Southern District Health Board chief executive Chris Fleming has apologised to the northern Southland community for the teething problems relating to turning the Lumsden Maternity Centre into a maternal and child hub.
But he has stopped short of sorry to the four women who experienced rapid births at the hub, because a separate report found that of the two women who were interviewed, both of their birthing outcomes were unavoidable.
A damning independent report from Ernst Young, which was released by the DHB on Friday, was critical of the DHB’s “informal” management processes during and after hubs were set up at Lumsden, Te Anau and Wanaka.
It was critical of the DHB’s project management, governance framework, and communications and change management, and it has made 10 recommendations.
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Fleming said while he thought the EY report was “reasonably balanced and quite fair”, he said there should have been a much more structured set up in place before the primary birthing unit became a hub.
When Fleming was asked how it could implement a hub service if it didn’t know what that was, he said: “We should have done better.”
“Clearly some of the things we know know, we could have done better at the time.
There should have been much more structure.”
It was clear that hubs would be used for emergency births, but there were issues with how they were to be equipped, and the there should have been a more structured handover, he said.
However, he said there were “tensions and challenges” in the community in terms of opposition to the transition to a hub, and the DHB had not done a good job at communicating with the northern Southland community.
“Given that, we should have redoubled our efforts in the set up, before the transition.
The hub setup had been “exceptionally difficult” for all of the DHB staff involved and it had lost some staff as a consequence, Fleming said.
But he says despite the issues raised in the reports, he has confidence in the hub model, there is no going back and the hub will remain.
“The outstanding biggie in all of this is what happens now?
“I don’t think the result will be a surprise to anyone.
The reports are helpful but they don’t establish a clear path that things are going to change and there’s a lot of unknowns attached.”
“An additional contributory factor pertaining to one woman was the lack of essential equipment available in the Lumsden hub in the presence of specific risk factors which could constitute the need for full resuscitation capacity,” the report says.
It says now, some women are planning to have a home birth out of necessity rather than preference, while other women are having unplanned homebirths because they are not confident that there is enough time to travel the extra distance to a birthing unit.