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Just 3pc of $500m ‘drawn down’ to improve or build mental health facilities

Author
RNZ,
Publish Date
Tue, 28 Mar 2023, 11:05AM
The Mason Clinic in Waitematā. Photo / Google Maps
The Mason Clinic in Waitematā. Photo / Google Maps

Just 3pc of $500m ‘drawn down’ to improve or build mental health facilities

Author
RNZ,
Publish Date
Tue, 28 Mar 2023, 11:05AM

By RNZ

New figures show the Government has called on just 3 per cent of the half a billion dollars approved to build or expand mental health hospital facilities.

It has “drawn down” just $15 million of the $501m Crown funding for a dozen projects, according to the figures released by the National Party, which is calling it a ‘“tragedy”.

Health bosses, though, say this is no reflection of where progress is at.

At the same time, revised dates for when the doors might finally open, released to RNZ, confirm that times are slipping, as projects cope with the fallout from what an official review called years of “over optimistic”, “unrealistic” and “light touch” planning.

Mass overhauls were promised in 2019 to facilities that Ombudsman inspections have found are often old, overcrowded and sometimes plain awful.

But by 2021, then health minister Andrew Little said he was “extraordinarily frustrated” at the slow progress, while at the same time, the Government rejected National’s calls for an inquiry.

Former Health Minister Andrew Little. Photo / File

Former Health Minister Andrew Little. Photo / File

On Monday, National’s mental health spokesman Andrew Doocey said “nothing has changed”.

“Two years on, we find there’s been no meaningful improvement.”

The Government put an implementation unit in charge in 2021 to push things along but it had not delivered.

“I think it speaks to incompetence at the top. Clearly what we need is leadership.”

Te Whatu Ora said the low figure of how much Crown equity had been drawn down was “not a reflection of progress”.

“The bulk of funding is not drawn down until after construction begins,” it told RNZ yesterday.

Planning, design, and civil and earthworks were usually done first, by the local hospital, before central funds were drawn down, it said.

However, the latest figures, set alongside previous equivalent figures, show the drawn-down total only inching up since 2021.

It stands now at $15.6m, just $9m more than 16 months ago. According to what the Government has said previously, this shows not much actual construction has begun.

The Ministry of Health has known for at least two years about “delays and quality issues in planning and business case preparation” identified in a 2021 government progress report.

Last year, the Government ordered a “deep-dive” review, and last week quietly released a briefing about the findings.

The review called for a full reset on five of the projects, and urgent action on another four to reduce the growing risks.

This week, further details have come to light.

On the drawn down funds, out of 12 projects funded in Budget 2019, nine of them had had zero Crown funding drawn down as of two weeks ago.

This includes for the $155.1m Waikato adult mental health facility, and the $20m West Coast mental health unit.

At the $160m rebuild of the Mason Clinic at Waitematā, just $500,000 had been drawn down.

Nine of the 12 projects are at the stage of post-approval design. One (Northland) is being built, and two (Whakatāne and Tauranga) are back at start-over point, doing another business case.

A Te Whatu Ora report last year said there was not enough money to do both of them.

As for the revised opening dates, in the worst cases, three projects - Lakes, MidCentral and Waitematā - were originally expected to be finished by 2022, and are overdue by more than three years.

Others never had an original end date, but did have an interim opening date; in four cases they are on track to meet that interim date, while several others have blown out by a year on average.

The budget figures do not take into account a blowout at MidCentral, which was budgeted at $30m, but has asked for another $27m.

The deep-dive review said more planning controls were being introduced by Te Whatu Ora.

Doocey labelled it “an absolute comedy of errors”.

“I mean, some business cases, there was incorrect number of beds ... one new build had the wrong site. And another new build had a business case where there was no project team in place, no plan or no timeline.

“It’s actually a tragedy because people’s lives are at risk.”

He had a 34-point plan to fix things if National won the election and made him the inaugural mental health minister.

Health Minister Ayesha Verrall was asked for comment.

Health Minister Ayesha Verrall. Photo / Jed Bradley

Health Minister Ayesha Verrall. Photo / Jed Bradley

Te Whatu Ora taking on oversight

Mental Health and Wellbeing Commission / Te Hiringa Mahara chief executive Karen Orsborn agreed progress had been slow and said it was important inpatient facilities were upgraded so that better treatment could be provided.

The establishment of Te Whatu Ora should provide better oversight and “faster traction” for the projects, she said.

“Stronger oversight of the complete programme of work would quite a big difference... They’re complex building projects.”

Karen Orsborn. Photo / Mark Coote

Karen Orsborn. Photo / Mark Coote

Consultation with clinicians, iwi and communities was also an important part of the process but it took time, she said.

Orsborn said there also needed to be a stronger plan around establishing a workforce.

“What is the staffing that is required, what’s the mix of staffing, the mix between clinical staff, staff with lived experience, cultural workforce and what’s the pipeline to develop those workforces and have them readily available to work in these facilities.”

Inspections by the Ombudsman since 2019 have found a series of facilities were “not fit for purpose”.

Two of the 16 mental health projects have been completed - the two started before 2019. One other, at Hutt Valley, is mostly privately funded so was not assessed.

Back in 2021, officials were warned that district health boards lacked “capability to do enough of the planning for the Government to be able to set indicative timeframes for project completion”.

Te Whatu Ora told RNZ that the main reason for project delays now were unforeseen or procurement issues, consenting delays, cost escalations and international supply chain delays.

Wet weather in the upper central North Island - Te Manawa Taki - was adding to time and costs.

At Lakes in Rotorua, the 50-year-old mental health was getting patched up as previous inspections had found insect infestations.

Its new unit has slipped from an original opening estimate of July 2022, to early 2025.

While the deep-dive said Lakes needed a “health check”, Te Whatu Ora now said those issues had all been ironed out and there was no need to re-visit the business case.

Designs were done, earthworks were under way and a contractor should be appointed mid-year.

- RNZ

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