Community health

Waitaki District Council has long challenged what services local government offers. We talk with Gary Kircher, Mayor of Waitaki about building healthy communities.

“In some ways, it’s a small pond thing — being able to go and have an effect in the community,” says Mayor Gary Kircher of Oamaru, when asked about his commitment to local government. “People have asked if I have ambitions around central government, but the reality is that in my role, I can have far more effects, and positive impact on our community and the people within it, than I ever could if I was an MP.”

One example of the impact Oamaru Council is having on their community is in healthcare. At present, they are the only council in New Zealand to own a hospital. This came about in the mid-90s, when the Oamaru hospital was becoming too expensive to maintain. Coupled with the centralisation of services that was happening at the time, Oamaru’s healthcare resources were set to move to a bigger centre like Dunedin. But the council recognised that their community needed access to immediate healthcare and formed an agreement with the government to transform a different building into a hospital and take ownership of it. “The hospital was rebuilt, and everything was moved on one day, including patients,” Gary says. “And life carried on.”

It’s unusual for a council to be so involved in its community’s healthcare, but for Oamaru it’s effective. “We have a service, which means that a lot of the immediate needs of our population are looked after here, and they don't have to go to Dunedin for those,” Gary explains. “If anything's getting too serious, they get transferred. But our team here is able to do a lot that they wouldn't otherwise be able to do.”

Providing healthcare isn’t cheap, nor is funding readily accessible. So, Oamaru District Council looked at the needs of their population and came up with a solution that addressed multiple challenges. “We were in a situation where there were a lot of people retiring here, and wanting a retirement village type of lifestyle, but we didn't have one,” Gary says. These community members, and the money they brought to the local economy, were moving elsewhere. So, Oamaru set up a retirement village, which not only serves the needs of the community, but also helps fund the hospital. “Now they've got the lifestyle that they want,” Gary says, “And that's actually helping fund the wellbeing of a lot of other people, as the money goes back into the health system.”

It’s a unique, locally targeted model that demonstrates the strength of local democracy in action. This example is particularly pertinent right now, as a central government review of The Future for Local Government is being carried out alongside major healthcare reforms. “It really is about councils broadening their minds to actually, ‘What are the new opportunities for things that they could do?’” Gary says of the lateral, opportunity-based thinking local government can do to help their communities.

Yet he’s also adamant that when it comes to shaping local government’s future, there needs to be changes at the central government level too. “As much as it's a review of local government, there also needs to be a review of central government,” he says. “It needs to be about them getting away from their quite siloed thinking, and actually gaining more trust in local government and in local governance,” Gary says.

The concept of local governance, which is about pulling together and utilising a broad network of resources and voices across a community, is something Gary thinks is key. “Local government is quite formal in how we do things, and the structures and the elected representation,” Gary explains. “One of the advantages is the fact that elected members are exactly that — they're all elected by their community.” Another is that they’re always going to be there, where other organisations may come and go.

On the other hand, a council might not have all the skills at the table to deal with the myriad issues a community faces. “But you combine that with local governance, and you broaden out that experience around the table,” he says. “It's not about counsellors needing to know everything and be on top of everything. But it's been making sure that you've got really good relationships within the community, that join local government and local governance. And you actually end up with a really good set of people who can make good decisions on the information they've got.”

Gary points to the council’s co-ordinated work with Stronger Waitaki as an example of great local governance. Stronger Waitaki is a council-administered organisation that represents over 190 non-profits and organisations working in a number of areas. “It’s a collective impact model,” says Helen Algar, Community Development Manager of Stronger Waitaki. “We use that collective intelligence, and a bottom-up, community-lead approach to find solutions to pressing local problems,” she explains.

Stronger Waitaki has nine working groups focused on various key areas for the Waitaki District, including mental health and addictions, community violence and a housing task force. The various organisations and community members working in these areas come to the Stronger Waitaki table with their own set of challenges, then work together to identify collective issues and solutions that will benefit everyone.

“It helps to minimise the duplication that might be happening otherwise,” Gary adds, “and the waste of money that would otherwise be happening, just to make sure that everyone's on the same page with where things are at. They can make sure that they are focused on delivering a solution that works for the people involved.”

There are major opportunities with this sort of local governance approach. “We have the ability to make much more nimble decisions,” Gary says. “We can go, 'Here's the problem. Here's the solution. Let's put some money that we're getting into that, and let's sort the problem out before it becomes worse than it needs to be,” Gary says. “So we won't have young people waiting months for a mental health counselling session, which can sometimes come too late.”

However, in order for it to be effective, Gary says they need more trust from central government when it comes to funding and how to spend it. “They need to see that this is more than just a dozen counsellors or so sitting around the table,” he says. “This is actually just a part of a network that goes much more broadly.”