Canterbury’s health board chairman is being urged to "front up" over the abrupt and unexplained resignation of his top official.
David Meates resigned as chief executive of the Canterbury and West Coast district health boards (DHBs) on Tuesday, triggering an outpouring of tributes and, given he has just weeks left in the role, conjecture he may have effectively been forced out.
Meates, who has been chief executive of the CDHB since 2009, led the region's health response through a decade bookended by disaster, responding to both the earthquakes and the March 15 terrorist attack. He has also clashed with Ministry of Health officials to advocate over funding and facilities.
“I’ve been here 10 years, and I’ve never heard anyone speak badly of him,” Christchurch Hospital vascular surgeon Dr Adib Khanafer said.
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However, questions remain about why Meates has decided to call time on his position.
His resignation comes during a tumultuous period for the CDHB, which is under pressure to claw back a mounting deficit that reached roughly $180 million in 2019-20. Two other members of the 11-strong executive management team also resigned recently, leaving a glaring leadership hole.
Last month, senior clinical leaders at the CDHB wrote to Prime Minister Jacinda Ardern saying the board was seeking to cut $47m from its budget – the equivalent of 500 staff and community-based services – and pleaded with her to intervene.
They had reluctantly reached a point of no confidence in the board and the ministry, the clinicians said.
Board chairman Sir John Hansen, who was appointed by former Health Minister David Clark, confirmed Meates’ resignation in a message to staff following an emergency board meeting on Tuesday. The statement did not say why Meates resigned, and Hansen refused to be interviewed.
The senior doctors’ union, the Association of Salaried Medical Specialists (ASMS), believes the board put Meates in an impossible position due to its focus on cost-cutting. They believe other senior executive resignations are also possible.
ASMS executive director Sarah Dalton said Hansen owed people an explanation and should front.
“It’s terrible for Canterbury.”
She had no evidence Meates was forced out, instead suggesting he was placed in an unconscionable position.
Meates and senior clinicians had repeatedly given the board evidence-based advice, which had been ignored, Dalton said.
“You can only beat your head against a brick wall for so long before you do some damage.”
DHB staff are understood to have reacted to the news with surprise and shock.
Dalton said a union member messaged her after the news was out to say: “God save the CDHB.”
“I think the staff feel really embattled, as if they’re not being heard ... And now their leader has been taken out.”
Clark last year appointed Crown monitor Lester Levy to the CDHB board over concerns with its financial position and refused to sign off on its 2019-20 annual plan.
The CDHB board had this year been trying to make extensive savings in a cost-cutting exercise, which Dalton said would cause job losses and reduced services.
“The sorry result of this board’s failings is the loss of an effective DHB chief executive and a number of his team at a time when the health system can ill-afford to lose strong, experienced leadership.”
Health Minister Chris Hipkins, Ministry of Health director-general of health Dr Ashley Bloomfield and Greater Christchurch Regeneration Minister Megan Woods, among others, have all praised Meates for his service.
“He has been a leader in our city that has been integral, and a critical person that has got us through the last decade, which has been really difficult,” Woods said.
In his statement to staff, Hansen said Meates was a resourceful and innovative leader.
“It is hard to imagine any other organisation in New Zealand that has had to contend with the challenges and complexities that have been managed by this DHB.”
Meates is leaving on September 4, meaning he can see out the move of the West Coast DHB into the new Te Nikau Grey Hospital in Greymouth and part of the move into the new Christchurch Hospital Hagley building.
In a statement to staff, Meates said his time with the Canterbury and West Coast DHBs had been “incredibly rewarding”.
”If I was to be sick anywhere in the world, I would want to be cared for here,” he said.
Stuff requested an interview, but a spokeswoman said Meates had nothing to add beyond his statement.
On Monday, CDHB planning, funding and decision support executive director Carolyn Gullery resigned. She is considered the second most influential person at the CDHB, and is close with Meates.
Stuff understands Gullery, who has been with the CDHB for 13 years, is leaving to take a new position overseas.
Another member of the executive team, CDHB chief people officer Michael Frampton, resigned in July, Stuff understands.
On Monday, Meates said the two senior executive resignations were “based on opportunities that have arisen for both of them to continue to develop and grow their careers”.
“The timing of both resignations is coincidental,” he said.
During his time in the top role, Meates has fought many battles with central Government, mostly about a lack of funding and facilities.
In 2015, documents released under the Official Information Act laid bare a strained relationship between the CDHB and the Ministry of Health, buckling under years of disagreement.
At the time, Meates made it clear the health system was under intense strain, exacerbated by ballooning mental health issues and an overseas workforce that was not funded by the public health system.
In 2013, the CDHB's performance following the earthquakes was given a glowing commendation in an independent review undertaken by UK health charity the King's Fund.
Meates challenged the ministry’s view of Canterbury’s population in 2017, which he said was out of date and would leave the DHB “exposed to untenable circumstances”.
In 2018, he said the board had to battle central government to prove it was facing a large jump in increased mental health needs.