Director General of Health, Dr Ashley Bloomfield. His Ministry is under fire

Two Cabinet Ministers and then the Auditor-General yesterday in strongly worded public statements damned how the Ministry of Health operates.

It was an unprecedented gang up on a Ministry whose Director-General Dr Ashley Bloomfield has become something of a national hero over his Covid briefing appearances with the Prime Minister.

But while Dr Bloomfield has been in the Beehive Theatrette, it seems back at his Ministry, decisions were being made with very little regard for proper process.

In an extraordinary move, the Minister of Health, Andrew Little, twice made it clear he did not agree with what his Ministry was doing.

He was joined by Maori Development Minister Willie Jackson, and they both then intervened in the row between the Whanau Ora Commissioning Agency and the Ministry over access to Maori health data to enable Covid vaccinations to proceed.

And yesterday the Auditor General released a report criticising the Ministry for failing to use proper process to manage a $50 million contract, and of not managing conflicts of interest.

The High Court had ordered the Ministry to reconsider its decision not to provide the access. It said it had reconsidered the matter and maintained its refusal.

The Agency announced yesterday it would appeal that decision.

Speaking to Newsroom, Jackson described the situation as a “disgrace” and said he was disappointed the supply of the data had not  happened.”

He said he’d spoken directly to Bloomfield and made his view on the matter clear.

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“Dr Bloomfield does what Dr Bloomfield does, I suppose.’’

Little said the High Court ruling “was pretty clear the court expected some further disclosure, and if that hasn’t happened that’s extraordinarily disappointing’’.

But the comments from the Ministers earned a rebuke from Speaker Trevor Mallard, who at one point suggested on Twitter in a tweet (that appears to have been deleted) that a Minister was bullying his own Ministry.

He explained: “I, for one, am very happy our system does not allow a Minister to decide to release details I have given under an obligation of confidence to my medical practitioner. If anyone thinks that such a retrospective power is desirable, they should change the law.”

In many ways, the unusual intervention of the Speaker in any political row, let alone an internal dispute inside his own party, speaks to the polarising impact that the Chief Executive of the Whanau Ora Commissioning Agency, John Tamihere, has on particularly Labour Party politicians.

In 2004 he was forced to resign as a Labour Government Minister after allegations he had avoided tax on a “golden handshake” payout from the Waipareira Trust, which he headed before he went into Parliament and which is back at the top of now.

In 2005 he lost his seat, ironically to Maori Party co-leader, Sir Pita Sharples.

Now Tamihere is in the Maori Party, but there is Maori opposition to his bid to get the data too.

The Whanau Ora Commissioning Agency is not the only umbrella Maori Health body; there is also the National Hauora Coalition, and some iwi have links into Primary Healthcare Organisations.

At the same time, work is underway to set up the Maori Health Authority, and it is widely believed that Tamahere is seeking to either have the Agency or for he himself play a major role in that.

It is against this background that Bloomfield’s comments on Monday make more sense.

He said the Ministry had been discussing whether to release the data “with a range of stakeholder groups, including iwi and other Maori stakeholder groups.”

“This went to the discussions we had with a range of groups, in particular iwi,” he said.

“And it was the reference to rangatiratanga and some of them, not all, but some had a very strong view about not wanting the data released of the iwi members in toto because they felt that that would potentially compromise the relationship between the iwi and the Crown.”

Not only are there a number of Maori healthcare organisations other than the Whanau Ora Commissioning Agency, but some of the general primary healthcare organisations also have close links to iwi.

In particular, Procare and Pegasus, which jointly own the telehealth provider Healthline (which has renamed itself Whakarongorau Aotearoa), are close to Ngati Whatua and Ngai Tahu.

In its` original affidavit seeking the judicial review of the Ministry’s decision, the Whanau ora Commissioning Agency complained that Whakarongorau was getting the same data it was not.

They argued that the Ministry’s decision to deny the data was inconsistent with the decision to supply Whakarongorau.

But in Parliament yesterday, health Minister Andrew Little repeated his support for the release of the data.

“It’s my expectation that Te Tiritiprinciples and the application of Tikanga will result in appropriate data sharing,” he said.

