Golden Bay Community Health - Te Hauora o Mohua
Comments from community feedback forms received December 2009
Integration – is it the best way to meet future health needs in Golden Bay? If not how do
we ensure the sustainability of health services, particularly rest home services given
1 Joan Whiting’s difficulties?
Yes - Integration of services yes, integration under one roof – no. Information technology now
permits one information system in different locations
- Yes – provided it is not just a band aid to Joan Whiting
- How do the same bed numbers become affordable?
- Great idea
- The primary requirement to ensuring the sustainability of our current excellent health
services is being able to attract new medical professionals in the coming years. The
present disparate facilities clearly don’t do that.
- Yes, as soon as possible
- Integration does seem to be a logical answer although the benefits expected, especially
in keeping costs down may not eventuate. Experience tells us that costs only spiral
upwards. There is room for more than one rest home in GB if they were properly
funded.
- Agree with integrated model, with a possibility of a rearrangement of the plans as
currently proposed.
- Integration is the best way.
- Yes we want integration. Would like to see dialogue with staff of the 3 current services
to ensure that any final design is practical for both users and staff – e.g. is a nursing
station needed in the rest home section.
- Yes, definitely.
- We fully support integration of health services in Golden Bay. It will have major cost
savings. It will be a huge advantage for our doctors, staff and patients having
consolidation of health care services.
- Integration is the best and only way forward for the long-term future of Golden Bay.
- Yes, if run properly. Up until now public have been shut out of decisions. The
committee have only 1 thing in view – get a integrated scheme (do it our way).
- Yes I believe it is the way forward
- Yes I am fully supportive of integration – it is the ? only way of meeting the health and
care needs of a rural community in the next 20+ years and ability to attract and retain
staff.
- I support the concept of integration. I do have concerns about the trust concept. I
would prefer the DHB to own and run the facility. There could still be a local committee.
- Integration – YES
- Support integration – need to secure adequate long term funding for this concept.
- Yes it is the best way.
- I fully support the concept of integration. A one-stop shop will save money in the long
term and must make it easier for health providers.
- Yes integration is the best way for future health needs in GB.
- Yes it is the best way to meet future health needs in the Bay.
- It will be the best way only if each service (Medical Centre, hospital and rest home) can
see benefits that would not otherwise be possible. However it seems a very big and
complex solution to solve rest home funding – what are our other problems?
- We support the integrated project.
- I think integration of hospital and medical centre is a good way to go. I am not so sure
about incorporating rest home is the best option and would prefer rest home services to
remain at Joan Whiting if at all possible but recognise the difficulties of this.
- Yes integration is the best plan, if the facility is well designed, has an appropriate
management/trust structure, is suitably funded, is supported by doctors and nurses and
is not “distance-managed” by PHO/DHB.
- Probably, provided our current level of service continues (or is improved) and costs to
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users of these services do not increase. The Joan Whiting rest home problem is largely
because income does not cover costs.
- Yes, the concept of integration makes sound sense but nowhere is there any
demonstrable case, based on objective analysis, that a Trust, as proposed, is the
optimal way to go.
- For the future, I support the concept that an integrated community health facility is the
most efficient and satisfying course to follow. Such a facility should be run by a board,
comprising members from both the NMDHB and the people of Golden Bay.
- We would like to applaud the IMG for the fantastic job they have done to date and we
fully support the concept of a new integrated health centre.
- I think so but it must be with a spirit of willingness and cooperation between all the
various levels of staff, prepared to make it work 100%.
- While I understand the concerns of Collingwood people and supporters of the Joan
Whiting rest home about the loss of the facility and loss of job opportunities, I can see
the merits of bringing the rest home and hospital together on one site. This I support but
I have reservations about the extent of financial savings to be made.
Don’t - I don’t believe access to doctors or nurses and patients will be any easier. We need
know more doctors working full time, not part time!
- Apart from the question of the rest home, the status quo still seems viable with some
improvements.
- Not convinced it’s the best way. It is not truly integrated with no provision or plan for
mental health requirements; e.g. a secure area.
- It looks expensive and would be a first in NZ. They don’t seem to know the building or
running cost.
- I don’t know but it does seem to be the only way to keep rest home facility in GB
- I don’t know
- I do not understand how by being incorporated into an integrated facility the Joan
Whiting Rest Home is going to miraculously become profitable. It will have an even
greater debt to pay off. Is the medical centre part of the integrated facility, which I
understand is already profitable, going to be required to subsidise the rest home part? I
can understand that integration can bring efficiencies, however I find it difficult to believe
that the efficiencies will be so great as to reverse the losses of the rest home. Can you
guarantee that the level of personal care given to residents will remain the same as at
present? I am unable to support the proposal for integration unless this financial
information is made available and the issue of the location of the medical centre is
satisfactorily addressed.
No - Integration between the health services should be managed without having to spend
millions of dollars on three new buildings. The hospital does not need to be replaced.
Neither does Joan Whiting. Only the medical centre really needs improvement. Joan
Whiting’s difficulties are caused by lack of government funding and the NMDHB not
being willing to continue to support it beyond the end of December. If it were a profit
making group running the place I might understand, but since it is a not for profit trust it
is sad that Ministry of Health has no ability to help the DHB maintain the service to keep
our elderly in the Bay. The funding will not change because there is a new location,
indeed it is likely to cost more to maintain people in the new facility and with staff cuts
the loving care may well decrease.
- No. Far too expensive for the community to prop up. DHB needs to run hospital.
Medical centre on site if desired.
- No, not necessarily. Integration may not be right for GB. Rest home facilities do not
need to be joined to hospital. It may be cheaper to renovate the existing Joan Whiting.
Complete overhaul.
- No. It is far too expensive for a small community such as Golden Bay to maintain
sustainably. Giving up a public hospital for a private one is a bad idea.
- No. Integration is bad for the Bay. Too costly and all we need is a new surgery.
- You will attract doctors by offering good money, not huge complex buildings. Putting
everything in one place is not likely to save enough money to cover the costs of the
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buildings.
- Integration has not been well defined or explained by the IMG or its predecessors. In
this question and in the information that has been provided to the public the physical
integration of services and the virtual integration of services have been intermingled and
confused. A new facility does not immediately create an integrated service, nor does
having separate buildings for each service mean that healthcare provision to the
patient/consumer cannot be fully integrated. Where is the information about the state of
current services of GB, from the point of view of the consumers within the community?
Where is the information about how GB health services compare to the health services
available in other parts of the NMDHB area and nationally? The community needs
information like this from the DHB and MoH to be better able to determine what its
services should be now and in the future. There needs to be better clarity of the actual
issues that are to be addressed by integration by the IMG proposals and how each will
be remedied or improved.
- I feel very strongly that the Central Takaka site is the wrong site for the medical centre.
It needs to be situated in the Takaka town area, which is the main population and
business centre of GB. I believe it is most important that the medical centre is located
where the population is based. The current medical centre is near (within walking
distance) to the greatest concentration of people in GB in particular the elderly
(Abbeyfield, pensioner flats and main people living in nearby private residences. A lot of
these are where they are because of the close proximity to the medical centre) and
school children (GB High School, Takaka Primary and kindergarten).
- I believe the medical centre should remain either at its present site (with a new wing
built on adjoining land that has already been purchased for this purpose) or new building
on Rototai Rd site. From an administrative point of view this does not necessarily
preclude integration. It simply means that the service is integrated but physically not all
situated on the one site.
