Integrated health facility: organisation structure, business case, employment, trust deed
Last week’s announcements moved the health integration process forward. The project will go ahead on the Golden Bay Community Hospital site and its land and buildings will be owned by a community trust, with a new trust deed. The announcements also led to some some important questions which we posed to John Peters, the chair of the Interim Management Group (IMG) this week.
The new trust deed
In a major change from the original proposal, the trust will be a property owner rather than a service provider.
“We had good public feedback on the original draft deed,” said Mr Peters. “We spoke with [Collingwood resident] Peter Foster, who has a particular interest and skill in these matters and the new trust deed reflects this. The trust will now focus on providing property and equipment. As a result we have changed the membership arrangement too. As the trust won’t be a service provider, the DHB doesn’t need such a large representation. Also Chris Mitson, who represents the Joan Whiting Trust on the IMG, provided some clarity around the the proposed trust’s meetings – when they will and won’t be open to the public. Obviously some discussions must take place in private. The deed reflects our willingness for the trust to do as much as possible in the open.”
Mr Peters said that the trust deed will be available again at the public meeting on 26 April. It is also available on the integrated health project’s website www.gbhealth.org.nz
Employment issues
Discussions with staff at the community hospital are continuing, said Mr Peters.
“The most important thing is that our business case is based on the assumption that existing terms and conditions will prevail. We understand that there are strong concerns around that.” He also said that the wish of staff to remain as employees of the DHB was “perfectly understandable”.
“We respect that wish, but the whole purpose of integration is to get the benefits of the coming together of the three entities. There is no suggestion that the new entity will be any less of a good employer than the DHB.”
Mor Peters added that the integration project did offer rest home staff security of employment, something they do not have in the current situation.
The IMG had been pleased that the GPs had been willing to become employees of the Primary Health Organisation (PHO), said Mr Peters. In the case of Dr Vic Eastman, Mr Peters said that agreement had been reached.
“We are pleased and relieved. Patient care will now be the same as or better than it is at the moment.”
Medical centre building
In relation to the proceeds of any sale of the building, negotiations are also continuing, said Mr Peters.
“We remain in discussions with TDC and the medical centre trust representatives. We’re hopeful that the money that the community has provided to the trust will be available to the integration project, but we can’t be dependent on it. We recognise that there’s a process still to be gone through and we’re developing the business case cautiously, without relying on this funding. We have to make sure that the business case describes an entity that is sustainable - at the start, and for a long time into the future.”
Organisation structure
The integrated facility will be run by a service manager, reporting to the CEO of the PHO. Under that manager will be an administration team leader, a medical director and a charge nurse manager.
“The admin team leader will be responsible for things like maintenance and cleaning,” said Mr Peters. “The medical director will be one of the GPs. They will handle the overall professional and medical decision-making of the facility while the charge nurse manager will be responsible for all the other professionals at the integrated facility.”
The interim
A new facility will take about 18 months to build, said Mr Peters and in the meantime it will be “business as usual.”
“Joan Whiting, the medical centre and the community hospital will all continue,” he said. “Once we’ve got all the agreements to go ahead – if that’s what happens – the design of the facility will be finalised using input from all the interested people. When it’s built, the transition plans will be put in place. When you are building on an existing site there’s quite a lot of ‘decanting’ from the old into the new so that the old can be done up,” he explained. “The DHB is quite experienced at this. We’ll be very much involved in the process.”
Speaking of the involvement of the DHB, Mr Peters went to great lengths to reiterate that continuity in the provision of services is not threatened by integration.
“The DHB will continue to fund the services,” he said.
Mr Peters said that he remained “committed, excited and confident” about the integration project.
“The great thing is that it ensures the retention of rest home facilities here,” he said. “I’m absolutely sure it’s the right thing for the Bay. Also, in the time that we have been advancing this project, the integration concept has come of age politically.”
Despite Mr Peters’ confidence, some locals are unhappy with the lack of information and the consultation process. They have called a public meeting to give the community a chance to “discuss concerns” (see the ad in the this edition of The GB Weekly).
For his part, Dr Vic Eastman said that his commitment is as it always has been, to serve “the people who are my patients or may become my patients, residents of Golden Bay and visitors. This is what I do – the arrangements that exist to make that happen are just back-room stuff.”
“Now it’s time to look forward and refocus on what’s important,” he said. “I’m like a lot of people who are giving their support. It’s support with expectations that what needs fixing gets fixed.”
Neil Wilson
