Opening Stage 1 of the new ED and Assessment and Diagnostic Unit, North Shore Hospital.

Speech – completion of Stage 1 of the new Emergency Department and Assessment and Diagnostic Unit

North Shore Hospital.

Tuesday 1 March 2011

Dr Lester Levy, Board members, representatives from Fletcher Construction and project architects Klein, community health partners, ladies and gentlemen.  

Thank you for that introduction and good morning everyone.

Today we are here to mark the completion of the Stage 1 of the new Emergency Department and Assessment and Diagnostic Unit here at North Shore Hospital.

Once all stages are completed by year’s end, this $50m investment will mean an expanded and redesigned emergency department, with an assessment and diagnostic unit, and 30 new beds bringing the total up to 84 beds.

This is part of an extra $1.2 billion plus the Government has invested in the public health service since coming to office.

My purpose in being here today is to acknowledge the completion of stage 1, but also to acknowledge your efforts to improve the performance of North Shore Hospital. More on this later.

But first, I want to again thank everyone in the New Zealand health services for their tremendous support for the people of Christchurch.

The way the public and private health services have pulled together in this time of great need should make us all proud.

Staff of the Canterbury DHB have made an enormous effort in the months since the September 4 quake. But what we have seen in the past week is truly extraordinary. 

Despite many losing their own homes, Canterbury health professionals and administrators have worked tirelessly caring for the seriously injured and their families.

I went to Christchurch on Wednesday the day after quake. It was amazing to see all the help arriving from all over New Zealand and the world.

But what was even more impressive was to see first hand Cantabrians working with vigour, strength, and compassion - even as they suffered grief and personal adversity that makes the rest of us weep.

In the first couple of days, Christchurch Hospital's orthopaedics teams treated many serious injuries, including a dozen patients with life threatening crush injuries, a similar number of spinal fractures and 35 hip fractures. 

By comparison Waitemata DHB has about 8 hip fractures a week. 

At times in Christchurch, there were five orthopaedics theatres operating at once.

Each one of these cases, as you all know, constitutes a major task for any hospital and for after-hospital services. Doing what must have normally been months of work in just a couple of days gives you some idea of what they were up against and how impressive their performance is.

My appreciation also goes to the Waitemata DHB staff who have volunteered to relieve staff in Christchurch. The challenge there will last for many months, and we will need a continuing flow of outside clinicians to support the frontline.

In May 2009, the Health and Disability Commissioner released a report on his investigation into the poor care of five elderly patients here at North Shore Hospital.

The Commissioner was highly critical of Waitemata DHB’s slow and inadequate response to over-crowding and poor service in the emergency department.

“For several years clinical leaders had consistently raised concerns, which led to numerous reviews and reports. There had been a lot of talk but not enough action at Board level. Despite valiant efforts there was inadequate planning and insufficient action to fix current problems at North Shore Hospital and to plan for anticipated population growth. It was not until the overload of winter 2007 was bearing down on the hospital that the Board took decisive action to approve more beds and future development. By then it was too late for sick patients and their families.

That’s why we gave this project such priority that approval for this project was fast-tracked when we came to office. For many of you this has been a long time coming. The conditions you have been enduring for many years have not been ideal.

Having said that, much progress is being made in recent times.

Today we are releasing the Quarter Two results of the National Health Targets. These are the results for October-December 2010.

Across the country we are seeing continuing improvement in patient access to timely, quality health services.

As you all know, Waitemata DHB has languished at the bottom of the country for Shorter Stays In the Emergency Department Target quarter after quarter after quarter.

When the target began mid-2009, only 61% of Waitemata patients were either admitted, treated or discharged within the six hour target.

But in the past six months you’ve made considerable progress, hitting an average of 82% in the past quarter^[1]. That’s a third more patients getting better care.

This means you’ve lifted yourself up from 20^th out of 20, to 17^th out of 20 in three months.

On several days in the last quarter, Waitemata actually hit the 95% target.

You’ve done this without this new facility. Imagine what you can achieve for patients in the next six months!

Further, you will also be interested to see on the tables published in the Herald tomorrow that Waitemata sits higher than Auckland DHB on all of the six targets.

I'll be talking to Auckland's chair about that…and I note he’s very conscious of it!

The Shorter Stays in ED target is not just about the ED … it is a barometer of how well a whole hospital is doing.

I know you don’t like reading about long delays and poor service at North Shore Hospital. I know you don’t like patients waiting too long or being treated rudely.

What these results show is that if the whole of the hospital team commits to reducing over-crowding and delays, then treatment quality and patient satisfaction both improve.

In the context of the current economic environment, the Lakeview Extension represents a significant commitment from the DHB and investment from the Government towards meeting the health needs of Waitemata DHB’s population.

More important than the facility itself will be the way you plan to change the way you care for patients.  New “models of care” will be critical for improving care and the performance of your health board. 

Closer integration of services across hospitals and the community will improve convenience for patients and reduce pressure on hospitals.  

Your Assessment and Diagnostic Unit will support primary care practitioners to avoid unnecessary hospital admissions by providing a same day clinic for patients requiring specialist assessment, but not necessarily admission. 

These careful and much better connections between primary and hospital services should make care management better for patients and for all clinicians.

And there’ll also be expanded radiology service here too.

GPs and specialists should expect less stress in their daily work as patients get a better, more expeditious health care journey.

In March, parts of Lakeview’s new Emergency Department and Assessment and Diagnostic Unit will become operational. 

It is a great privilege being Minister of Health. And I want a second term in this job. Because the public health service in New Zealand is now making real progress for patients.

Unlike so many other countries around the world, ours is a government determined to protect and grow the public health service.

But we are borrowing $300 million a week and that can’t continue if we are to avoid the sort of meltdown seen in other countries.

As we all know, the demand for better and more health services grows every year, always faster and stronger than any funding increases.

But our investment in Health has kept pace with inflation and population change.

In 2009, Vote: Health got half of all new government spending - some $750 million. The other 30 plus Votes shared the other half.

This year, Budget 2010 made available $512 million to Health for new spending, some of it from reprioritised money within Health.

Money will be tighter in the coming year. More than ever, DHBs need to ensure they get the best value they can from every health dollar. Just as you are doing here.

The increase in available beds, more efficient patient care between the hospital and community, and improvements to patients facilities mean nothing less than a transformation of emergency care services at North Shore Hospital.

Patients will get a better service, and better outcomes. And staff will no doubt enjoy that, and the better work environment.

My congratulations to everyone for the work you have done to get this far.

It gives me great pleasure to join you in opening Stage 1 of the new Emergency Department and Assessment and Diagnostic Unit at North Shore Hospital.