The Board of DHB on Wednesday (16 June) will consider a DHB staff proposal to set up a special panel to recommend an appropriate governance structure for Cranford.
Good news, right? Maybe; maybe not.
The current services contract with Presbyterian Support to operate Cranford expires on 30 June 2010, and PSEC’s management role vis-a-vis Cranford has been severely criticised by most in the community, as well as by independent auditors. As a result, PSEC’s former Chair and CEO have both resigned to pursue other opportunities.
The objective of the special panel review, as described in the staff memo, is “to develop an appropriate governance structure for Cranford that best meets the needs of patients and their families and restores and maintains the full confidence of the DHB and the Hawke’s Bay Community.”
If DHB and “the Hawke’s Bay Community” are in sync on the solution, then we’re in for some good news. For there can be no doubt that the community is quietly rallying around a proposal Mayor Yule and others have advanced to establish a new independent trust, with strong community leadership, to own and manage Cranford Hospice. And DHB’s CEO Kevin Snee has said on various occasions everything just short of: “I plan to sack PSEC.”
But why then is the odd panel and process proposed?
In the proposal, the panel will be chaired by the outside-the-Bay Commissioner, Sir John Anderson. Other members of the panel will be two representatives of the DHB Board; two representatives from the PSEC Board; and two “HB community leaders.”
This is a decision of deep importance to the people of Hawke’s Bay … and it should be made by those most representative of Hawke’s Bay … that would be the elected Board members of DHB. As the proposal stands, the two DHB Board reps could be selected from the appointed commissioners, who would be joined by two PSEC board members (sitting in judgment of themselves) and Anderson.
So much for community representation and responsiveness! To my observation, the DHB Board members most engaged in calling the question re Cranford’s situation have been Kevin Atkinson, David Ritchie and Diana Kirton. If they are not included on this panel, the exercise will have little credibility.
Then there is the matter of timing and decision-roles.
The proposal calls for recommendations to be received and considered by the DHB Board and the PSEC Board in September, with “joint announcement of agreed outcomes” (!) at the end of September. This language appears to put the PSEC Board on a par with the DHB Board. Rubbish!
There’s only one thing PSEC needs to decide in this process … whether they want to remain involved as landlord (they own the Cranford facility and property) to the new trust, sell facility to the new trust, or tell the new trust to bugger off and find its own facility.
It shouldn’t take PSEC three and a half months to make that decision, nor the special panel that much time to vet the viability of a new independent trust. Much of the legwork for that has already been done.
This is a case where time is mischief. The longer Cranford governance is unresolved, the longer it will take to re-open inpatient care at Cranford Hospice. Simple as that.
DHB staff has already botched the re-hiring process for Cranford (or executed it exquisitely well, depending upon your “change management” philosophy), and now proposes to take fifteen weeks to consider the fate of PSEC.
I’ll wager … if the DHB Board simply takes the opportunity to vote on Wednesday whether or not to proceed with blessing the creation of a new trust and abandoning PSEC, work on the new trust would move forward the same afternoon!
One can assume that PSEC is desperate to hang on to Cranford for its financial and brand halo reach into the community, and has convinced DHB staff to stretch the process out … “See, we’ve managed our change process (i.e, fired any nurse who ever questioned PSEC managers), allowed our wrist to be slapped, atoned for our sins by parting with two of our own, and we want another chance.”
Ironically, by proposing a fifteen week schedule, the DHB staff winds up landing the recommendations, at end September, smack in the middle of the Board election balloting (voting papers drop 17 September and Election day is 9 October). So it might be a “lame duck” Health Board making the decision on Cranford governance, assuming the old Board still met one more time in October.
This kind of timing is guaranteed to make the Health Board election a referendum on how Cranford should be owned and governed. Anyone care to take a bet on how that question will turn out in our community?!
But perhaps these are minor details out-of-towner Sir John and relative newcomer Kevin Snee haven’t absorbed yet!
Much, but not all, of this will be discussed in public session of the DHB Board meeting at 12:30 on Wednesday. But I can only expect that Sir John will want to discuss the individuals to be appointed to the special panel in the public excluded portion of the meeting.
Watch this space!