Maori ways

John Tovey, Consumer Consultant for Capital & Coast District Health Board, General Adult Mental Health Services.

Consumer Consultants

John smiles as he tells me he used to be the one who 'rattled the cage from the outside' and told the service how much they needed to do before they got it right. But for the last three and half years he has been on the inside and learning how to make improvements and facilitate progress while advocating for peers and the services he is associated with. John is one of a team of five peers that are employed as Consumer Consultants, or Consumer Advisors, that work for Capital & Coast. These positions began with just a single person about ten years ago, and that person slowly won funding for the other positions that have joined in this effort to take advantage of the experience of those with mental illness to inform the programming and service delivery while helping to make direct improvements in the day to day operations. John meets weekly with the team leader of the in-patient ward to discuss the latest issues that have been brought to bear regarding consumer needs and rights. He has one title but wears many hats, I was present when he was called by a consumer in the in-patient ward requesting John's advocacy in settling a critical sense of violation between this consumer and the psychiatrist for the ward. John responded and met the same day with the consumer even though it was a bit of a drive and John had to shift his schedule to do so. The outcome was very positive from what I heard the consumer say a few days later, largely due to the process John helped to facilitate in partnership with the treating psychiatrist and the consumer. John is also featured as one of the five people with experience of mental illness in the new documentary (they like to say 'doco' here) called "Mental Notes". John makes an impressive presentation of his experiences, and recovery, from institutional care. John is very welcoming and gracious, but what impressed me the most is the high regard his peers, both those with the experience of mental illness and those lacking that experience, have for him. The psychiatrist for the in-patient ward told me she has a high regard. So I was pleased when John was willing to take some time from his very busy schedule to sit with me and explain more about his role and the team he works within. Next week before I leave I am hoping to sit with another of his team members, Anne Helm, who is also featured in the film "Mental Notes".

Bi-Cultural Training Day

This is the class setting for the one day seminar on Bi-Cultural training required by the district health board

Capital and Coast made arrangements so that I could sit in for this day long training on the Maori and British treaty of Waitangi in 1840 that has set all the debates in motion that continue to this day regarding the rights of the Maori in their homeland. The Maori were promised many rights that the crown and New Zealand government are still trying to live up to. In the 172 years since, the Maori have had their culture attacked on many fronts. Many Maori of my generation were punished in the public schools for using any Maori words, or references to their beliefs. Consequently many of these Maori can no longer speak the language of their ancestors. Around 1970 many Maori elders decide to work at reclaiming their cultural practices and tribal rights. Some began Maori immersion schools to resurrect their language and beliefs. I know a few children here that are in these schools because their parents are Maori and want their children to learn and respect the language and ways of their ancestors. For the Maori, illness is viewed in part as the result of separation and disconnection, as in a loss of connection from whanau (family, both in the small and larger senses of the word), and their iwi (tribe/ bones of their people). So mental health services are tasked with facilitating a reconnection for the person who is ill with their environment and whanau through spiritual connection, the energies and responsibilities of relationship. The presenter for this Bi-Cultural Day was very good, speaking extemporaneously most of the time but with a very solid grounding in his culture and history, and taking many questions from the audience. I sat next to a Maori woman who was nearly the same age as myself and she was one who can not speak the language but gets by knowing some words and terms. She is a nurse in the hospital and helped explain some of the Maori beliefs, that were familiar, to me. Around the mid 80's the country gave official recognition to the Maori language and then required all signage to be bi-lingual, TV included Maori features, many greeting habits normalized more of the Maori practices in public events, and the arts especially worked to highlight Maori creative and traditional arts. This something Carla van Zon did a great deal to improve in her various roles with the many festivals organizers and artists.

John Whaanga is an independent consultant for this day training on Bi-Cultural awareness.

Maori Ways

Stained glass wall for the entrance into the marae for the iwi at the National Museum of Te Papa

Maori adage posted on a cafe wall and the first thing my friend Tua wrote into my notebook when I asked him to share something important to him and his Maori beliefs. 

