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David Clark has spent a lot of time attacking National over Dunedin Hospital. With his chance of being health minister boosted by Jacinda Ardern’s leadership, he may soon have to defend it, reports Eileen Goodwin. 

Dunedin Hospital’s woes proved a useful source of ammunition for Dunedin North MP David Clark to prove himself in his first two terms. Leaking operating theatres, struggling services, a delayed rebuild, and a food outsourcing debacle furnished rich material for the up and coming MP.

In a couple of weeks, Dr Clark might have to start answering for its failings. Every government deflects criticism by blaming the last one. It worked well for National, and Labour will be no different.

National will seize on Dunedin Hospital to attack the new minister in his home patch.

The Dunedin Hospital rebuild could prove trickier than Labour expects.Its guarantee of a central city rebuild will be predicated on working with the University of Otago to free up a site.

Even with university land, procuring the site will probably involve commercial purchases. Labour will be under pressure to start the build in its first term. It will be hoping to avoid invoking the Public Works Act. It plans to set up a group with the city and regional councils, Ngai Tahu, and the university, which will take time. It is unclear whether the politically appointed group led by rebuild chairman Andrew Blair would continue under Labour. Perhaps the source of most pressure and embarrassment will be the existing facility.

It has to limp along until the new hospital is built. Labour will need to decide how much to spend on a facility that is likely to be torn down. It will not want publicity about leaking operating theatres, but neither will it want to answer for over-the-top spending on a building at the end of its life. Its promise to rule out a public-private partnership is more straightforward. Under National, Dunedin Hospital’s privatised rebuild will be an experiment, as no major hospital has been built under this model in New Zealand, and it will face serious public opposition.

Labour will need to make a decision on what to do about capital charges on public money, as the Southern DHB is unable to afford an annual charge on $1.4 billion.

Labour has said it will review public capital charges (National already has a review under way). Dr Clark is also promising to review the controversial population-based funding formula. While the official line is that all boards complain about the funding formula, thus it must be about right, those who know mostly acknowledge it does not work for the South.

One issue is lower house values in this region, meaning the DHB has to front up with more rest-home subsidies in aged care. Then there is the issue of providing a top-level "tertiary" hospital in an isolated area where the in-flow of patients from other areas is minimal, reducing revenue.

Dr Clark understands these problems, but if a review reveals spending shortfalls, it could create a headache if Labour’s health budget is already committed.  Hopefully, Dr Clark will be more amenable to interview requests than National’s Jonathan Coleman. The Health Minister has never agreed to an interview with the Otago Daily Times, despite the many problems affecting the health board and his sacking of  board members in 2015.