On 9 February the Democracy Project (hosted by Victoria University) published online a detailed article on how business consultants were commissioned to do a hatchet job on the senior management team of the Canterbury District Health Board (CDHB).
The article attracted much positive feedback, a comment from someone when confirming a coffee catch-up that this was assuming I didn’t mysteriously disappear, and stony silence from predictable quarters. There are further observations that deserve to be made.
Health unions vigilance required
Using a report fudged in order to keep it out of the public eye, written to be used for a hatchet job, and based on erroneous use of nursing staffing and bed management and resourcing data is a disgrace. This disgrace does reputational damage by association to all business consultants in the health system. It must never happen again (although most likely it will in the new health system environment we are being drawn into).
There can be situations where it is appropriate for DHBs to engage external business consultants. But not in areas where they have less expertise than those employed in it except on occasions as additional hired help. This is especially the case where the work involves service design, configuration and delivery whether this is for specific services or organisation-wide. There can sometimes be a role in areas that are more technical, more immediately fixable, and where additional capabilities are required.
The CDHB/EY disgrace highlights the importance of the health unions in the highly unionised DHB workforces pro-actively insisting that they actively engaged at the earliest practical opportunity over whether it is appropriate for a DHB to use external business consultants and, if so, on what terms including that they are accountable not just to DHBs but also to affected workforces through their unions. Engagement needs to be much stronger than limited formal consultation.
The new Board of CDHB didn’t want the third report from EY Consultants (EY) to become public. Hardly surprising given its purpose was to be a hatchet job on CDHB’s senior management and its poor understanding of workforce data.
In order to decline requests from media and others under the Official Information Act the Board described the report as a draft without formal status. Devious? You be the judge of that. I’ve already made my judgement. Fortunately I was able to obtain a copy without resort to the OIA.
Pretentious innovation claims
For many years Canterbury DHB had a well-deserved reputation as a leader in innovation and systems improvement. Instead of acknowledging this, EY not only did a hatchet job but went further in what can reasonably be interpreted as a promotion for more DHB contracts. EY condescendingly and lazily included a ‘primer’ on strategy for CDHB to follow.
However, there was a credibility problem. The ‘primer’ was lifted from another EY publication written for a quite different European context with many elements inapplicable to the New Zealand situation such as pharmaceutical procurement practices which, in contrast, are centralised here.
EY also promoted some extraordinary ‘blue sky’ assumptions it claimed were lessons from Covid-19 about improving DHB performance. EY proposed what it called their ‘regional planning tool’. The mind bobbles how people with limited and dated experience of the health system could make such long-term assumptions based on an unprecedented pandemic that was only a few months old. Unsurprisingly this ‘tool’ was rejected collectively by all the South Island DHBs.
What makes EY’s opines particularly pretentious is that was in a report supposedly about the management of CDHB’s operational costs. Trying to extrapolate somewhat abstract notions derived from an unprecedented pandemic that was still at the getting worse before getting better stage to tangible operational management is quite simply navel gazing at best; bananas at worst.
Moral of the story. Never trust business consultants (and those who hire them) who purport to know more about service design, configuration and delivery (including workforce capacity and capability) than the health professionals working in these services. Health unions be vigilant and assertive!