Detail from a portrait called "The Other Sister" by Sophia Minson

Many Maori are brown skinned but these days many Maori are also not brown skinned due to many decades of families created with non Maori, mostly european immigrants. These portraits show examples of Maori who are light skinned but who have connected with their ancestral families who are Maori and then committed to their ways, and express it in their moko, or facial tattoos. Traditionally this signifies their mana, or prestige. Traditionally these tattoos were requested and or granted by the iwi elders to signify distinction in an individual's role within the iwi. In these times they are less formally sought and taken for individual expressions of identity, but often a tattoo continues to demonstrate the connection and expression of an individuals spiritual connection to their environment and their relationships.

Detail from a portrait "Tom" by Andre Bronniman

Where my sabbatical got its official start, the office of Tony Littlejohns, Operations Manager for Capital & Coast DHB

Tony Littlejohns, supporting member of the International Initiative of Mental Health Leadership

And the view that will be my last night in Wellington shortly before I get on the 6am flight to Brisbane and home on the 11th of May.

Mental Notes, the documentary film by Marbrook

Mental Notes is a new documentary film that follows five people with experience of mental illness who survived the institutional treatment of the 'bins' who now reflect on their experiences, many that were dehumanizing. These five people are now very active contributors to their respective communities, but not by any virtue of their institutional 'care'.
I saw the film last Friday, where the director spoke before the showing. I am fortunate to have met and shared some conversation with two of the five featured in the film: Anne Helm and John Tovey. They both were able to present vivid and compelling personal accounts of their experiences and reflections of value, on the process of their illness and that of their recovery, from not only the huge challenges of their illness but most disturbingly, the torments of their treatment.
Today both Anne and John work as Consumer Consultants for the local government district health board, Capital and Coast, the organization that has hosted most of my sabbatical connections here. Trailers of the film are available if you Goggle: Mental Notes, the movie. After the film on Friday I returned to Te Whare Marie to see if Tua Hekenui's family might still be around but the marae was without visitors any longer and resting after the large groups that had come the previous two days. Tua's body was taken in the very early hours of Friday morning by train up to the central North Island where his iwi is.
Yesterday I was fortunate to have the pleasure of Dr Richard Holt and his wife Dr Kristen Sparks who had come to help pick apples at Gregg and Carla's. Richard filled me in on the memorial service at Te Whare Marie, clearly a stressful time for most everyone involved.
Richard and Kristen are both American psychiatrists, both graduated from their MD schools at the top of their class. About seven months ago they moved here to live and work. They are both highly regarded as you can imagine. They spoke of some of the differences in medical and clinical practices here, mostly favorable and advantageous to recovery and wellness. Significantly, they sited the differences in boundaries that I have written about, and find that these less vigilant boundaries and the associated risk issues are culturally more appropriate and congruent with improved recovery and wellness models. The focus shifts in these models from the more egocentric focus in the western models to whanua, that is family, and its sense of inclusiveness beyond just immediate family.
In my observations a great deal of illness and disease is the consequence of stressors brought on by disconnection: disconnection from environment and disconnection with others/ family/ community. These experiences of disconnection engender degrees of relative disorientation and the loss of a sense of belonging. Individual motivation ebbs under these circumstances, and the less active we become, then the more significant the negative impact to our physical health systems result. The recovery process and the subsequent steps involved in our wellness are then dependent on reconnecting and recovering a sense of belonging/ valued roles; reorienting to a sense of inclusion, involvement, individual value, process, and purpose. This then reignites hope and the critical motivation for the spiritual centering of connection and conviction of purpose: living life in wellness.

The tree Tua especially liked at Te Whare Marie

Details of the woven trunk that is distinctive of this tree in front of Te Whare Marie

Dr Richard Holt and Dr Kristen Sparks at Gregg and Carla's apple orchard 

Giant bubble bee the length and breadth of my thumb, makes me think of Tua Hekenui and his aroha, the shortness of life and the need to live with purpose.

I have less than three weeks left now here in New Zealand and will see what I can do to wrap up with some interviews with people who I have come to know hold a very good sense of how recovery and wellness are effectively facilitated.