- Rest home facilities do not need to be joined to hospital. It may be cheaper to renovate
the existing Joan Whiting. Complete overhaul. Takaka medical centre, other
departments, x-rays etc could be joined to the existing hospital which would make things
more economical and yet still be very convenient for doctors, nurses etc.
- I remain unconvinced, in fact more unconvinced that I was before. I do question the
merit of having all medical facilities in GB on one site; it does leave them and the district
in a vulnerable position in the case of natural disaster. In the case of flooding most of
the population of GB could well have no access to medical facilities. (Flooding
frequently cuts the main road at Bridger’s hollow, just south of town, and can also cut
the alternate route at Cassidy’s corner at Motupipi. If Joan Whiting rest home is not
viable now, how will the new facility suddenly become profitable? It will have no more
beds and will have a much higher debt to service, i.e. it will have more expenses. I do
not believe that integration will save such a huge amount of money. If you want to
convince people of the viability of the rest home part of the scheme then come up with a
budget and some hard figures. I accept that coordination between health providers in
GB may not be as good as it could be. However I feel we do have services that we as
the community and providers can be proud of. An integrated system as proposed may
solve some problems; it will not solve them all, and almost certainly will have its own
weaknesses and will create problems of its own. I question whether the financial
savings of integration will be so great as to justify the expenditure. In its proposed form I
do no support the integrated system. The essential changes to convince me to support
it are:
o 1. that the medical centre remain in some form in, or near the present location.
o 2. that there is open and honest disclosure about funding and
o 3. there is a a clear process to establish the support or otherwise of the GB
residents.
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2 Site – is the hospital the best site given it will be less costly and, we believe, quicker to
develop?
Yes - Not the best site but the most sensible one
- It seems the obvious site – economically. 95% of the population have to travel by car
wherever they live, especially if unwell. Almost 100% already drive to the chemists, so
nearness to the pharmacy is irrelevant.
- Yes. This hospital is only 15? Years old. Don’t dare waste taxpayers’ money for having
all new site etc.
- Yes but plan is short on rooms; e.g. it is only providing the same number of aged care
and rest home beds that are available currently.
- Site is ok – but think the Rototai site provides better access for more people. Hospital
corner is a worry.
- I prefer the hospital site.
- I prefer the Park Ave site but can settle for the hospital site.
- Yes the best site is where the hospital is now situated.
- The hospital site should be used.
- I support the hospital site and adding to the infrastructure already there. A Collingwood
medical centre facility needs to be retained somewhere.
- Yes, expand on what already exists.
- Yes, my only concern would be the distance for High School students to travel. They
often visit current medical facility during the lunch hour. Propose mobile unit for this and
other community use.
- Yes! And I’m told there is further land available for future expansion.
- Yes
- Open mind on site but if cost difference of sites is major then guess obviously go with
the cheaper option. Flooding access will always be a problem, wherever you build.
- It is a good site and $3 million cheaper so you could build a bit bigger.
- Yes, perhaps use the Wrinklies bus for a daily shuttle service.
- Less costly – therefore best.
- Yes! I always thought it the most practical option.
- Yes, with present hospital in its current location it seems a waste of building and money
to build a new building (hospital).
- When the new hospital was built it should have been in Takaka, then the eventual
integration process would have gone much more smoothly. Takaka is the logical site,
however mothballing the present hospital would be stupid, so it should be redeveloped
into the new integrated facility.
- Park Ave would be the best site but the hospital if it is the only affordable one is ok. Not
Rototai.
- Hospital site is the best site.
- Yes, why would be want to abandon the present hospital and its grounds when other
facilities can be simply and easily slotted in.
- Either current hospital site or Windle’s Park Ave – they may be prepared to donate the
land.
- Either the hospital or next to the High School, Rototai Rd – not Park Ave.
- It is good that you plan to retain the existing hospital building and its pleasant grounds. I
have always felt that it would be a criminal waste to abandon this relatively new purpose
built facility.
- Of the three sites it appears to have the best site, the existing buildings and facilities,
services (with modifications), landscaped and affording a quiet and pleasant area to
expand into. As for being out of town, as someone else has observed, most of the bay’s
population is spread throughout the bay! Re Park Ave, who would want the facility
among sports fields, near a café and bar and retail and mixed use businesses? Re
Rototai, is building the facility at the busy intersection and roads and across the road
from GB High School in the best interests of either the high school and the primary
school and the health centre? I don’t think so! Think of the congestion, trucking traffic
and cars and kids. The noise factors and all.
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Don’t - I do not feel that IMG have provided enough information about the sites yet. The
know information table published in the GB Weekly was far too brtief, the information at the
Open Days sparse and the information and plans are still not available on the web.
Further information must be provided before the community can judge the
appropriateness of the sites.
- The IMG needs to provide more information separating the financial implications of
building a new facility (the capital costs upfront) the ongoing cost of servicing the capital
costs and the running costs of the new facility. These three financial areas have not
been well explained to the public and as mentioned before, a new building doesn’t
automatically mean that services are integrated. The attraction of a new facility to the
community does not negate the major financial implications of financing the building
project. This must be considered separately to the ongoing running costs of the facility,
which will necessarily include new income stream provision for the under funding of rest
home beds and potentially under funding of the hospital beds.
- The hospital appears to be poorly planned at inception. Jettison the future grief.
- Who says it will be less costly?! Where is the information to support this?
Cheaper/quicker is not always better.
- Not sure. We would like to see the impact on costs for Park Ave – if TDC favour
residential development there and developer willing to pay for all needed services. Park
Ave a better site, further off the highway, especially allowing wider community area for
older residents to walk around.
- Where do the figures of $2-3 million for the other site come from? This is a loaded
question. Where are the studies of the various site/cost evaluations, which say that the
hospital site is best?
- I don’t know
- While I reject the proposal for building in the flood zone, there is grossly insufficient
information to make too intelligent a response to IMG’s proposals as there is NO
information about costs.
- That’s for the financial whiz kids to sort out and play games behind the scenes with the
owners of Park Ave and Rototai. Altering an existing building may be more costly. Do
your sums.
- Please do whatever is necessary to obtain the information you need to make a decision
about site. It has been a long time! I am sure there are unknowns, negatives and
positives about all three sites.
- Find out what you need to know – ie what are the costs going to be at each site? Start
talking to the landowners to find out what they are offering.
-
No - I do question the merit of having all medical facilities in GB on one site. It does leave
them and the district in a vulnerable position in the case of natural disaster. In the case
of flooding most of the population of GB could well have no access to medical facilities.
(Flooding frequently cuts the main road at Bridger’s hollow, just south of town, and can
also cut the alternate route at Cassidy’s corner at Motopipi.
- We think the Park Ave landowners’ plan to co-locate St Johns and a retirement village
within a residential community has great merit for the community.
- No – the Rototai site would be more convenient and no compromises need to be made
in the fresh design. All sites need land to be bought and infrastructure to be developed
that will take considerable time after consents are given. I cannot believe that anything
will be up and running in under 3 years from the date of the final decision to go ahead if
that is given.
- Surgery opposite Takaka School.
- Developing the hospital site will be a nightmare for all those working or staying in the
hospital during the building period. Because the designer will need to attach the new
wings on to the old building compromises to design will have to be made. This will
mean that the money spent will not provide the wonderful forward thinking building that
has been touted, the cost of road entry development may be greater. It is too far away
from the bulk of the population and the high school. How will the people who normally
walk to the medical centre get there?
