathering extensive data, not previously available on services and costs.

The board has a plan to get the company to a break even. This is made up of a number of components from additional revenue streams and SDHB contract review.

There have been no discussions nor initiatives to reduce services that are currently being provided by the company.

Communication with the community has increased, with more information being given to the media through Press Releases.

However, the board also recognised last year when it did a ground-up review of its Strategic Plan, involving staff, that more community involvement was needed, by expanding the Community Health Forums which had existed previously which involved mainly invited groups with dwindling numbers attending.

As a result, a new Terms of Reference was prepared for Community Forums to involve not only stakeholders, but the whole community. They are to commence in the New Year.

The board also overhauled the Terms of Reference for Staff Forums.

However, the company is directly responsible, in the first instance, to its shareholder.

The layout of the existing hospital has remained virtually the same since it was built and opened in June 2000. It is struggling to meet the demands of modern health services, which is contributing to inefficiencies in the way it operates, and is under review. This review is due to the fact that we believe some of our inefficiencies may be able to be addressed through services being located closer to similar services.

That review, which has just started with its first discussions, has already involved some staff and, as it progresses, will continue to involve staff and the community.

The review of the layout has nothing to do with any decisions relating to the hospital kitchen

The company owns buildings surrounding the hospital, and they are included as part of the review to see how best they may be utilised.