Return to Te Whare Marie, VincentsArt, and an intro to Blueprint

Maori Specialty Mental Health Services

On Tuesday I was able to return to Maori Specialty Mental Health Services where I sat in on the Multi-Disciplinary Team. They began with the traditional karakia, which is like a prayer-combo-blessing, and then the team consultant psychiatrist, Dr Allister Bush, lead an exercise with guitar playing and a song that all joined in on. Then he lead a mindfulness exercise for "a safe place"with guided imagery for relaxation. Then the regular clinical business was attended to. The meeting concluded with a karakia as well. Outside of this meeting I was fortunate to have several conversations regarding the work this team does. Tua also explained to me the meaning of the word and reference to "marae", after I asked him about its modern use vs it's traditional use. The word is a construction of two words: 'ma' being the word for pure, and 'rae' being the word for forehead. So the Maori significance of marae is its implication for pure thought, as a concept that involves the environment as you approach the meeting/ spirit house. Tua made the point to say that the environmental awareness would be a comprehensive involvement that begins with the earth below, the life within and the sky and heavens above, all calling for pure thought that leads to right action. Marae is often used today in terms of a collective reference to all the buildings and grounds of a spiritual center for a Maori community/ iwi.
Today, Thursday April 19 at 4:15 Te Whare Marie held a memorial service for Tua Hekenui, eldest son, father, husband, Cultural Therapist for Maori Specialty Mental Health Services, student of his Maori culture and history, who died quite suddenly. I will miss his warm welcome and generous sharing of his knowledge of spiritual wellness. He greeted me just last week with the hongi, and he made a point to share the breath of life with me in earnest and with a great smile that followed. I am thankful for having been able to meet and know him enough to know him as a friend. He liked to sing and often sung while preparing himself for the staff meeting. I learned of his memorial service too late to be able to attend. It is in fact happening as I write this. I first met Tua the day I turned 55, Monday March 5th, my initial welcome into the marae at Te Whare Marie. He was very kind to me and I will remember him well.

Tua Hekenui

Vincents Art Workshop

Antoinette, artist/tutor at Vincents Art Workshop

I made my way to Vincents Art Workshop ( www.vincentsartworkshop.co.nz )on Wednesday, where I was able to sit and just observe for a couple of hours before I let on who I was and why I was there. That's when I met Antoinette Ratcliffe, ( www.the-sick-bay.com ) installation artist and fill-in tutor at Vincents. She is seen above with the art work of one of the members just going up for a one man show. The environment of Vincents is very welcoming, bright and colorful. There is a great deal of artists' work all about, on the walls and ceilings, in cubbies, draws and shelves. Vincents differs from the prior two art/ creative space programs I had visited earlier by the fact that Vincents does not restrict members to those with experience of mental illness. Vincents is welcoming to any community people who want to experience a welcoming creative/ art space. I saw this in full effect when a mother brought her two young children in to make some art work. She had brought her children before, and this is a week that schools were out so it was a natural choice for this mom to spend some time at Vincents. There were over a dozen members who came in to work on their art while I was there. There were also two tutors present while I waited for the program coordinator to arrive from a community meeting.

Andrew, artist/tutor at Vincents 

Below is Glen, Vincents coordinator who leads this community asset with a passion and a great understanding for the value of inclusiveness when it comes to welcoming everyone for creative expression. Vincents has a gallery central to its space where they feature a lot of the work done by its members. Once a week they provide a structured workshop and they reach out to the forensic and in-patient population regularly as well. They keep Thursday each week just for women to attend. Although the life drawing that is hosted here on Tuesday and Thursday evenings is open to all. I was lucky to be able to attend the Thursday evening life drawing. The model was very skilled and the group of a dozen artists were quite focused, and comfortable with a new face in the group.
Vincent's just celebrated their 25th anniversary. They have a large number of awards that adorn the walls along with the art. Glen helped me connect with Art Access New Zealand that works with the 85 creative art space programs across new Zealand.

