It is the latest in a long line of reports, strategic plans and advisory groups that have given Wakatipu residents hope of a major upgrade for their ageing, under-equipped hospital.
Last week’s release of the Sapere report, which cost $108,000, was a long time coming.
Australasian consultant Sapere Research Group was commissioned by the Ministry of Health early last year to consider how Frankton’s Lakes District Hospital might be run by a community trust instead of the beleaguered Southern District Health Board.
The report was born of mounting frustration in a community sick and tired of long trips to the region’s base hospitals in Dunedin and Invercargill to see specialists for routine procedures.
The 63-page report was finally released on August 8, along with a DHB announcement of a minor upgrade for the hospital.
It had a clear answer: rejection of a community trust model as the solution to Queenstown’s health woes.
The report’s release came more than a year later than initially indicated, and just over a month after the Otago Daily Times complained to the Ombudsman about the ministry’s repeated refusals to release it or even give a timeframe for doing so.
Ministry critical projects director Michael Hundleby says the delay was caused by the other issues it and the DHB have been grappling with for the past year — addressing the DHB’s deficit and its planned redevelopment of Dunedin Hospital.
Queenstown health advocate Maria Cole is in no doubt of the politics behind the report’s timing.
The simultaneous release of the DHB’s hospital upgrade announcement was "way too coincidental".
All politics aside, the report makes fascinating reading.
Its authors say the five rural towns in the DHB catchment that own their own hospitals are different from the resort: their populations are static and more homogeneous, they have a lower cost of living and a stronger sense of "unity and purpose".
Queenstown’s rapid population growth and rising visitor numbers require an investment in the hospital’s capacity at a "higher level than would otherwise be funded through a population-based funding formula".
Given the DHB’s financial position — an expected $34.2million deficit in the last financial year — it instead recommends a public-private alliance as the best opportunity for funding a major redevelopment.
The DHB has endorsed the report’s rejection of the community trust model, and tightened its grip on the hospital with a multimillion-dollar upgrade promise.
To be completed in 2018, the upgrade will consist of improvements to the emergency department, an audiovisual suite for telemedicine, general refurbishment and "exploring options" for a CT scanner and ultrasound services.
DHB deputy commissioner Richard Thomson says the board will address the hospital’s immediate needs "while we continue a fuller district-wide discussion about the longer term vision for Lakes Hospital".
The ministry has also slammed the door shut on self-governance, pointing to a public private alliance as the way forward.
Mr Hundleby told the ODT: "There is no precedent for self-governance of hospital facilities which service communities with the demographic and growth profile of Queenstown Lakes".
There are recent examples of private companies building facilities at public hospitals, Mr Hundleby says, and DHBs considering new hospital builds must consider public private partnerships in their business cases.
Mrs Cole finds the Sapere report’s conclusions about Queenstown’s unsuitability for the community trust model "less than convincing".
The report ignores the "enormous opportunities" of self-governance, instead focusing on potential pitfalls that she believes could be overcome with the right structure.
The "lack of precedent" argument is an expedient excuse for a lack of vision, she says.
"Unfortunately, we have long experience with the lack of vision emanating from the DHB and their history of consultations of one kind or another that have never taken us anywhere."
Although she sees potential in a public private partnership, the long-term prospects of a major redevelopment of the hospital remain up in the air.
"There is at this stage no long-term strategy for Queenstown, and indeed one could say there is considerable conflict of interest from southern interests who are somewhat reliant on a patient flow from Queenstown, necessary to continue their own funding streams and services.
"We need to be in control of our own destiny and not be reliant on out-of-town bureaucrats who may be reluctant to consider our needs objectively.
"We could have and should have the finest regional hospital in New Zealand."
However, Queenstown Lakes District Council candidate and GP Val Miller says the report is "by far the most enlightened" of the many written about Wakatipu’s health services over the years.
While a community-owned hospital may have been the right answer a few years ago, the Wakatipu’s population and visitor explosion meant it was unlikely to be viable.
She backs the report’s conclusions about the potential of public private ventures; private health providers such as Southern Cross had shown serious interest in the resort in the past, and particular services, such as surgery, will become viable when the population reaches a "critical number".
In the meantime, the resort’s political representatives — particularly its MP — need to be lobbying the Government for direct funding to redevelop the hospital, Dr Miller says.
"They can’t expect the community, or a DHB that’s strapped for cash, to do this."
