Ashburn staff laid off

An article from the Otago Daily Times by Eileen Goodwin

Involuntary redundancies at Dunedin's Ashburn Clinic have been lower than expected, with only two full-time staff forced to take redundancy among the staff laid off, says clinic business manager Lindsay Smith.
Last month, Ashburn, the country's oldest private psychiatric hospital, announced it had to drop 9.7 full-time equivalent (FTE) staff to cope with a $900,000 funding shortfall.
It has also mothballed a hostel for self-sufficient patients - Alexander House - to save heating costs during winter.
Mr Smith said the staff cuts were managed mostly through voluntary redundancies or staff agreeing to fewer hours.
On top of two involuntary redundancies, one worker had been unwilling to take a 0.5FTE role, and was "snapped up by Cadbury's".
Mr Smith's own position reduces from full-time to 0.5FTE.
As well as that, kitchen staff reduce 1FTE, psychiatric staff 0.7FTE, psychotherapy 1FTE, office staff 1FTE and nurses 5.5FTE.
"It has been distressing for staff to see long-time work colleagues going, and to see Alexander House shut."
Ashburn, established in 1882, had never had to cut staff before, he said.
Staff were already being farewelled, almost on a daily basis.
Ashburn had to move quickly once it realised the seriousness of its financial position.
The patients were "coping brilliantly" with the changes, which included combining two inpatient wards in order to temporarily close Alexander House.
Ashburn's "therapeutic community" meant patients were included in the change process, he said.
During the past five years, ACC funding for sexual-abuse inpatients dropped from $2 million to $900,000 in 2009-10, with referrals now non-existent.
The clinic has also lost a $500,000 five-bed eating-disorder contract with the Ministry of Health, although earlier this month it picked up a more modest outreach eating-disorder contract from the Southern District Health Board.
Ashburn has also been hit by the recession, with private patients opting for shorter stays.

© Allied Press Limited 2010
http://www.odt.co.nz/news/dunedin/117930/ashburn-staff-laid

Mental health funds slashed by more than $20 million

A press release from the Labour Party by Ruth Dyson

Community and public mental health programmes have had their funding cut by more than $20 million, Labour Health spokesperson Ruth Dyson says.
“Budget papers released last week revealed a $4 million cut to mental health training, $4.2 to Like Minds-Like Mine and $5 million to mental health research. A further $6 million in health promotion around mental health issues was cut, $1 million in alcohol and drugs programmes, $200,000 in mental health advice, $1.2 million to not apply the future funding track for anticipated demographic rises; all these cuts totalling $21.6 million,” Ruth Dyson said.
“This comes on top of cuts of $4.2 million last year to Mental Health Blueprint funding and does not include the $600,000 cut in mental health funding at Nelson Marlborough DHB, or the partial closure of Ashburn Hall and the loss of 10 staff and their 5 eating disorder treatment beds.
“Money simply should not be removed from community or public mental health services.
“The Budget documents released last week show that the National Government does not view community or public health initiatives as a priority.
“It’s fairly obvious that cuts in these programmes are being used to fund the new $6 million in set-up costs for the National Health Board and the more than $40 million needed over the next four years to pay for patients dumped by ACC onto public hospital services.
“Health Minister Tony Ryall can claim all he wants that cuts to programmes like mental health training are going back into frontline services, or there is some kind of health ‘switch’, but it simply isn’t true and the public knows that. Under National there have been more than 80 cuts to patient services, and budget documents reveal that the number of cuts will continue to increase.
“It's clear that the National Government doesn’t value community or public health initiatives and the health of New Zealanders will suffer as a result,” Ruth Dyson said.