Glen McDonald, program Coordinator and heart of the program at Vincents

Friends of Vincents

The main workshop art space

Blueprint

Sally granted me a visit last week so I could sit with her and find out more about her program Blueprint      ( www.blueprint.co.nz ), one of the nine organizations in the WiseGroup Collective. You may remember that Pathways was another NGO that I visited a few weeks earlier from the WiseGroup. Blueprint specializes as the educational training arm of WiseGroup. Innovative trainings for leadership within the mental health services nationally as well as for many community based groups like police, fire fighters, educators, and government leaders. The principle training for these community services is MH101, a program funded by the Ministry of Health for New Zealand. It is a collaboration that involved The Royal Australian and New Zealand College of Psychiatrists; ProCARE; The Mental Health Foundation of New Zealand and the Kites Trust. The three principles of MH101 is Recognize, Relate, and Respond.                 ( www.MH101.co.nz )
Sally pointed out to me that Blueprint, like each of the other WiseGroup organizations subscribe to the principles of Sustainable Peak Performance, a business model based in core values that highlight ownership by everyone in the organization, and innovative practices,  notably used by Toyota, and Proctor and Gamble. One of the consequences of this business model for WiseGroup is that they screen new hires based on compatible values driven work that focuses on innovation and wellness. New Zealand, and the Wellington area in particular, has been struggling with a drawn out economic recession much like the USA, and Blueprint sees its future is advantaged by the fact that it has this very strong values based core to its operational strategies and the fact that it is a part of a much larger group that allows it to stay focused on what it does best while the other groups provide certain efficiencies: i.e., Wild Bamboo,                               ( www.wildbamboo.co.nz )another group member that develops specific computer software to meet their needs and the needs of the other group members like Te Pou, ( www.tepou.co.nz ) the group dedicated to researching mental health and related issues like employment for the disabled. From my very limited perspective this does indeed appear to be a very smart approach that advantages each group member organization within WiseGroup.

Sally Pitts-Brown, CEO for Blueprint, integral organization within WiseGroup

Return to Kites Trust and a forum on supported employment

Monthly Inner City Committee Meeting with reps from nearly twelve different NGOs

I was invited by Kites Trust to sit in on the above meeting where discussion focused mostly on the legal opinion from the Wellington Community Law Centre ( www.wclc.org.nz ) regarding the implementation of two new initiates in the mental health service arena: Special Circumstances Court, for a treatment alternative to the standard prison route for repeat low level offenders with mental health issues; and a new funding program for teenage parents. It is interesting to me that the Community Law Centre works for these NGO's collectively to review potential issues of discriminatory practices and policies by government and other serve organizations. The law centre has several lawyers who tackle the legality of various emerging issues. This Inner City Comm. is a forum for review and discussion of the congruency of policy and practices with the national movement for combating discrimination and stigma for people with experience of mental illness. This proved to be a good discussion that allowed many perspectives to be heard and considered. Another discussion brought some focus to issues of suicide and points made that have been found to mark dropped rates in the national suicide rate in New Zealand in recent years.

Kites Trust Team Building

Preparing the afternoon tea for the team building session with Kites Trust

I was invited to take part in the monthly team building session at Kites Trust ( www.kites.org.nz ). Above you can see Eileen and Ruth are setting up the afternoon tea at the Wellington Croquet Club, the site for the afternoon's team building session. Ruth Jackson is one of the featured writer's in the book "Stepping out of the Shadows", a very insightful account of mental illness and service experiences that the authors have lived through, and then achieved personal recovery and wellness.

Kim is focusing on how to best apply the recently discussed team strategies 

Our Wellington Croquet veteran explains the rules of the game and team strategies

Margaret works at applying the team strategy

The Visitor as team player, trying to make the opposing team work harder for their points.

Below is the locale of where I joined a group presentation on supported employment programs for refugees and people with mental illness. The Wellington area has at least six different NGOs whose services focus on helping people with disabilities find and keep jobs. The refugee programs involve many supportive services here, from translators, to housing, therapy and employment services. Margaret Donald who had long ago worked with the Kites Trust is now providing her own referral service for primary care providers. She works with many general practitioners who refer people with mild to moderate mental health needs for Margaret to connect to the appropriate services in Wellington. Margaret has a nursing background and does a lot of work getting people with experience of mental illness connected to effective services. Her offices are located adjacent to many of the refugee services available here. Margaret organized todays presentation on supported employment services in this area, which involved the Multicultural Services Centre that specializes in refugee and migrant communities in Wellington. This group is connected to the Wellington Refugees as Survivors trust that I visited last week. These are essential services that provide effective supports for people with mental illness experiences that are often the result of trauma. Being able to return to work or find work is known to be critical to effective recovery for the person and their community life. Discrimination and stigma issues continue to find challenging initiatives from these service providers.

These large buildings are all part of the Wellington Regional Hospital complex

Art Space! And the radio waves with All Access radio NZ!