- I believe that there are problems with the idea of taking the medical centre away from its
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present site and locating it out of town at the hospital site in Central Takaka. It is
important that people already living near the medical centre can easily get to the
medical centre. After all a lot of people living in that part of Takaka have difficulty
arranging transport, and often live there because they will be close to the doctors. Also
it is important that school pupils, particularly secondary school pupils have ready,
discrete and confidential access to doctors. That will not be possible if they have to
arrange to travel all the way through town to Central Takaka.
- We have always had a doctor in Takaka and we fund raised in the 1960s for the present
site, so get rid of the present house on site and redevelop the surgery, say for $400,000.
- Medical centres should be situated in towns where people live, not miles away in the
country, which makes access difficult for some people, especially the elderly. Additions
to existing buildings can be more costly, inconvenient and not conducive to good
planning.
- In our opinion the proposed Park Ave site would be much better suited due to the
following reasons:
o It has a blank canvass to work with
o It can be positioned for the sun, with sustainable building practice and good
health, sun is paramount
o There is space for shops, cafeterias etc
o It has a greater space to grow when needed
o The recreation park is alongside, allowing patients to be involved in sporting and
community events e.g. Saturday rugby and soccer or the annual pig hunt
competition
o It allows walks around the park and is a great safe area for kids fi they are
visiting the integrated health centre
o With proposed rezoning people will be able to build their homes around this
centre
o It could be near to the proposed retirement village
o It will be away from the noisy and dangerous main road
o It could be part of the proposed new St John’s rooms, ambulance bay and
staffing quarters
o After discussing this with members of the Central Takaka syndicate, we can now
share their vision. We truly believe that their proposal for a health centre to be
built at Park Ave is not for capital gain, but for the benefit of Golden Bay.
o Golden Bay is growing and if it is to go forward, it will continue to grow and we
need to give it room to do so. Let’s share the vision and not just do with the
cheapest option but the best option.
- If the rest home is part of integration I would prefer the section closer to town. Can also
see the merits of rest home being near the proposed retirement village. Has cost of
buying additional land next to the hospital been taken into consideration – given that the
seller will have a “captive” buyer. It will be disruptive to the hospital residents and more
difficult for contractors.
- Our preference is Rototai. In order 1 Rototai, 2 Park Ave, 3 hospital.
- No – Rototai Rd better – more central or close to high school. I’m not convinced
hospital site would be less costly in a broad sense – hospital a small part of whole
complex and would need adjustments (expensive) plus difficulty of maintaining services
at same time as being a building site. More efficient to start afresh.
- Rototai is best. Forget about sewerage; council have tried to scare committee into
sewerage problem. Hospital site 2nd. Park Ave a no go – forget about the straw houses
etc.
- The present hospital site will not be the best site because:
o There are no figures for cost of extra land
o No detail and costing of sewerage and waste water upgrade
o No knowledge of extra water availability
o the Central Takaka Rd comes onto SH 60 with dangerous vision to the south, of
which we have had many frightening entrances
o According to staff having to work with an existing building with many design
faults. Surely it would be cheaper and more efficient to start from scratch
o The hospital site is away from the community – especially for rest home. It
needs to have people around, young and old, giving our older generation a
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better quality of life. The Park Ave site would provide this plus the lovely park
and easy access from retirement village.
- No – why constrain to the gutted present site when a green-field is available in a ready
to go state, central position for the Bay, especially GBHS, Abbeyfield, helipad available,
hospital sale value and no dislocation.
- Rototai Rd is where it should be. Patients can see children coming and going, seeing a
child waving to you is the best tonic a patient can have. Think of your patients.
- The hospital could make a nice rest home if the facilities were split and put the medical
centre and new hospital in the new development at Park Ave.
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If integration doesn’t take place, what other options are there to keep rest home care in
3 Golden Bay? Does it matter if there is no rest home care in Golden Bay?
Yes - Yes, there should be rest home care in Golden Bay and the current proposal makes the
most sense (as far as can be judged from the paucity of detail).
- Yes. If no integration maybe a private organisation would invest in one.
- One of the main reasons that integration is so important is to ensure that rest home care
continues in the Bay
- We must retain rest home care.
- Everyone talks about how wonderful the care is at Joan Whiting. No one talks about
how wonderful the buildings are. Imagine good staff in a good building. Fab!
- It is imperative that there are rest home facilities in Golden Bay!! It should be located in
Takaka. Query Park Ave retirement village site??
- Integration is a key reason to keep rest home care in GB. It is extremely important to
keep rest home in the Bay.
- Yes it does matter! We must have rest home care in GB and in Takaka where it is more
central, closer to activities and stimulation.
- No other options. If there were other options the trustees would have thought of them
by now. It would be a tragedy to lose rest home care in Golden Bay.
- It does matter.
- Appears to be no other option than integration and it does matter.
- Essential to keep the rest home in GB, therefore integration is essential.
- (Without integration) little opportunity to retain a rest home in GB. Yes (it does matter).
- There needs to be rest home care in GB and if the Joan Whiting was better funded it
could stay open. Another rest home also needs to be developed at the hospital, as
there will be a future need as the population ages. Joan Whiting may eventually close
and become something else. Marketing GB as an ideal place to come for rest home
care could be the answer in attracting more clients.
- Yes it does matter. (Other options)– probably a private one.
- Possibly a new building in another site closer to town. I think it is important to maintain
what’s already here.
- We definitely need something.
- The Bay needs a rest home – better at the integrated site.
- Only a privately owned and run facility, which would probably cost far more and be
beyond the reach of many. Yes yes, as an impending “oldie” (and like most GB
residents) I never want to leave our lovely Bay.
- Yes, an essential service. No other options.
- It does matter.
- GB needs a rest home. It is too far to go over the hill. It is a pity to sell the Collingwood
site as it is so nicely situated with such a nice view. It would be great if Collingwood
could be saved. I think it is extremely difficult. The elderly people syndrome is growing
bigger and bigger so need extra rooms in a few years time.
- No other options – must have one.
- From all indications any alternative would be short lived. Yes for those who have spent
a lifetime here it would be strange to move away to die.
- I believe we need to seek as many quality solutions to our ageing population as
possible. Given the projected 65+ demographic and the spike in numbers we must be
forward thinking now. One additional idea is one sustainable building alliance is working
on with the Washbourn Trust (Liza Eastman’s family) to include younger new
homeowners onto land (clustered, grade C and D, private, pedestrian oriented) owned
and occupied by elderly citizens. Support these people with their gardening, grocery
shopping, day-to-day life that’s part of the neighbourhood/rural community living.
- There are no other options. The current rest home has been running at a loss for years.
Much of the gifts and grants etc have gone on an ageing facility. It is HUGELY
important we keep a rest home in GB.
- Definitely need a rest home in GB.
- I support the retention of a rest home in GB. My preference is for the complex to be
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owned and run by the DHB. If this is impossible for a rest home then maybe this part
could continue to be run by a trust or public/private partnership.
- We definitely need a rest home in GB.
- It is vital for GB to have rest home care – elderly people must have close contact with
their families and not sent over the hill!
- Yes, we must have rest home care in the Bay. Integration must take place and include
rest home care.
- It is important that GB has a rest home. However where is the budget to show that an
integrated facility will be any more viable?
- Yes it would matter if there were no rest home! If Collingwood is too old to be viable we
build a new one in Takaka.
- Of course it matters – bad enough to leave one’s home, without having to leave the Bay.