http://www.scoop.co.nz/stories/PA1007/S00202.htm

Question to Minister: ACC - Culture Change

Hon ANNETTE KING (Deputy Leader—Labour) to the Minister for ACC: Does he think the huge culture change within ACC has gone too far?
Hon Dr NICK SMITH (Minister for ACC): I am very conscious of the need to get the balance of accident compensation right between containing costs and levy increases and ensuring that people receive their proper entitlements. Costs were clearly out of control under the previous Government, and a culture change was needed. I am closely monitoring the accident compensation review data, and would be concerned if there were an increase in the number of Accident Compensation Corporation (ACC) decisions being overturned. There is no such trend. A similar proportion of claim decisions are being upheld now as were upheld under the previous Government, indicating that ACC has got the balance right.
Hon Annette King: As part of that culture change, does he recall ACC saying: “We take our relationship with counsellors and clinicians seriously,”; if so, why has he not ensured that ACC takes seriously the warning from clinicians at Ashburn Clinic - health professionals who provide New Zealand’s foremost treatment programme for victims of sexual crimes, who have had no referrals from ACC since October, and who have had to lay off 10 crucial staff?
Hon Dr NICK SMITH: Clinical decisions, whether in terms of surgery or in terms of sensitive mental health issues, are properly made by clinicians. I would be concerned if decisions that had been made by ACC’s clinicians were being repeatedly overturned in the independent review process. That would suggest that ACC had got the balance wrong. In regard to the specific issue of sexual abuse, I have initiated an independent review, which is being done Dr Barbara Disley, and I am looking forward to receiving her report.
Hon Annette King: Does he recall ACC saying that it would like to explain the changes that have been made for victims of sexual crimes so that clinicians can see “what we are doing to improve service performance”; if so, how does he intend to explain the loss of the long-term residential service at Ashburn Clinic, which had helped victims rebuild their lives - a loss because of a $900,000 shortfall, while he boasts of a $2 billion surplus?
Hon Dr NICK SMITH: The key decisions on whether clients go to Ashburn Clinic or receive care in other establishments should be made by clinicians, not Ministers. If Ashburn Clinic or any members opposite believe that people are inappropriately being turned down for treatment, the proper process for them to follow is to seek a review of the case. If the member has evidence of that, I would be more than happy to see it.
David Bennett: By how much did ACC’s claims and administration costs go up over the preceding 4 years, requiring a change in culture?
Hon Dr NICK SMITH: ACC administration costs between 2004 and 2008 went up by an average of $50 million extra per year—that is, from $302 million in 2004 to $494 million in 2008. In the National Government’s first year we reduced those administration costs by $35 million. Claim costs between 2004 and 2008 went up by nearly $300 million extra every year - a rate of increase that was 5 times the rate of inflation. That was clearly unsustainable. As in so many parts of the public service, Labour let costs get out of control.
Hon David Parker: Can the Minister not see that the change of culture and the push towards privatisation that he has lauded are exactly what led his appointed chair of ACC, John Judge, to say that doctors, in addition to facing disciplinary action, should pay financial penalties for medical errors?
Hon Dr NICK SMITH: Firstly, the member deliberately misquotes Mr Judge. He deliberately misquotes him, as is so often the case.
Hon Trevor Mallard: I raise a point of order, Mr Speaker. To deliberately misquote is to mislead the House. That allegation is not allowed to be made by a member of Parliament by way of answer.
Mr SPEAKER: I accept the point the member makes. Perhaps the member could change his language so that he is not making that accusation.
Hon Dr NICK SMITH: The member misquotes the chair of ACC, who has had an incredibly challenging job, given that the previous Government in just 3 years, according to the audited accounts, let the liabilities of the accident compensation scheme blow out by $10 billion. Mr Judge has had an awfully challenging job to try to get them under control.
Hon David Parker: Is the Minister concerned that the chair of ACC is so obviously out of touch with the underlying principles of our accident compensation system that he is clearly pushing towards a litigious, Americanised private insurance model?
Hon Dr NICK SMITH: The member is way off beam. This Government is totally committed to an efficient, 24/7, no-fault scheme. But I make no apologies for this Government and Mr Judge looking at sensible ways that we can engage with the private sector to better manage claims in order to rehabilitate patients more quickly. I congratulate Mr Judge on reversing the decline in rehabilitation rates that occurred under the previous Government.
Hon David Parker: Why is the Minister so at ease with the undermining of the current accident compensation model by moves to privatisation and financial penalties for doctors—which is what John Judge did say, I tell the Minister—when it is abundantly clear that the Americanised insurance model that he and Mr Judge are pushing New Zealand towards leads to more conservative and expensive medical treatment as well as money being wasted on lawyers and insurance company margins?
Hon Dr NICK SMITH: Under any model to incorporate the private sector that this Government looks at, exactly the same entitlements will be involved and exactly the same independent review processes will be involved. Be we make absolutely no apologies for wanting to use the private sector so that we can rehabilitate people and get them back to work where they can make a positive contribution, rather than continuing the culture of the previous Government, which seemed happy to have thousands and thousands of New Zealanders sitting on accident compensation, not being rehabilitated, and not able to work.
Hon Annette King: I seek leave to table a letter from the medical director of Ashburn Clinic, which states: “Our primary concern is the care of the patients who are being denied treatment under the current ACC guidelines.”
Mr SPEAKER: Leave is sought to table that document. Is there any objection? There is no objection. Document, by leave, laid on the Table of the House.
http://www.scoop.co.nz/stories/PA1007/S00006.htm