Some of the creative art space

 I was able to spend significant time with the people at Pablos and Vincents art spaces here in downtown Wellington this week. These are two of the longest running creative art workshop spaces in New Zealand. Pablos is dedicated to providing creative art opportunities  to people who have experience of mental illness, and Vincent's is just celebrating it's 25th year welcomes all community members, but is especially supportive of people with mental illness experience. Vincent's offers a life drawing session two evenings each week, and I am in hopes of sitting in soon. Next week will mark my official welcome and introduction to Vincents, when the director will host my visit.

This is Chris who works as an art tutor at Pablo's Art Workshop and is here pictured in the Roar Gallery

I was impressed with the art piece just behind Chris's right shoulder with "no" brushed in on the black background. It struck me as 'white no'ies', with probably 2000 no's and frequent "X"s.

Galen, who is the director of Pablos. Pablos is a creative art space dedicated to people who have a mental illness.

 Pablos is a great space for exploring creative interests for people who have experience of mental illness. They are dedicated to providing most materials and space use to its members free of charge. I was welcomed without the benefit of an official introduction. Chris opened up the gallery for me and was more than happy to explain the Roar Gallery's role within the Pablos' experience. Above you can see Chris with a few examples of the art produced by Pablos' members. I was lucky enough to get to talk with several of the members, some who have enjoyed and benefitted from Pablos' program for several years. One man was a former graphic design artist who was exploring and developing his skills in the studio space. He had recently challenged himself to "stretch" by painting "outside the lines", an approach very much foreign to his orientation of tight controls in his graphic design background. He was beaming with a smile that had satisfaction running from ear to ear dispute the lack of control his drippy acrylics was confronting him with.  Another fellow was proud to tell me of his partnership with an Australian art dealer who sells some of pieces outside of New Zealand. My visit at Pablos was punctuated with the very gracious welcome by its director, Ms. Galen, who was more than happy to discuss the challenges of keeping a community art space like Pablos in operation for the past twenty years. I am looking forward to returning to the art scene of Pablos and Vincents.
 

The official poster for the half-hour radio show that invited me to sit in. 

click here:  to hear the March 27th show

The studio session in action with Brendon and Dan from The A Team, a Pathways and Social Angels supported program

Two cool guys who entertain weekly on the radio waves of 783am, All Access Radio

 Brendon was keen to meet this New England Yankee from America. One of his big dreams was to have his own radio show and he has done it with the support of New Zealand's Social Angels, and the people at Pathways, like Daniel Crozier, who provides the technical support for Brendon to be able to enjoy and thrive in his radio role each week.

BRENDON: ON the AIR and LIVE! 783am radio New Zealand

Local message at the sustainable and renewable housing fair this past weekend in Paraparaumu

Above is Saba, who recently moved to Wellington with her fiancé from the Canadian Maritimes. In talking with her I learned that her fiancé, Doug, has an art and design background and she thought he would be interested in getting connected with the art spaces I had just visited in the last two days. Doug would like to get involved as a tutor, or otherwise provide some type of support. Doug has now connected with me via email and we will meet early next week so that I can help get him connected to Wellington's creative art spaces that support strengthening the voice and expression of people with experience of mental illness.

Pathways, one of the largest NGOs connected to Capital & Coast

Regional Operations Manager David Hughes of Pathways

Pathways is one of the largest NGOs that provide community based support services for people with mental illness in the Wellington area. Nationally they have 500 employes, and about 100 here in the Wellington and Kapiti Coast area. They are also part of a larger organization called WiseGroup. They are an alliance of over a 1000 employees providing a variety of community based support services in the mental health and wellness field. For those interested they have a terrific website with a very forward thinking mission. They embrace the challenges of change for the potential of innovation and leadership opportunities. Recently they have used incentivized programming for staff and clients to help bring on improvements of wellness, most reentry focused on smoking cessation.
I was invited to sit in on a meeting with a Capital & Coast service co-ordinator, Vikki, for their Needs Assessment and Co-ordination Service, on a project that is transitioning 30 people from long term support services into more independent settings in the community.
I was able to make several site visits with their staff that included an extended care residence, and three different respite houses. They have a strong mobile support program, one that specializes in medication supports in the home.  The residential staff are very motivated to help service users transition while using a recovery based approach to their treatment. A lot of their housing program success is due to the three women pictured below: Dee, Teresa, and Karen, all very committed to supporting a recovery and wellness driven service that is naturally strengths based in its focus of supports. Each housing site has a garden plot, so amongst the many skills based support work is a focus on being able to grow some of the food they eat. Of course many of the residents also like growing some flowers as well.  The Pathways homes are well appointed, bright and comfortable places to stay and visit, with a highly regarded record of effectiveness. One of the respite houses has a room called the 'sensory room' designed to help teach people techniques for deescalation and self soothing skills that has proven to be very effective.
 I hope to be able to return and spend some time with their mobile support teams soon.

