OPINION: By Ian Powell
In December the regular newsletter of the Kāpiti Health Advisory Group (KHAG – an advisory committee of Kāpiti Coast District Council) reported that its polyclinic initiative (endorsed by KCDC last May) was “out of reach”.
The polyclinic initiative involved the gradual expansion of the services at the Health New Zealand owned Kāpiti Health Centre in Paraparaumu to become a health polyclinic providing community care, urgent care, and non-acute hospital diagnosis and treatment.
Less than two months later, however, KHAG reported that the polyclinic initiative was “…very much alive and continuing to gain ground.” In other words, it was ‘in reach’. What a transformation! What was behind this claimed turnaround? Surely not a surprise Christmas present from Santa!
Alas Santa had nothing to do with this dramatic change. Rather it was my column published by KC News on 15 January responding to KHAG’s “out of reach” comment.
I put it in the context of KCDC senior management arbitrarily taking over the lead role in implementing the polyclinic initiative once KHAG had done the hard yards in getting KCDC endorsement for it last May. I also referred to the limited health system experience within senior management.
PR damage control campaign
This led me to ask whether the polyclinic initiative that I was central to its development was now a “dead duck”. On 3 February KHAG Chair Sandra Daly responded in KC News arguing that the duck wasn’t dead; instead it was very much alive and still quacking (my paraphrasing). This was followed by a similar but shorter statement from KCDC to Beach FM and a more expansive article in the fortnightly print Kāpiti News largely based on comments from Sandra Daly. The latter included more background on the original development of the polyclinic initiative.
There is only one problem with this PR campaign in response to my KC News column; it is embellished. The groundwork for much of the progress claimed was already undertaken before KCDC senior management took over the lead role in the polyclinic initiative in June.
I was at the first formal meeting with Health NZ where this was further discussed. It was only at that meeting that it started to become evident that senior management were taking the initiative over. Subsequent events confirmed this thereby forcing my resignation from KHAG. There has been little practical advance in the following over eight months since then.
Unfortunately senior management lacks sufficient experience and persistence in working beyond the scenes to progress issues in between formal meetings which, to make it worse, are infrequent. They also lack the time to undertake this basic work because of their many other time-consuming duties.
The unsurprising outcome is that the momentum with Health NZ that had been developed before KCDC endorsed the polyclinic initiative last May, and that needed to continue, has been lost.
I resigned from KHAG because the conduct, relative inexperience and arrogance of senior management meant that I could no longer play an effective role in pursuing the initiative. Instead I assessed that my advocacy for the polyclinic would be more effective outside KHAG; the PR response to my KC News column vindicates this assessment.
Leadership culture
There is a related wider issue that arises out of this situation. I’m not the first to resign from the wider KHAG group. KHAG has a number of subgroups which do good work. One focusses on population health.
Although the circumstances are different, frustration with the attitude of management was a key factor in the resignation of a locally based public health specialist from this subgroup.
KCDC has a number of other advisory groups including on economic development, climate change, older people and youth. These are all good initiatives and made up by volunteers with a range of experiences and expertise. I understand that KHAG is not alone in experiencing this type of frustration.
The challenge is when the volunteers on the advisory groups have more expertise and experience than the KCDC management they sometimes need to work with.
With the right engagement and respectful senior management leadership culture this challenge should be a positive tension that works well for all. Unfortunately this was not the case with the polyclinic initiative.
It is incumbent on KCDC to ensure that this leadership culture is pervasive throughout its senior management. KHAG leadership toughening up a bit would not be a bad idea either; just saying!
Column by Ian Powell