“I expect that a way forward will be found, however, now the legal process must play out, and discussions are ongoing.”

However, he said that the Court decision because it  did not order specific disclosure of data but ordered the Ministry to reconsider its decision, “suggested that the court struggled with where the line was to be drawn between data that should be released that was appropriate and in accordance with the ministry weighing its competing obligations.”

National MP, Harete Hipango, asked Little if he acknowledged that the Māori vaccination rates would not be 21 per cent below the general population if the data had been shared with Whānau Ora nine months ago when it was initially requested?

“We know that the vaccination campaign when it comes to Māori vaccination, has worked very hard and struggled in many quarters to lift those vaccination rates,” he said.

“There are a lot of reasons for that—perfectly justifiable reasons—and we always anticipated that it would take extra special effort involving a whole range of parties, but, most importantly, kaupapa Māori health providers, iwi, and others connected to Māori communities so that we could get those vaccination levels up.

“That is happening. It will be assisted by the release of more data, and I am confident both the Ministry and the various other parties that it’s engaging with will reach that end.”

It wasn’t a good day overall for the Ministry of Health yesterday as it also came under fire from the Auditor General over its allocation of a $50 million-plus contract to deliver saliva testing for Covid.

Proposals were called for in April, and two companies, the Asia Pacific Health Group and Rako Science, submitted proposals.

The contract was awarded to the Asia Pacific Health Group, and Rako then launched a high profile media and lobbying campaign to try and get a share of the tender.

The Asia Pacific Health Group (APHG) is the country’s largest provider of medical laboratory services but took no chances in trying to win the tender and hired the lobbying firm Thompson Lewis, headed by a former Chief of Staff to the Prime Minister, GJ Thompson.

Rako, in turn, relied on its high profile director, Leon Grice, who was appointed to a number of posts by National Party Minister, Murray McCully, was played a leading role in developing the Christchurch Call after the Christchurch Mosque massacre.

Rako got early and public support from former NZ First Leader Winston Peters, and it was his complaints about the Ministry of Health’s process which prompted the Auditor General’s inquiry.

The Auditor-General, John Ryan, was surprised there was no formal procurement plan for the testing.

“We would have expected a procurement plan to be prepared for a contract worth more than $50 million and for an important subject such as this,” he said in a letter to the Ministry.

The Ministry told the Auditor General there had been no procurement plan because the need was urgent to let the contract. testing was supposed to begin by mid-April

But the contract was only awarded to APHG on May 26.

“The Ministry told us it took longer than expected to assess the responses it received because of their size and detail,” said Ryan.

“There were also delays in getting appropriate internal approval to proceed.”

Ryan said his office asked Ministry staff why there had been a delay in implementing saliva testing following the decision about the successful party.

“We were told that seeking a policy decision on saliva testing took significantly longer than anticipated and that some industry sectors were also reluctant to implement a new testing regime once the Ministry engaged with them,” he said.

There were allegations of conflicts of interest in the letting of the tender; four of the five members of the panel which considered the bids had potential conflicts through having worked for respondents or associated laboratories or through extensive contact with staff and organisations that might respond.

Ryan’s letter to Bloomfield said some panel members already had their own opinion about different approaches to saliva testing.

“Overall, because of the way conflicts of interest were managed, the Ministry left itself open to a perception of bias,” Ryan’s letter said.

Peters was typically colourful in his response to the Auditor General’s letter.

“Today’s findings from the Auditor General’s look into saliva testing procurement shows the government has an unhealthy penchant for crony capitalism and protecting their mates,” he said.

“The government did not learn its lessons from these same issues the first time around with the Auckland light-rail project last term – again called into question by the Auditor General after the 2020 election.

“Moreover, they have again blatantly decided to run roughshod over due process and transparency in favour of their own back-patting advice.”

Judge Cheryl Gwyn’s decision in the court case, the response of the two Ministers to the Ministry’s failure to back down on its refusal to supply data and the Auditor General’s letter all add up to a damning condemnation of the Ministry of Health and the way it operates.

But in a way, the problem is already solved.

Under the health reforms currently in transition, it is to be reduced to becoming a small policy advisory Ministry.