Dee, Housing Co-ordinator and Teresa, team leader.

Wet Room for the Extended Care Home

Karen, respite house Team leader

Choice and Partnership Approach Training - CAPA

Dr Richard Holt, (American) psychiatrist, and the QA Coordinator, and then Malcolm Robson,
 Operations  Manager for Maori Specialty Mental Health Services and Health Pacifika.

It was another very early start, jumping on my bicycle by 6:30 (still quite dark) so that I would be sure to make one of the early trains that leaves from a station 10 miles down the coast. Once at my train stop, I had a challenging hike for 30 minutes up onto the hospital hill complex. Thankfully I found the site for this days' conference training with a few minutes to spare before the training got underway. A pleasant surprise was to be warmly and traditionally greeted by Te Wera, Consumer Consultant, and an inspiring person for me since I met him a couple of weeks ago. Te Wera is a skilled and very thoughtful listener. He just enrolled ( with what I suspect is a well deserved scholarship) in a three year program at a Maori College based in Otaki.  

Last Friday I spent the day learning more about the CAPA system for service organizational structuring, a system that eliminates waiting lists and provides a high degree of scheduling flexibility in response to known service demands. It also is highly congruent with a recovery based approach that begins with many elements of robust motivational interviewing (first appointment) and then moves quickly into goal specific evidenced based practices that are well matched to the presenting need. This system is highly utilized in many parts of the U.K. in its child and family services. New Zealand is one of the first service systems to put it to use in their adult service system, to help facilitate the recovery oriented evidenced based practices. Three Consumer Consultants were present for this day long presentation and I was glad to be able to sit and talk with two of them. Dr Richard Holt suggested that I give consideration to working abroad. He is an American trained psychiatrist who started his career in mental health as a case manager, did a stint in the Peace Corps in Mali, and returned to school and graduated at the top of his medical class in Florida. His wife, also a psychiatrist here with the APS ward also graduated at the top of her class in Ohio. They have been most recently working here for the past five months. Richard has an impressive command of the Maori language and cultural practices. He is from all reports to me, and several have come from outside his place of service, the most effective psychiatrist I hear spoken of. He is involved in the active cases of approximately 160 patients, all are in some measure of acute care but being treated primarily in the community. I hope to spend more time learning about the Maori services team he works in.

CAPA Conference 

The CAPA creators/ presenters: Dr Anne York and Dr Steve Kingsbury

 Anne and Steve are dynamic speakers, with excellent means of illustrating their systems approach to effective and responsive (flexible) service scheduling. They shared many stories of how they have constructed and fine tuned a systems approach that leaves clinicians and consumers/ families feeling less stressed and more effectively served. Today's workshop was the 102nd for them on CAPA. When the group was wrapping up the morning session they had two senior members of Capital and Coast bring out their guitars and lead some humorous sing alongs with very spirited and inspired playing. It was great fun and added an unexpected twist to the day. I regret not having my camera at the ready to capture this component of the day's experience.

Tony and Sue have been a great help to me in supplying contacts and opportunities for inclusion in service system introductions and exposure,  like here at the CAPA training. Tony is a member of the International Initiative for Mental Health Leadership, my primary connection here in New Zealand to the mental health services. The IIMHL was founded by a past New Hampshire community mental health center CEO            ( Monadnock Family Services ) Fran Silvestri, who left a legacy as the only CMHC in NH who had incorporated a sabbatical policy and practice from 1975. When Fran decided to leave his post as CEO there, after some 15 years in that position, he started the IIMHL, which currently includes a consortium of seven countries, including the USA. They host an international conference every 18 months, and the next one will take place here in New Zealand in 2013. New Zealand leads New Hampshire in its recovery based services, most notably in the inclusion of Consumer Consultants, NGOs primarily staffed by people with mental illness experience,  and minority culture based services.  

The Key People who have been arranging most of my sabbatical contacts: Tony Littlejohns, Operations Manager for Capital and Coast District Health Board, and Sue Campbell his Administrative Leader