$900,000 shortfall; clinic losing ten staff

An article from the Otago Daily Times by Eileen Goodwin

Dunedin's Ashburn Clinic is losing nearly 10 full-time equivalent staff, combining two inpatient wards and mothballing a hostel to make up a $900,000 funding shortfall.
Business manager Lindsay Smith said yesterday the clinic had lost ACC referrals for sexual abuse sufferers, a Ministry of Health eating disorder contract, and had fewer DHB referrals and self-referrals.
The hospital was staffed for 45 to 50 patients, but needed to provide for 30 to 35.
Two inpatient wards - Gwen Wilson and Frank Hay - would combine as a single ward. Alexander House, a residential building catering for nine self-sufficient inpatients, would be mothballed, with its inhabitants moving to the former Frank Hay ward. Closing the building would save about $100,000 annually on power bills.
The clinic was choosing to mothball the hostel, rather than the extra ward, because it was more expensive to heat.
Mr Smith's own position would halve, in a voluntary move, which would allow him to stand in October's elections as a city councillor, he said.
Kitchen staff would reduce by one full-time equivalent (FTE), nurses 5.5 FTE, psychiatric staff 0.7 FTE, psychotherapy 1 FTE and office staff 1 FTE.
All up, 9.7 FTE would go, although it was not possible to say yet how many actual staff members that entailed. Details would be worked through in the next two to three weeks.
It was important the clinic acted before the situation worsened.
Ashburn did not have a shortfall for the 2009-10 financial year.
During the past five years, ACC funding for sexual-abuse inpatients dropped from $2 million to $900,000 in the 2009-10 financial year. Referrals for the service were now non-existent. ACC stopped using the contract between six and nine months ago.
The clinic lost a $500,000 five-bed eating-disorder contract with the Ministry of Health, effective from the end of this month.
DHB referrals had dropped too, and private paying patients were opting for shorter stays.
The clinic raised its fees last December, had become more proactive in gaining new contracts and introducing new programmes, and had cut costs.
Deputy medical director Dr Stephanie du Fresne said losing staff - Ashburn's "treasure" - had been distressing as the clinic enjoyed a stable workforce with extremely low staff turnover. Dr du Fresne said staff and patients had worked together to find creative ways to save money, reflecting Ashburn's philosophy as a "therapeutic community" empowering patients.
ACC claims management general manager Denise Cosgrove, responding by email, said the contract with Ashburn for intensive residential rehabilitation remained, but long-term treatment was not always the most appropriate for sexual abuse sufferers. Funding to Ashburn had been dropping since 2002-03, when it was about $2 million a year, she said.

http://www.odt.co.nz/news/dunedin/112875/900000-shortfall-clinic-losing-10-staff
© Allied Press Limited 2010