Editorial
State hospital mess calls for outside help

There was an air of desperation in the comment last week by Gov. Ben Cayetano that it might be time to turn the state mental hospital in Kane'ohe over to private management.

But desperation may be the correct response to a situation that has cried out for cure for more years than anyone should be forced to tolerate.

Despite clear improvements in some areas of the hospital in recent years, it remains a difficult challenge for the state. Changes ordered as the result of a 1991 federal lawsuit and consent agreement are not yet fully in place.

The threat of a federal takeover remains viable, which would strip all decision-making and priority-setting out of local hands.

A recent series of escapes — or "walk-offs" — has aroused community concern about safety and security.

Crowding, even after the construction of new facilities, remains a problem.

Cayetano's suggestion of privatization drew the immediate expected response from unions that represent workers at the hospital. They are willing to entertain private management, but not at the cost of existing jobs and existing job rights.

That makes privatization a relatively hollow suggestion. Private operation of the hospital would only appeal if the company had the freedom to set its own job rules and staff size.

And Hawai'i's mixed experience with private prisons on the Mainland, where many Island prisoners are kept, suggests that private operators are no sure sign of quality.

Part of the problem facing the hospital today is that the issue is being hashed out by forces who are all stakeholders in the current system. The unions are focused on job rights and job protection; the federal court is focused narrowly on getting the state to meet the obligations of federal law come hell or high water; the state is trying to balance the needs of the State Hospital against other demands and limited resources.

That leaves none able to see the situation entirely clearly.

That's why it is crucial that a third party — independent of the various interests and stakeholders — be brought in to sort things out. U.S. District Court Judge David Ezra has appointed federal Magistrate Kevin Chang to take on just such responsibilities as a special master.

Ideally, Chang will look at things from that outsider's viewpoint. That is, his work will be most valuable if he looks at the problems and potential solutions not from the viewpoint of the federal court — or any of the other stakeholders for that matter — but rather from the viewpoint of what is truly most important: the needs and health of the patients.