- Of course it matters if there is no rest home in GB. There are lots of aged people in GB
who need care and will need care in future. Joan Whiting is fully occupied with a waiting
list yet you ponder such a question??
- It is absolutely vital that the rest home care stay in the Bay and integration takes place.
- Yes it is essential to have quality care in the Bay for older residents beyond home and
Abbeyfield etc.
- Hospital site not as good as Collingwood, but close second. We definitely need a rest
facility.
- It is vital to keep rest home services in GB, which are viable long term.
- There needs to be a rest home in GB and all avenues need to be explored with all
sections of the community working together, not fragmented.
- Need rest home care – aging population.
Keep - Lobby the government until they increase the subsidy for residents or make up the short
Joan fall, specifically for Joan Whiting.
Whiting - Increased government subsidy would make current rest home viable.
open - DHB continue to subsidise. Money set aside for integration be used to add more rooms
onto Joan Whiting.
- Keep Joan Whiting with present financial “prop up” and extend it by enough beds to
rooms to self- support.
- Lobby government for proper funding. Fundraising campaign to raise money for more
rooms.
- Try to ensure better funding for rural rest homes (doctors receive rural dollars).
Definitely think a rest home is highly desirable in an isolated rural population of 5000 but
I guess we’d adjust if there weren’t one.
- Ideally there should be but not vital.
- The Windles seem keen to have a rest home on their land so that could solve the rest
home problem.
- It matters a great deal to this community or any community to be able to keep their
elderly close to their roots and family. It will be a social disaster if there is no rest home
care in GB. It disappoints me greatly that for want of $140,000 a year the powers that
be will jeopardise and up and running eldercare facility. Even if the new facilities are
built we are going to need the extra beds provided at Joan Whiting. Why is dementia
care not to be offered?
- Keep Joan Whiting open. Add more to it and don’t spend millions on another unit in
Takaka.
- All that is needed is for the Ministry of Health to fund the cost of the care to a degree
that covers the actual cost of looking after people whose needs, when they enter a rest
home, are greater than they used to be.
- Rural communities face different challenges in providing elder care than urban
populations. The DHB/PHO/IMG and community representatives need to be addressing
the continuing provision of elder care services in our rural and geographically isolated
region with all levels of funders, MoH and government. The elderly care entitlement
needs to be automatically inflation proofed and the legislation preventing a co-payment
system for elder care should be challenged and abolished. The NMDHB should be
more proactive in lobbying MoH ensuring this because t he NMDHB population has a
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slightly older age-structure compared with New Zealand has a whole. Rest home care
must stay available in GB. The information provided by the IMG on how to ensure rest
home beds in GB in the IMG proposals have not addressed the issues that the current
Joan Whiting rest home is facing. The additional savings of a combined kitchen and
some nursing staff has not been shown to be able to overcome the continuing funding
shortfall for each rest home bed. I do not believe that any of the proposed services to
be continued into the IMG have $130,000 to spare to cross fund the rest home shortfall,
particularly in the light of the likely continued under funding with respect to inflation.
Unfortunately I think that it is likely that the rest home will need to be recognised as a
charity, similar to many other important services, and it will need to rely on substantial
community donations to continue operations. This is particularly the case until the
government changes the legislation relating to co-payments by privately funded rest
home residents.
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4 Is there anything else you want to know about how an integrated facility would
operate?
- I would like you to let the community who is designing it – a specialist hospital
architect?
- Integration means just that – not only the facilities of the doctors/hospital and rest
home but retirement village also. These are all stepping stones in the right direction
for the long term needs of the community and the development of the town.
- Significant alterations are proposed to the hospital, if the hospital site is chosen. Has
any consideration been given to the logistics and practicality of continuing to run the
hospital while building and alternations are made?
- What proportion of costs will NMDHB (government) fund?
- No – happy to leave it to the health professionals who know what they are doing.
- I hope this includes hospice care.
- Already spelt out well by the IMG.
- Would it mean that more surgical procedures will be able to be carried out? Will we
still have to travel to Nelson for these?
- How is it to be financed? Both building costs and future running.
- Staffing levels (wages), ongoing costs and their recovery and who is paying for all
this?
- A concern that the funds won’t be squeezed once we get going.
- I want to know how it will be funded. Will staff be paid full rates?
- Will need to be self-funded.
- Can understand basically how it works.
- Only information as it comes available to you. Keep us updated. Through the GB
Weekly is excellent.
- More information on the funding. Staff has concerns about possibly salary levels.
- What happens when the DHB under funds the project?
- There needs to be scope for alternative medicine practitioners and dentists to be
involved if they wish as part of integration.
- The financial side does concern me. Please make a decision soon if this is to go
ahead as it won’t get any cheaper than now.
- Feel there should be public meetings, not foregone conclusions presented by the
integration group.
- Yes. What is being done to ensure the new facility will have a long life - 30-plus
years? Will all staff be well paid etc? Will there be the same front line staff levels?
- I will be most surprised if this facility attracts health professionals to GB. I will be
happy to be wrong!
- Does this mean hospital boards and government cease to offer finance for all the
integrated system?
- We need to be clear as to the services DHB will provide and what control the doctors
will have. They have done a good job since the inception of GB medical centre.
Uncertain as to restraints by PHO etc in providing quality care in sustainable manner
into future.
- It should be run and all money provided by NMDHB, all staff on equal pay as the rest
of the country, with a local elected management board.
- I was not satisfied with the meeting the other day (Fire Brigade). The ones I talked to
have limited knowledge of the past so was no more wiser afterwards.
- Is it a government requirement for each ensuite to have a shower? In my experience
of rest homes each room has own basin and toilet, not shower. In some cases it could
be a danger for residents to attempt to shower themselves without assistance. ‘
- There have been comments about the difficulty of getting equipment in and out of
rooms at present hospital. Will those concerns be met in doing alterations?
- Yes (would like to know more). However we’re not likely to know those questions until
it’s up and running.
- (Would like to know) full information about all likely costs, with access to complete
business plan and funding streams information.
11
- Given that the consultation process must be genuine and not a sham, sufficient time
for consultation must be allowed. The party obliged to consult must provide enough
information to enable the person consulted to be adequately informed so as to be able
to make intelligent and useful responses. The GB community has NOT been given
time to consider and discuss issues arising from the Takaka meeting on 2 December,
nor the later one in Collingwood.
- There is no access to information about
o The current version of the full business plan
o Running costs to date for IMG, NBPH and NMDHB to reach even this stage
o Possible/likely funding streams, as well as
o Inadequate information about costings for both sites.
- Rumours circulate that IMG believes that the community may have to raise more than
$2 million. There is a clear and urgent need that the community be told exactly what
is projected.
- How can it possibly pay its way, let alone make a profit for possible investors? In what
possible way can it reduce staff numbers if the same or a better standard of care is
maintained?
- You’re doing a good job; please keep it moving forward.
- Who by and where will paying of staff, ordering, purchasing etc take place? These are
timing consuming and will neutralise any other savings eg cooking, cleaning.
- Yes, where is the money coming from? Why so tight lipped about the financial side?
Will the community have to put its hand in its pocket?
- How will nurses be recruited if wages slashed as in Mot? Who is paying? How much
will community have to fork out?
- Would the nurses swap among the 3 services instead of specialising as they currently
do? I’m interested in who’s the boss in the proposal? People usually access one
service at a time, so one staff group being a team doesn’t really affect service one way
or another.
- It would be interesting to know land cost and building cost. Also cost to visit the
doctors. It cost more here than Motueka or Fendalton and they are private practices.
