No regrets for National over Middlemore Hospital horror story

by Graham Adams / 12 April, 2018

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Middlemore Hospital, Auckland.

Middlemore Hospital has sewage leaks and serious rot and mould problems. Photo/Wikimedia Commons.

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Raw sewage in the walls of a hospital is a horror story for the Opposition.

Most people like sewage to stay where it’s meant to be. In pipes. Certainly not in the water at our beaches where it now turns up often enough. And certainly not in the walls of our hospitals.

These days we are pretty used to mould contaminating the structure of buildings and the water leaks that cause it but sewage takes things to another level.

It has become the defining image of the former National-led government’s neglect of the nation’s social infrastructure. Human excrement in hospital walls screams “Third World!” in a way that even diseases of poverty such as rheumatic fever in Middlemore’s catchment area could never quite match in the popular imagination. Faeces in the Walls is a horror movie for National, starring Jonathan Coleman, the former health minister.

National’s leader, Simon Bridges, is putting the best possible face on the disaster. Basically, he’s saying, “Shit happens! Get over it!”

In an extended version of this hardball approach, he’s also saying: “Yeah, we left you some problems but we also left you the money to deal with it.”

His impatience is obvious as he fronts up to media. He wants to tell us about the “strong economy” National left behind after nine years in office but all people want to talk about is the sewage in the walls at Middlemore Hospital. As Jack Tame told Bridges on Breakfast, we’ve got “sewage running through the place”, which conjures an image of effluent flooding the corridors.

Bridges says the “tens of millions” required to fix Middlemore represents a tiny portion of the health budget and Labour should “stop whining” and get on with fixing the problem. 

Simon Bridges

National leader Simon Bridges believes there's enough money to deal with Middlemore's building problems. Photo/Getty.

Unfortunately, Treasury estimates that the nation’s DHBs collectively need $14 billion in capital expenditure over the next 10 years. Its 2018 Investment Statement also points out that “over 19 percent of hospital assets (by book value) are rated in poor or very poor condition”.

Fourteen billion dollars is a considerable sum of money that can’t be wished away as easily as Bridges hopes and National certainly didn’t leave a sum that large lying around to be used at Labour’s discretion.

It’s hard to believe that just eight months ago, Jonathan Coleman as Health Minister was telling a meeting of cancer charity leaders that New Zealand’s health system was the “envy of the world”.

It was a risible claim, including to some of those attending that August 8 conference. Siobhan Conroy, chief executive of the Unicorn Foundation, said afterwards: “Actually, I think we are the laughing stock. If you look at the number of Givealittle pages – the number of New Zealanders out there currently seeking access to treatment and medicines – we’re not doing that well.” 

And, astonishingly, Coleman’s claim about New Zealand’s enviable position came just a week after what was described as a “crisis in patient care” was exposed at Dunedin Hospital, particularly in the urology department

And that wasn’t the first of the bad news in the South Island. A report in May 2017 found more than a dozen people had suffered vision loss after delayed eye appointments in Dunedin and Invercargill, despite warnings from doctors.

In February 2017, a select committee was told leaks after a thunderstorm meant water had run down the walls of two surgical operating theatres in Dunedin’s hospital. 

Coleman remained unrepentant to the end. Nevertheless, in his last weeks as a politician, he wisely didn’t reprise the theme of New Zealand’s health system being “the envy of the world”.

Now he’s gone and Simon Bridges is left to carry the can, so to speak. Bridges has declared that we have a “first-class health system that is strong and resilient” but that will sound like wishful thinking to many given the evidence from Middlemore and Dunedin.

Labour will continue to drip-feed more examples of National’s neglect of vital infrastructure over the next few weeks and I suspect, in response, we’re going to hear a lot more from Bridges about the strong economy the new government has inherited.

As a tactic, that may not work out as well as he hopes. It opens the door to a close scrutiny of exactly what a “strong economy” means. In particular, it raises the question of whether good economic management should involve a lot more than simply wrangling fiscal surpluses by massively underfunding the infrastructure required to manage huge population growth.

And the impression of heavy-handed government wrangling is hard to avoid when the acting CEO of the Counties Manukau District Health Board, Gloria Johnson, told RNZ that the board hadn't asked for funding to fix its stricken buildings because of pressure from the government to stay in surplus. 

The unfortunate conclusion may be that, after nine years of National’s management, our economy is sound only in the way a company that is dressed up to appear attractive to prospective buyers is sound. Cooking the books by pumping up revenue while costs are slashed  a technique beloved of private equity firms offers only short-term gain alongside the inevitability of long-term pain.

By trying to turn the nation’s focus onto his claims of a “strong economy”, Bridges may inadvertently invite discussion about what has underpinned New Zealand’s GDP growth in recent years – massive immigration. It’s clearly unsustainable socially, environmentally and politically – not least because Auckland, where most immigrants settle, lacks the infrastructure to accommodate the influx. Unfortunately, immigration was the last government’s only big idea and principal means of boosting the economy.

Now the chickens are coming home to roost. As Gloria Johnson told RNZ, Middlemore will need $1.6 billion to remediate the problems in multiple buildings, add new buildings to meet demand, and about the same amount of money to build a new acute hospital and facilities which population growth will require.

At the very least, we need to have a national discussion about immigration and developing a population policy that is sustainable.

National desperately wants to keep the focus on the coalition government’s perceived weaknesses and away from the perception that many of the problems the new administration faces are the result of nine years of its own mismanagement and its disastrous immigration policy that has given rise to so many of them.

The opposition had a good run for a few weeks while the ramifications of a meeting in a Wellington cafe between Broadcasting Minister Clare Curran and RNZ executive Carol Hirschfeld were forensically and extensively dissected in the media but a coffee rendezvous is never going to capture the public’s imagination like sewer pipes leaking faeces into an overburdened hospital’s walls. 

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