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Michelle Arrowsmith’s unexpected resignation comes in less than two years from what has been described as a controversial term. Oliver Lewis reports.
A top Health Ministry executive responsible for overseeing massive hospital constructions and the performance of the district health board abruptly resigned.
As DHB’s Deputy Director General for Performance, Support and Infrastructure, Michelle Arrowsmith controls one of the largest and most important directorates in the ministry.
His resignation was announced to staff last Friday, less than two years after he took office in December 2018.
The departure of such a key executive so early in his tenure is unusual, according to healthcare sources, who emphasized the impact Arrowsmith’s loss would have on the ministry, as it comes at a crucial time for DHBs, which They have been working through their annual plans.
However, his time on paper has not been without controversy.
“I am aware that the healthcare industry and in particular DHBs found their style difficult and abrasive,” said health commentator and former senior physician union executive director Ian Powell.
“There was widespread anguish and tension from DHBs in general about his style.”
Arrowsmith had a top-down approach, Powell said, which he said was characteristic of the administration on the NHS in the UK, where he previously worked for 20 years.
Another healthcare source, who spoke on condition of anonymity, said of Arrowsmith: “It was very direct. And I think probably some CEOs and presidents could have been offended by that. “
Arrowsmith declined to comment when approached by Newsroom and referred questions to the ministry instead.
The ministry declined to comment.
Arrowsmith’s leadership is responsible for ensuring a strong working relationship between the ministry and DHBs, ensuring leadership and support for DHB planning and funding, ensuring accountability for operational performance, and overseeing infrastructure and projects. capital of DHB.
During his time in office, DHBs have run record deficits.
In 2018-19, the 20 DHBs posted a sector-wide deficit of more than $ 1 billion (a large amount of which was for one-time items, including Holiday Act back payments); As of March, they were heading for a projected deficit of $ 643 million for the year 2019-20 (the ministry did not provide more up-to-date figures).
And that has caused renewed pressure from the government.
Shortly after taking office, Health Minister Chris Hipkins told DHB Board Chairs that, with increased funding provided to DHBs, the government expected the health board deficits to return. zero in two years, according to the minutes of a public. section excluded from a Canterbury DHB board meeting obtained by Newsroom.
Arrowsmith has been a key figure in trying to force DHBs to make more savings, in part by providing feedback on their preliminary annual plans.
The same minutes from the July CDHB board meeting show that she wanted DHB to recover $ 90 million this financial year, a request deemed impossible by management.
Instead, the CDHB board voted last month to present an annual plan with savings of $ 56.9 million, including $ 16.5 million in nursing care. As the vote was taking place, protesters outside the Christchurch corporate office gathered to express outrage at the proposed cuts and concern over the unprecedented exodus of senior managers.
In recent weeks, the CDHB has lost seven of its 11 senior management team members, including CEO David Meates. One of the outgoing executives, Medical Director Dr. Sue Nightingale, has attributed her decision to leave to a supposedly antagonistic and divisive approach from the Crown council and monitor, Dr. Lester Levy.
The CDHB posted a deficit of approximately $ 180 million in 2019-20, the largest of any board of health, yet much of this is made up of capital charges and depreciation costs; CDHB management has also pointed out the costs associated with the delays in entering the new Christchurch Hospital Hagley building.
When asked about the impact of Arrowsmith’s resignation, Levy said that he and the CDHB board needed an ongoing link with the ministry to answer questions and issues.
“That link is even more critical to CDHB management, especially in relation to infrastructure,” he said.
While there were people in the ministry and at the CDHB who could provide continuity, Levy said that for all DHBs, the role of Arrowsmith “will be an important role for the [ministry] to replace”.
Hipkins declined to comment on Arrowsmith’s departure and did not directly address the timeframe of DHB’s two-year deficit, saying instead “we do not accept that deficits are inevitable.”
The government had provided substantial increases in operating funding to all DHBs, including an increase of $ 980 million per year in the latest budget, Hipkins said.
“We do not expect all DHBs to recover immediately after years of underfunding, but it is important that they show that they are moving toward this goal and that they are doing so without cutting services.”
As part of his role, Arrowsmith also oversaw DHB’s infrastructure projects, including the $ 1.4 billion Dunedin Hospital remodel and the $ 525 million Christchurch Hospital Hagley Building.
A source close to the Dunedin project told Newsroom that she wielded considerable influence when it came to decision making.
The email informing staff of his resignation said that Arrowsmith would take time out to pursue other career opportunities in the UK.
Powell said his departure left a vacuum in the ministry, adding that it would be difficult to find a suitable replacement and quickly bring them up to speed on the issues.
“It takes time to make a replacement appointment, so it’s a gap.
“But I think it also highlights how doubly confident you have to be about the person you’re appointing in terms of their relationship skills for such a critical role as this.”
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