- How will funding miraculously cope with the extra costs of loan payments for the
building and the continuing lack of adequate funding for rest home beds under new
management? How soon do you realistically think the new place will be built? We
have already waited 5 years! Why are there to be no directly voted for members of
the new trust? Why is the management not being put out to tender?
- We have not been told how the integrated facility would be operated at all yet. So I
hope that information is in the pipeline. We have not even been told what the cost will
be, nor where the money is to be found
- No – already spelt out well by the IMG.
- Building will cater for next 10 years and could be extended for future population
growth.
- I am very concerned at the lack of operational planning and discussion that has been
released (or considered?) by the IMG.
o There have been no suggestions of how the proposals will address the national
and international issues that are facing healthcare service provision – for example
recruitment of general practitioners to rural areas. For example, practices in
Tasmania are unable to attract recruits even with substantially increased salaries,
perks and reduced workloads.
o I feel that the IMG needs to immediately open its meetings to further community
input, particularly since the members of the IMG have, by their own admission, not
communicated openly and honestly with the segments of the healthcare and NGO
workers that they work alongside, nor with the associated services, nor with the
other members of the community.
o If the IMG truly believes in getting the healthcare services of GB right and ensure
that they are sustainable, there needs to be substantially more informed input than
they have had, particularly from those who are directly involved in healthcare
service provision in GB. Better to spend more time planning than make (more)
avoidable mistakes. (Even though the timeframe is already so long, perhaps the
new members to the IMG could improve its missteps and speed up its progress.)
12
o I would like to know the extent of the consultation that has gone on with the
associated healthcare service providers and NGOs and community support
workers directly with the IMG – including (but not limited to) Te Whare Mahana,
GB Community workers, dentists (particularly in relation to their urgent dental
services) pharmacy (also in relation to urgent services), physiotherapy etc.
o I would also like to know the attendance lists (and apologies) for the IMG meetings
that have been held over the past year. I think that it is very reasonable for the
apparently represented services and the community to be made aware of the
attendance record of the IMG participants, especially because the IMG has run so
far behind the timeframes for public information that had been promised. I feel the
community needs more information about how the PHO plans to provide services
and what services it plans to provide. This should also relate to the issues in Q1.
The NBPHO does not have any experience or expertise in running an integrated
facility, or even at this point, a full medical practice. The community needs to be
provided with more information on how it plans to do this, and what aspects of its
provision of management and services will be via its back offices in Nelson and
what will be located in GB.
o I would also like information on the provision of after-hours services that is
suggested to be improved by the proposals. Also was the IMG provided with
information from the after hours services provision survey that was carried out
(privately for CME) by doctors at the GBMC?
o I would like to ask the question about the provision of further jobs related to the
proposed new facility, as there is no GM currently, surely this is a new position?
Also within the proposed management structure, more information should be made
available to the existing healthcare service workers for their understanding and
possibly their further input at the PHO has no experience in running such a facility.
I would also like to know how the proposals plan for the financial sustainability as
in all likelihood government funding contracts for rest home and hospital beds will
continue to lag behind true costs.
13
Do you have any concerns about the proposal for the integrated facility to be run by a
5 community trust? Is there anything you want to know?
- Prefer the doctors to run their own business and not be salaried staff. Possibly
doctors own businesses but are under contract to the proposed trust.
- Cost – initially and ongoing. How much and who pays.
- Yes. DHB should run facility as in Murchison.
- I think the present set up works well with doctors being self-employed. Have they
given opinions on this?
- Budgeting at inception has to plan for plant replacement/maintenance though reserve
funding generated over the years for the eventuality of replacement/refurbishment.
- I took the opportunity to visit your display about the proposed integrated health facility
for GB. While I was interested to see the draft plans I was very concerned that there
was no information available about the financing of this proposal. I would like to know:
o How much is it going to cost?
o Who is going to pay for it?
o What fund raising do you plan to do within the GB community?
o If the trust board find themselves in the situation of the Joan Whiting board,
with insufficient resources to operate profitably, what will happen? Who will
bail them out?
- My major concern is that IMG, having provided this perhaps single opportunity for
consultation, will now take the position that, as it has had enough consultation, it will
continue its almost secretive anonymous way through to formalisation of the deed and
establishment of the trust, without any further consultation.
- The building looks well planned but
o Is there enough waiting room space for physios, nurses etc?
o There is a need for a mortuary and I would like this point to be seriously
considered. There will be double the number of elderly patients in this
complex. Would there be room to extend the plant room? This would provide
easy access for the funeral director who would then not have to enter the main
corridors.
- Yes – DHB seems intent on withdrawing funds from rural areas. It is rural areas that
need their support more so than urban areas. Funding from central/local government
and DHB is essential together with some local financial support (community based).
- A community trust is a good idea. Continued government commitment to adequately
funding services is vital.
- Yes! I don’t believe the area population is large enough the fund the facility long term.
- No – not as explained at the open day. The essentials are that the present staff are all
happy with the proposals.
- Let’s hope the trust operates more smoothly than the current collection of bodies!
- No – questions already answered satisfactorily.
- Keep the NMBHB in the loop.
- In my view it is a good idea to have a trust so the money stays here and profits can be
used for the hospital etc.
- I will follow with interest ongoing fors and againsts.
- No concerns – not yet.
- I think a trust is a strong idea/solution.
- Further information on how the trust would work.
- To take time planning to avoid short sightedness and gross overspending.
- I would not like the facility to be run privately. The community needs to have an
interest in the way it is run.
- Is there another option? Is there anywhere else in NZ where a similar integration is
happening and what structure do they have?
- No. However it would be helpful to know what the expected remuneration of trustees
will be. I would like to see the Joan Whiting trust on the board.
- Only the concern that nursing professionals won’t want to be employed by a trust.
- Funding – trust not appropriate. Staff – losses due to lack of funding.
14
- Our only concern is to know the staff will be paid by the same standards as they are
now, and not changed 2 years down the track.
- Uncertain as to restraints by PHO etc in providing quality care in sustainable manner
into future.
- There’s always concern about the level of funding, given the call on the health budget.
- Yes. Finance. The Bay will pay again and again. It is a government hospital in
Takaka now – keep it open.
- Yes the cost. The Jack Inglis hospital in Motueka seems to do a lot of fund raising.
- No
- No
- No
- It has been stated on a number of occasions that the scheme would not proceed
unless the people of GB want it, yet little thought seems to have been given to the
question of how to find out if we actually want it. How do you plan to do this?
Trust - CT governance essential. Perhaps a public forum prior to trust meetings.
concept - I do not want a community trust like Motueka or anywhere else where the community
concern is forever having to fund it. GB people have already put a lot into JW and the medical
centre over the years.
- Does this mean the community trust will be responsible for sourcing funding?
- Yes – staff pay will be insufficient. I propose that the staff be employed by the DHB.
Yes, the nurses seem concerned about not being under DHB. They need to know
their wages will not be jeopardised.
- Who elects it? Who pays for it – is it voluntary? How do they go about
acquiring/receiving funding? How much funding is the responsibility of the
government?
- Yes I do have concerns. My preference is for DHB owned and operated. I am
concerned the DHB will under fund the trust and result in struggles such as with Joan
Whiting.
- Trusts are out! Evident by the Joan Whiting Trust – why should people of GB be faced
with never ending fund raising.
- Yes I have grave concern. It needs to be run by Health board or hospital board, not a
community trust. The community has not the population in GB to fund this – has it?
