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The toxic mould and rot of Middlemore is the legacy of a crisis in values

And it goes to the fundamental question about what we choose to value Counties Manukau Health in South Auckland, serves a population of more than 600,000 people with at least one third of them, including 40,000 children, living in significant poverty. Likened by some to Baragwanath, the main hospital of Soweto, Middlemore is New Zealand’s busiest and, like Baragwanath, a place reknowned for its hard working staff and good culture. Although we serve a diverse population, the majority who live in our district carry some or all of the cards of the South Auckland full house – a six card hand of obesity, diabetes, heart disease, hypertension, chronic kidney disease and gout. Add to that poverty and poor quality overcrowded housing and you will better understand why every day upward of 300 people will visit our emergency department seeking help. Of that number 60% will be admitted to the inpatient services for an average of 2.3 days, to be stabilised, diagnosed and treated before being discharged into the same environment which led to many of their health issues in the first place. Both the number and the acuity of the patients we are seeing have been rising fast for some time. We have known about the drivers of that demand for a long time. They were obvious during the long period of underinvestment in health and social services in the 1990s and were obvious again (to anyone with a pulse) 20 years later during the recent National government’s nine years of neglect. Another round of endemic poverty, low wages and rising inequity; homelessness, grossly inadequate housing with people sleeping in cars; no action to limit access to cheap, high fat foods and sugary drinks in the face of a rising incidence of obesity and the expensive, life threatening complications of diabetes related complications; alcohol and drug misuse and addiction; a run-down mental health system with high rates of depression, suicide and more. In the same way as it was in the 90s, this recurring pattern of co-morbid disease and its complications has been exacerbated by significant under funding for acute hospital services so it’s no surprise to me that hospitals such as mine are now overwhelmed with work. The ideology behind that – to reduce government expenditure and privatise costs to individual New Zealanders – extends across other areas of the social sector that traditionally rely on government funding. So with a change to a government with different priorities and an opening of the books, it seems like a new problem emerges every day. Only now is the public starting to see and appreciate the herculean task facing this new administration as it seeks to right our listing ship whilst at the same time charting a different course. Clearly the massive extent of the clean up needed will take time and will not be possible for the coalition government in one three-year term at the helm. So to those of you who want a better and fairer New Zealand, I say, be patient. One of the latest emerging problems is the news that the buildings at Middlemore Hospital have become rotten and infested with a toxic black mould. I found out in the middle of a late-night ward round from a Radio NZ journalist who phoned seeking comment – I had none, because it was news to me. The next morning, the rest of our staff and all of New Zealand heard the story and over the next few days there followed a confusion of detail about the extent of the problems and who knew what when. Although I was too tired and busy to think deeply about it at the time, I was overcome with embarrassment and a sense of outrage for this systematic betrayal of the very people we are here to serve and of the staff that works so hard to help them, to promote good health and keep people well. In medicine when people are inadvertently harmed by what we do, we follow the principles of open disclosure: to make a heartfelt apology or an expression of regret for the harm caused and to support those harmed; to investigate how the harm occurred; and put in place interventions to reduce the likelihood of the same thing happening to others.

For the original new release incorporating any other photos or videos, take a look at https://thespinoff.co.nz/society/03-04-2018/the-toxic-mould-and-rot-of-middlemore-is-the-legacy-of-a-crisis-in-values/

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