'Absent management' in 'Wild West' environment, says Central Health review

A review of Central Health management released Thursday tells a tale of two towns: Gander and Grand Falls-Windsor, with an "us against them" mentality and a "'Wild West' feeling that anything goes when there is 'absent management.'"

Newfoundland and Labrador Health Minister John Haggie, whoannounced the review in February, said overall he's "really pleased," by the report, which was received at the beginning of the week, released to the Central Health board and then released publicly.

"There's work in there for everybody to do. There's items for government, there's items for the board, for the physicians, and for the communities," Haggie told reporters.

Disparity in service levels

The report notes disparity in service levels in some areas between the two towns, with "leading practices in both collaborative care and primary-care obstetrics" in Grand Falls-Windsor but struggling services in Gander.

The report recommends more collaboration between the two municipalities.

"It's crucial that we have viable obstetrics services in both locations," said Haggie.

"I think what we have are some huge opportunities. We have the midwifery program rolling out. There is a commitment to place that in Gander and use that as a test bedfor rural, low-risk obstetric services."

Haggiesaid he doesn't see Gander and Grand Falls-Windsor as competing for resources but rather supplementing and backing each other up.

"There's always a little bit of difference between the two, and I don't think you should imply anything more than that," he said.

The report said part of the problemis that the integration of the previous health authority boards into Central Health was seen as being done "in name only."

"Silos and rivalries between the two referral facilities have perpetuated an 'us against them' mentality the board and senior management have been unable to resolve," says the report, which adds there is a feeling that Gander services suffer because the corporate offices are located in Grand Falls-Windsor, where the majority of senior staff live.

Haggieacknowledged that mentality is a problem, despite the many recommendations 32 in all made by the report.

"In terms of difficulties between communities that live near each other, it's a wiser man than I that can come up with a recommendation in front of a microphone as to how to remedy something like that," he said. "It's a problem, I accept, and the magnitude of it, and how you fix it, I'll leave to wiser minds than mine."

Among the recommendations:

• Incentivize collaboration between the municipalities of Grand Falls-Windsor and Gander.
  
• Amend board bylaws to open meetings to the public beyond the annual meeting.
  
• Hold management accountable for measurable improvement in organizational culturecivility and respect.
  
• Locate senior management offices equally between Central Newfoundland Regional Health Centre in Grand Falls-Windsor and James Paton Memorial Regional Health Centre in Gander.
  
• Human resources leadership should "make a concerted effort to be visible, get out of their offices and talk to and listen to staff where staff work on a daily basis [report's emphasis]."