- Yes I do – local elected management board.
- I think if integration goes ahead you want community trust elected by the people, not
self-appointed as now. You have two deadheads in there now – one male, one
female. The integrated facility could be run by the Community Board. The current
trust system doesn’t appear to function very well.
- I do have some concerns – although there are good examples of community trusts
running successful businesses. Would trustees be voted on in an open election?
How many trustees would simply be appointed from vested interests?
- Yes, huge concerns. How can you guarantee that people from the Bay will be willing
to stand for trust board membership? People approached to stand for the Joan
Whiting trust have constantly stated that they have too many other commitments.
Why is a trust even being considered? Government money is never guaranteed to
keep up with expenses. How will the trust raise the shortfall for what will likely end up
in the same under funded situation as the current rest home. If the DHB is forced to
rescue the services in the future it will be far more costly than rescuing the rest home
now!
- I feel very unhappy at community trust idea – too uncertain. As most (or all?) funding
comes via DHB why can’t it be a DHB organisation, like local government CCOs.
- We have to fundraise for so many things compared with larger places – this is just too
big an ask.
- Trusts have a bad reputation for being a law unto themselves. To place the
responsibility for all the health services into the hands of a trust is a dreadful idea.
- I have great concerns about it being run by a community trust – where is the money
coming from? The DHB is pretty devious but at least there is some degree of
accountability.
- I am concerned about the proposed trust structure.
15
o Concern that the trustees will have neither the expertise nor, more importantly,
the resources to successfully and profitably run what will be quite a complex
organisation. I feel the trust may well end up in the same situation as the Joan
Whiting trust with insufficient funding to maintain long term viability. I believe
the proposed facility should be owned and run by DHB who have the
resources and one would hope the expertise to run it successfully.
o Trust document: representation of the GB community (8.4) - The community
must have the opportunity to appoint who it pleases as its representatives. It is
unacceptable that the representatives be appointed by NMDHB and TDC. I
would feel deeply resentful that Maori representatives could appoint their own
representative but the rest of us would have to make do with individuals
appointed on our behalf.
o I note there is no provision on the board for a staff representative. There
should be; they are the people at the coalface and their contributions and
opinions should be sought and valued.
o There is very little reference to the residents of GB in the document. After all
they are what is it all about. The trust would actually be set up to serve their
need. What are their rights e.g. attending meetings?
o Likewise there is little reference to staff. I believe there needs to be reference
to the trust developing a good and mutually respectful relationship with staff,
with the trust valuing staff, not a new integrated building (or management) that
makes existing services and would make a new integrated system work well.
- I am very concerned that the proposals are to be run by a community trust.
o There has been no information about how the new trust will be able to make up
the continuing shortfall in funding that currently plagues the JW rest home.
The only new income stream, with the proposals as they stand, is from the
doctors’ surgery fees.
o The Nelson Bays PHO should not be contracted as part of the Objects of the
proposed draft trust deed. The NBPHO should be a contractor that tenders its
services and this must be separate to the trust deed. The new trust cannot be
tied by its trust deed to a single provider for any such services, be they medical
care or gardening or anything else. Currently also PHOs are in a fragile
political position nationally and the DHBs are likely to have to reduce their
spending next year by a further 5-10%.
o Assurances by the DHB that it will continue to put the money it does now into
GB is not assurance enough, but needs to be more along the lines of it will pay
the provided funds for the hospital/rest-home beds etc that are provided to it by
the MoH. Any provision for wrapping up the trust should require assets to
remain in GB, not just within NZ.
o I would like the IMG to address the reason for requiring a new singular trust to
be set up, rather than allowing a new facility to be the home of a range of
services and service providers (or their trusts). There seems to be a much
greater risk to ALL of the healthcare services if they are forced to
conglomerate. Representation for each part of the healthcare system would
be substantially disabled and the ability to operate efficiently potentially
reduced as everything is put directly into one pot.
o True integration is at base about communication and there are a myriad of
places that communication between the providers could be improved without
requiring them to all be members of the same trust. I believe that transparency
financially would also be improved with clear distinctions between the funding
streams – and does not preclude one service from paying towards the
provision of other services under a specific cost-sharing agreement, and it
would improved the ability for transparency in community fundraising also. (I
am sure that community donations and support will still be required, as
previously mentioned, there’s no answer to where shortfalls will be made up.)
16
Trust - Why does the TDC have to have a representative? Is it an elected councillor or …?
deed Why does the Community Board have to have a rep? Who would you choose from
input the current board??!! Why not have people stand for those places and have an
election at the same time as the local body elections? Open, not closed appointment.
- Get the trust deed right to guarantee transparency and accountability. The IMG
should decide on key things like the relationships between PHO and DHB and itself,
then ensure that the trust deed reflects those decisions. The draft is pretty messy.
- Accountability and transparency are concerns. Get the framework right for posterity.
The draft trust deed doesn’t seem to specify the nature of the relationship between the
trust and PHO/DHB.
- Comments about draft trust deed:
o Who is the settlor – who signs the trust deed
o Appointment of trustees: Clause 8.1 – are there 13 people on this group who
will become initial trustees? Names to be published please.
o Clause 8.4a – sitting councillor appointed by Tasman District Council must live
in GB.
o To me trust board is loaded from organisations’ appointees. I would prefer 1
person appointed by NMDHB and 3 people elected by the community, not by a
selection panel.
o On many boards members retiring after 3 years (or whatever period of time is
elected) are eligible for re-election. Will that be the case with trustees? If so
there needs to be a maximum time that any one can be a trustee.
o Trustee meetings need to be publicly notified, perhaps open forum prior to
meetings.
o Board of trustees to report to community via public meetings at least once a
year.
- Trust Deed – 8.4.a.ii should read “one sitting GB councillor appointed” (add GB). Do
not want a conflict of interest.
- I was advised at the meeting that all suggested amendments from this ‘consultation’
would be considered by IMG, and a second draft circulated [somehow] before
formalization. I trust that this WILL occur. Below, I comment on paragraphs by
heading, page, and / or number.
- Interpretation Section: Chairperson – why has this person to be appointed by the
Trust Board? Why not elected by the community?
- Representative Body: who are the Shareholders referred to? Why must members
of the community be treated as ‘consumers’? What is wrong with patients or
taxpaying members of the local community?
- Charitable Objects: is not ‘Objective’ a more correct word? (don’t objects get
projected at people and things). I like the tone of this but suggest a full stop after
‘when they are unwell’ and the inclusion in a second Schedule of ALL those
primary health services to be made available.
- I welcome the use of the mandatory word ‘shall’ in 5.2. 5.3 and 5.4.
- 5.3 This draft clause surely and actively prevents any other entity seeking to
contract with the Trust for the provision of management and services, and can
only be seen as in complete contradiction to clauses 9.1 and 9.2. This anomaly
must be clarified; is this not creating a ‘closed shop’ or monopoly?
- If there already is a draft agreement or ‘contract’ between IMG, for this as yet
unregistered Trust, and Nelson Bays Primary Health, why may this draft not be
available for public information? Secrecy suggests ‘something to hide’?
- Does IMG have currently any authority to enter into any agreement with Nelson
Bays Primary Health?
- Has this draft ‘contract’ been scrutinized by any independent agent, independent
that is, of IMG and PHO?
- If later Nelson Bays Primary Health is found to be defective, how then can the
trust ‘escape’? This sub clause, taken in conjunction with Schedule A. c., creates
scope for the Trust to develop any number of private entities over which the
Community will have no control, as long as the Trustees ‘think fit’. That is wrong.
