The military takeover of the Covid-19 isolation and quarantine response comes after what appears to have been a clash of cultures within the All of Government Committee originally set up to deal with the pandemic.
As a consequence the Director General of Health has had an Air Force officer put over him and Megan Woods has moved in to provide political oversight.
POLITIK has spoken to a number of sources all familiar with the way the committee has been operating and all report the same thing; that there were tensions within the committee, particularly between the Police and the Ministry of Health.
The Police apparently approached their role by looking at the crisis as a potential catastrophe with talk of field hospitals and the need to purchase extra body bags.
Health, on the other hand, had control over Public Health Units which ordinarily deal with environmental health issues and matters like anti-smoking and obesity and general health promotion.
Last year the Ministry was caught out when it had insufficient vaccine for the worst measles outbreak since 1938.
What Health did not have was effective control of the District Health Boards.
It is the DHBs who deliver health services.
Heather Simpson’s proposal to set up a separate agency to manage the DHBs and to shrink the Ministry to a purely policy advisory Ministry is a tacit acknowledgement that the Ministry is not up to delivering health services.
What is clear is that the testing of incoming passengers and the monitoring of the isolation and quarantine facilities and the enforcement of rules did not happen.
It is not clear who was responsible for this.
But yesterday the Prime Minister made it clear she was unimpressed with the admission from the Director-General of health, Ashley Bloomfield, that 2400 people had left isolation since June 9 without being tested for Covid-19.
“I think it’s unacceptable that the tests weren’t done in the first place,” she said.
“That’s what I think.
“Now, our job is to make sure that health works through every single person who is released after 14 days, keeping a mind that is the most important thing and give further information on those cases.”
That comment came after Dr Bloomfield had on Sunday attempted to play down the concern about the lack of testing.
“They will have all completed their 14 days of isolation and managed isolation before being released,” he said on Sunday.
The Ministry is now trying to track them down for tests.
Its approach to testing was questioned right from the start.
Professor Sir David Skegg told the Epidemic Response Committee’s first meeting that testing had been heavily skewed towards people who had returned from overseas or their contacts.
“So it’s no surprise that most of the cases detected have links to overseas travel,” he said.
“The actual number of people who have been infected will be far higher than the 589 notified, and we really have no idea of the extent of community spread.”
Sir David’s comments raised questions which were asked at the Committee on April 7 by ACT leader David Seymour about how confident the Ministry could be about its data on cases.
Health Minister David Clark said aid “the direction of travel” was to get more data online in real-time.
That never happened.
Originally the All of GovernmentCommittee was chaired by John Ombler and included the Controller of Civil defence, Sarah Stuart-Blackman; the former Commissioner of Police, Mike Bush; the Director-General of Health, Ashley Bloomfield and some officials from the Ministry of Business Innovation and Employment.
The committee reported through the Department of Prime Minister and Cabinet to the Cabinet Covid-19 subcommittee chaired by the Prime Minister.
But the police presence seems to have been a trigger for some of the tensions which provoked some pushback from the Ministry of Health.
The Ministry meanwhile was essentially riding the District Health Board tiger. It was the DHBs who were responsible for distributing the PPE, a task that some had difficulty with.
The Auditor-General last week reported that initially, the Ministry did not know what PPE stock DHBs held or how quickly that stock was being distributed.
The Auditor General’s report then found that evidence of some inconsistency in DHBs’ approaches to supplying PPE to community health providers.
“In some instances, DHBs told community health providers that they were not in a position to supply PPE,” it said.
“We acknowledge that DHBs were being asked to do something during a national crisis that had not been planned for and that they had not done before.”
There also appears to have been a change in distribution suppliers imposed by the Committee in Wellington with Mainfreight taking the job over in mid-April.
Thus there were early signs that the Ministry, which is essentially a policy Ministry, was out of its depth trying to run a complex nationwide health delivery process within a system that it has only limited control over.
This is what has fallen apart over the past two or three weeks.
Now that Air Commodore Webb has been appointed to effectively replace Dr Bloomfield in running the whole Covid-19 management process has said he would conduct an end to end review of the managed isolation and quarantine process.
That will look at the end to end induction process. Dr Bloomfield confirmed his Ministry was looking at would include
- End to end induction process
- General security and safety of travellers
- Provision of health services; and
- Standardisation of procedures including COVID testing and screening
In the meantime, the number of personnel from the New Zealand Defence Force onsite at the Managed Isolation facilities in Auckland has been doubled to 72 staff.
“Police’s onsite presence has also increased, with additional staff in each facility, and specifically identified after-hours support should it be required,” he said on Sunday.
“These personnel will assist local staff in a number of roles, including ensuring the security and safety of returnees during their time in Managed Isolation.
“Testing has been ramped up, and all returnees must be tested on day three and day twelve of their stay.
“We have robust systems in place, and strong accountability at both a national level through my role and at each of the facilities through a designated onsite operational lead.”
Webb stressed that people needed to be responsible for their own actions.
“Let me be very clear, people must take responsibility for their actions, and if they choose not to, there are consequences.”
Webb’s get-tough approach is what the Police were supposed to have brought to the process in the first place but, possibly for internal political reasons, never quite managed to.