Many may view last week's announcement to extend the term of the commissioner appointed to oversee the Southern District Health Board by three years (bypassing the 2016 local body elections until those in 2019) with shock and outrage.
Health Minister Jonathan Coleman says the extension (unprecedented in the health sector and requiring a law change to implement) is because progress is being made in turning around the board's deficit, but more time is needed to implement the commissioner team's work plan (the one-page document released at the beginning of last month, more than four months after board members were sacked by the Government and the commissioners appointed).
The news may increase the anxiety levels of those who fear the Government has a hidden agenda. They will point to a history of unease: Dr Coleman's rejection of commissioner rumours in April, before he installed one in June; his statement that month the 2016 board election would go ahead, but one from a spokeswoman last week saying that had not been promised; the announcement of funding approval for some Dunedin Hospital unit upgrades and the appointment of a Southern Partnership Group to work towards the full clinical services building rebuild, but only one South Island appointee on the group and ongoing delays in the rebuild business case.
Then there is the official document which states the hospital upgrade is ''being used as an opportunity'' to change how health services are delivered in the South; and debate around the actual deficit, and therefore the commissioner team's supposed progress.
So often, important announcements generate more questions than answers. Dr Coleman was reportedly too busy to talk to this newspaper for the two days following this announcement, which was emailed to media. That does not help generate trust.
On the other hand, was there actually any other choice once the Government intervened but to keep the commissioner team on? Elections next year would surely put the whole process back even further.
And given the situation, would there be enough willing - and able - people to take on the board roles?
The board's forecast deficit of between $30 million and $42 million for 2015-16 was clearly unsustainable - arguments around the population-based funding model aside.
If the board and previous ones couldn't achieve a quick or easy fix, how can the Government do so - short of making drastic cuts to staff and services.
The fact that hasn't been done, and the commissioners have another three years to make progress, leaves room for hope.
But there is so little information available on which to make judgements. If difficult decisions need to be made - and no-one is unaware of the pressures on the health system - the least the public deserves is open, honest communication about them.
Transparency and accountability are as important for the Government and commissioners as the board. After all, some of the Government's health decisions have been questionable. (The scrapped cost-cutting entity Health Benefits Ltd is a case in point.)
For the moment, all the public can do is trust Dr Coleman's official statement that: ''Exempting Southern DHB from next year's board elections is essential to give the commissioner team time to implement the financially sustainable plan to ensure that high-quality health services are delivered, as well as the vital redevelopment of Dunedin Hospital.
''It will also ensure that the next board, to be appointed as part of the 2019 local body elections, will begin its term on a more secure financial footing.''
It is certainly to be hoped the additional three-year time frame will, if not heal all wounds, at least not open any new ones.