- Appointment and Removal of Trustees. 8.1 - Why thirteen ‘initial Trustees’?
17
What is significant about 13, other than it is unlucky?
- Why do they have to be ‘current members of the GBIHS IMG? While it is not
unreasonable that the experience of current members should be retained, such a
blanket appointment of principally un-elected people to represent the community
at the very start of this endeavour smacks of ‘jobs for the boys and girls’, rather
than any people’s choice. Perhaps an election for the Trust at the time of the next
Local Body election?
- And the Fact Sheet prepared for the meetings mentions that “the centre would
be run by a locally managed trust”, [emphasis added] with three members from
regional organisations!
- 8.4 a .i Why should NMDHB appoint two persons? Why not just one like
Tasman District Council? Is there something inherently wrong with elections?
- 8.4.a.ii What reasoned justification exists for the Territorial Local Authority to
have – as of right – a place on the Trust?
- 8.4. a v. As there were NO presentations to the community in July/August, the
appropriateness of this sub-clause merits re-examination, why should Trustees
assume authority to choose persons to represent the community? (…selection
panel comprising of three trustees … and three members of the …Community
Board…)
- 8.4 c - Could not the Chairperson of the Trust be publicly elected?
- 8.6 - Should this not read“…the TrusteeS may, by Special Resolution...”
- 8.9 - While this refers to ‘the appropriate Schedule’ there is no such appropriate
Schedule in the draft!
- 8.12. f - This reads strangely. Perhaps it might be amended to read: “is convicted
of an indictable offence, and has exercised all rights of further appeal.”
- 8.12. h - The document fails to spell out what is a ‘failure to fulfil his or her duties’
as a Trustee; surely the Trust must set out at an very early stage the precise
duties of a Trustee; as well as establish a formal procedure to deal with alleged
failures to fulfill duties. Otherwise, a real risk emerges of potential for a
‘kangaroo’ court.
- Duties and Functions of the Board: 9.1 - It needs to be spelt out what precisely is
meant by: “in an open and transparent manner”. Does that mean, as it should,
that the community being served by this Trust has access to all documents and
reports, to all meetings, including a ‘public forum’ at every meeting? I accept that
on rare occasions, there might be need to move into committee, a power to be
exercised rarely; and when exercised, there should be a public explanation of that
decision. As its exercise must be based on a clear policy statement, not on a
case-by-case basis, the Trust must draft procedures to define the process for
‘moving into committee’.
- 9.3 - It is right that the Board monitor the activities of the Trust to ensure
effectiveness of operations; it is right that the Board demonstrate its effectiveness
to bodies and organizations which fund and support; and IT IS ESSENTIAL that
the Board recognise its primary duty to demonstrate its effectiveness to its
community, who, after all, as taxpayers, are paying!
- It will be helpful to find, in the final Deed, information about how the Board will be
monitoring its effectiveness, and I assume that all reports relating to such
monitoring will be publicly available. It is assumed further that annually the Board
will present to its Community an Annual Report which reports on such
effectiveness, and on the standards against which it has measured its
effectiveness, and that such reports will cover issues of professional clinical [say
- from the Health and Disability Commissioner, or Professional Tribunals] and
fiscal reviews from the Auditor. There is however no reference to this whatsoever.
- Proceedings of the Board: 10.2 and 10.3 - There is nothing here, referring to
Voting, to indicate that records will show how each Trustee voted. The
community needs to know how its Trustees voted!
- 10.5 - Here a vital word, NOT, has been erroneously omitted between ‘may’ and
‘be’!
- Meetings: 11.2 - I have already commented above to the need for public access
to meetings and papers.
- Accounts: 15.a -This sub clause should be amended to read that the Trust will
18
keep complete and accurate records to be kept in accord with generally accepted
principles, rather than leaving the Trust to keep records as IT “ thinks fit”, a
possible recipe for disaster!
- Declaration of Interest - Surely, every Trustee before appointment, nomination, or
election must be required to affirm on any possible personal or pecuniary interest,
which might influence her/his independence.
- Remuneration of Trustees and Payment of Expenses: 18.1- It is not for the
Trustees to determine their own remuneration. There are too many contemporary
examples of such rorts in both the New Zealand and British Parliaments. Such
remuneration should be established only with the agreement of the Controller and
Auditor General.
- Schedule A. As this Schedule appears NOT to be attached to any specific
Clause of the Deed, perhaps it should be attached to “Duties and Functions of the
Board”
- a and n - “To raise money by all means” is rather too sweeping, and should read
“by all legitimate means.” These two sub clauses seem the same! While Self
Promotion is an understandable need, any such publication must be
demonstrably Objective, and its purpose justified on grounds only of
Effectiveness.
- c,d,e - The case for the creation of any new sub-organization MUST be based
solely on Improved Effectiveness; with the Trust’s case being made public before
the date for establishment of any such organisation. It seems wrong that having
created such an entity the Trust then demands control through the obligatory
inclusion of one of its members in its creature. There are surely other methods of
establishing Accountability!
- m - I welcome reference to acting as ‘ a good employer’, and assume that it will
apply as much to the relationship of the Trustee to a Medical Professional, or a
Manager, as to a cleaner! Indeed, this requirement should NOT be hidden away
in a Schedule, as yet unattached.
- t - While it may be helpful to appoint committees, it needs to be very clear that
any such committee is accountable to the Trust
- v - It surely is not up to the Trust to decide whether it may ‘do such other lawful
acts’. The Law requires that!
19
Is there anything else you want to say or ask? (Please provide contact details so we can
6 come back to you with information).
- Need to get on with it. Existing medical centre not adequate now.
- It is unhelpful to ask if an integrated facility is required without knowing what it will cost,
who will pay and who will manage it.
- Come back to the community during a public meeting. What are you afraid of?
- Where is the provision for respite care? Also an area for “wandering” dementia clients
so they can stay in the Bay and not be sent to Stillwater Gardens, Naomi Courts etc.
- Using the income of the other health services to subsidise rest home care is a lose-lose.
The rest home is full with a waiting list. The hospital is half empty. Put resources in to
the rest home.
- The current hospital has a wonderful aura about it – a sanctuary, rather than the cold,
clinical Nelson style hospital. Please keep it this way.
- Will there be a public meeting? How will you know if you have public backing, which is
stated as a condition of this proceeding? People need to know for themselves if the
business plan is viable – when will it be available to the public? When will staffing levels
be made public? A reply in the GB Weekly will be sufficient.
- All parties seem to be leading information at a terribly slow rate. I don’t trust either
outcome due to lack of info provided.
- Does the government (as chief funder) have final say as to the final product?
- If the facility was to be sited at Park Ave how helpful would TDC be? Let’s ask them
that – it may make it a less expensive and time-consuming option.
- Thank you to all of you who have put so much time and thought into this project. Please
hang in there.
- I suggest you have a group of people bombard you with the hard questions so that you
know what the public will want to know.
- The IMG need to be more up front and publicise more widely
o Their intentions
o How decisions were arrived at/what studies done
o More options/public consultation!!!
- A big thank you to all those who have worked on trying to bring the vision together.
Please ensure the plan meets the community need over the next 5 years and can be
expanded in future as needed.
- Do you feel the acute care section to be too close to the main road (noise factor)? Are
the dining rooms large enough for the number of residents?
