With the Government under fire over the lack of new mental health beds, one DHB has been clashing with the ministry about adding four extra to a planned new build. Oliver Lewis reports.
Documents obtained by Newsroom show the Bay of Plenty District Health Board (BOPDHB) and the Ministry of Health have been ‘debating’ the number of beds needed in a planned new mental health unit at Whakatāne Hospital. The documents, which date from late last year, show at the time the ministry was opting for a 10-bed build, the same number as the existing unit, while the DHB considered the minimum should be 14.
“The DHB mental health service would rather fix up the sub-standard existing building rather than support the $18m investment in a 10-bed facility,” the form, a spreadsheet detailing future capital projects, said.
It comes as the Government faces mounting pressure over its performance on mental health, in particular the delivery of a record $1.9b package announced in Budget 2019.
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Following a Newsroom series on the dire condition of inpatient mental health facilities and systemic overcrowding, Newshub last week published a story claiming just five new mental health beds had been added since Budget 2019.
Little refuted the five bed claim, indicating in the House that the uptick in beds had come from other funding, not the $1.9b. However, he said he was “extraordinarily frustrated” that the spend was not flowing through fast enough to services, suggesting last week he would initiate a review of the package.
The health minister and National’s mental health spokesman, Matt Doocey, have both called for faster progress rolling out planned new mental health facilities. Only about $9m of the $235m for facilities included as part of the $1.9b has been spent.
The new Whakatāne unit was announced in early 2020 as part of the $300m New Zealand Upgrade Programme. Crown funding was estimated at $15m. Documents released at the time said the replacement facility would provide better support for service users and meet future demand.
Problems with the current 10-bed unit, called Te Toki Maurere, included fire compliance and seismic issues, according to the documents obtained by Newsroom under the Official Information Act (OIA). An Ombudsman inspection report published in 2019 said the unit looked uninspiring and tired, while the seclusion and low stimulus space was described as dark and oppressive.
The unit also routinely runs over its 10-bed capacity.
In the year to November 2020, the unit had more service users than funded beds for 142 days, more than a third of the year. There were more beds available, but once they were used up, an earlier OIA response from the DHB indicated people were housed in other rooms, including the assessment lounge and in the seclusion rooms.
In response to Newsroom, BOPDHB facilities and business operations general manager Jeff Hodson said the number of days where the unit was over occupancy had been increasing over the years. Demand was high, he said.
Newsroom asked if the DHB and the ministry had reached an agreement on the number of beds. Hodson said service planning was underway and the business case for the project had not yet been approved.
“The exact number of new beds is still being determined through service planning across the wider continuum of care,” he said. Increasing capacity was not just about inpatient facilities, Hodson added. It could involve beds in the community or other step-down alternatives.
Newsroom asked why there was disagreement on bed numbers, and if it had slowed down the planning process. Hodson did not address the second part of the question.
“It is critical that we do service planning to ensure we are building appropriate facilities for our communities.”
A ministry spokesman said it would be wrong to say the ministry was insisting on any specific number of beds.
“The District Health Board and the ministry have been working on service planning and the outcome of this work will inform the appropriate number of beds required.
“This is critical work and will underpin the business case development and determine the cost of the investment.”
If bed numbers could not be agreed on, the DHB estimated the fallback option to upgrade its existing facility would cost $10m, according to the OIA documents. Creating a new, 15-bed facility would see the budget increase to $25m.