- I have a degree of mistrust about the process in that government support and monies
could be withheld and health provision becomes a privately owned entity (e.g. some
insurance company or overseas band eventually becomes the owner). Wages could be
depressed. Concerned also about the increased traffic safety at the intersection of SH
60 and Central Takaka Rd.
- There doesn’t appear to be any after-care beds/provision in the maternity wing. In my
own case I was profoundly thankful for two weeks’ recovery bed rest, rather than having
to deal with more children at home and an unhelpful mate (not my present one!).
- At present there are 17 beds for elderly people. In a few years you need more so build
another 5 more now.
- I am pleased the hospital site has been chosen as we know this is good.
- It is very important that we have a regular designated residential respite beds in the rest
home and a day programme for those still being cared for in the community.
- To have space available for complementary health care practitioners, to support the
recovery, health and holistic well being of patients.
- Proceeds from the JW trust and medical centre could go to the DHB as community
contributions to the integrated centre.
- I do not want any alternate health practitioners to be part of integration.
- Strongly feel that remarks that if staff refuse to work under the DHB, services would be
withdrawn from GB speaks highly of blackmail. I feel an explanation is required!
- I’d love all factions to pull together now and put the energy into making it happen.
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- What is the timetable? The name if the rest home wing should be the Joan Whiting
Rest Home Wing.
- A big worry will be the government and DHB decreasing financial support so that GB
has to fund our health services alone.
- I have grave doubts about this, however it seems to be the way we are headed. Do not
cut staff in the name of cost cutting! A new building does not take care of patients –
nurses do.
- The Government or health board make the rules and the community are asked to abide
them, thus all becomes very hard on the community as they also have to keep many
other public things supported. I am worried about finance in this venture – where will it
come from?
- We have concerns that the proposed plan is the best one for an integrated health
facility. The proposal to build a new integrated health facility should be advertised so
that architects can register an interest as we would hope it would be done with the
construction of the final building. A well-planned building can have many savings and
advantages in the final construction and easily cover the cost of the architect. The only
logical place for this facility is where the council favour the next growth phase for
Takaka, mainly because of infrastructure developments.
- Concern over future freighting of massive seafood out of Bay – rumoured to follow
Glenview Rd/ Hospital corner – do it only once so we want future proofing and
sustainable servicing.
- You need more feedback from the public to committee – not as at present. This is what
is best for you. Think about it. Thanks for chance to comment.
- I was born in Takaka 77 years ago. There are council people in Richmond saying and
talking about all sorts of flood etc. Why don’t they ask some of the older inhabitants – I
was living in Motupipi St in 1983.
- We think it is important the project proceeds asap.
- Has any provision been made for storage of ambulance or ar St John not part of
integration? I would like to see public meeting when the group can report back on
questions and comments from the open days and this questionnaire.
- Please hold some public meetings to discuss the feedback and explain where the
proposal is going and answer the multitude of questions that keep arising about funding,
staffing, the actual benefits (compared with huge costs and upheaval).
- How will the IMG decide if there is enough support from the people to go ahead? So far
this whole exercise has been anything but transparent. Please put all the answers to
the questions on the website so that people can gauge the worries or otherwise that
others have about integrating all the health services into one physical plant.
- If the community is to support this facility wholeheartedly, as it has supported the GB
medical centre, community hospital and Joan Whiting trust, IMG must enable that
community, actively, not passively as at present, to believe that is has a real stake in the
development of this new facility. IMG, must earn that support, rather than expect that
support will automatically come to it.
- All information is public I hope. I’ll see it. Thanks.
- How much money and time has been wasted looking into this project over the last 5
years, especially because there seem to be so few answers available that give us the
opportunity to make an informed decision? Making a decision to support integratoing all
our health services right now would be like joining a Mickey Mouse space odyssey.
- I would have liked Jim Hayter’s house at Collingwood rest home made into a doctor’s
room and the present doctors’ rooms converted into extra rest home with ensuites.
- For the future, I support the concept that an integrated community health facility is the
most efficient and satisfying course to follow. Such a facility should be run by a board,
comprising members from both the NMHB and GB. Top marks for the concept plan
draft 5 for a community hospital facility at the existing hospital site. The reserve
extension areas for acute, primary care, rest home and aged care are wise. They
should suffice for two or three decades without major structural or services increases. I
know that positive long term forecasting of needed capacity in such an area of
community services as this plan addresses, is not possible. This magnificent approach
needs to have confidence that in one hundred years all plans made now can be
efficiently expanded to accommodate a volume of services at least double that of the
existing draft. Future proofing needs generous land held in reserve for buildings, car
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parks, green areas etc. Over boundary services such as power, water, effluent
disposal, vehicle flow etc need to be tagged with the possible double capacity label. An
exclusive large fire-fighting water storage and its automatic independent engined
pumping unit to supply the sprinkler system needs accommodating on site. A
store/workshop to attend to small technical, structural and groundsman equipment is
also a need of such an organisation as this.
- The DHB’s own documents note that the ability to treat injuries in a primary care setting
is advantageous.
o Why is the IMG not paying more attention to the importance of continuing the X-
ray facility available in GB? This is an area of major consideration for this
isolated community, and is an area that reduces costs not only to patients but
also to the DHB. “If this care is to be directed to the primary sector, then it is
suggested that GPs will require access to diagnostics, especially imaging. Up-
skilling in certain areas of practice and, possibly, investment in equipment and
space may also be needed. A good example would be the GP management of a
simple fracture requiring an X-ray and plastering. And one of the recommended
actions: the DHB and PHOs will develop improved patient access to affordable
community diagnostics imaging.” (Acute Care Services Review November 09
Board Version Final).
o I think that the lack of transparency and the delays in the process have been
horrendous, and that the members of the IMG and the PHO and the DHB should
stand up and start trying harder to make that right. I am very surprised that
members of the IMG who are members of the DHB and the Community Board
haven’t applied their knowledge of processes of community consultation to this
project, and made greater attempts to inform the public at the very least in the
spirit of the legislative requirements for community consultation that they should
be familiar with. In fact I think it is likely that as the IMG proposal effectively
closes the public hospital facility (The GBCH) and opens a private facility (owned
and operated by a trust), that this is a major change in the DHB’s provision of
services and therefore must go through the DHB’s legislated requirements for
community consultation. I think that public meetings are absolutely required, first
rounds for information provision and later rounds for decision making.
o The Open Day that I attended was dreadfully lacking in information and the
information that has been published in the GB Weekly, while emotive, has not
contained enough information. The website should link to appropriate policy and
strategic work done by NMDHB and NBPHO (where any exists) and once the
IMG clarifies its objectives, it could show those in relation to the national
healthcare services strategies and rural strategies also. Other DHBs seem to
have done very good work determining that needs for their rural communities
and I’m sure the NMDHB should be able to provide similar information. It is
disturbing however that the NMDHB represents the proposals as far further
forward (and supported) than they are on its website. If the IMG can effectively
communicate what is actually proposed, how they align with strategies at policy
and operational levels, then the community will be better served, as, at the end
of the day, we will be the ones paying for whatever results (literally and
figuratively).
- Golden Bay hospice group is currently being set up. Purpose to fund raise for a hospice
room and family facilities on site. In your plan the whanau room and palliative care and
adjacent room will serve this purpose. Requests:
o space for 3-4 family members to stay overnight or longer
o kitchen facilities – small but fridge and freezer space necessary
o hanging space for clothes and bags
o tv and chairs
o ensuite
o outside quiet courtyard adjacent hopefully with entrance door from whanau
room. Hospice could raise money for furniture etc.
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