DHB Deficit Is Real & Cannot All Be 'Saved Away'

DHB deficit is real - It cannot all be 'saved away', Minister Coleman

A Waikato DHB member has criticised his DHB’s Chair and the Minister of Health for claiming in media interviews that Waikato DHB will be returning a ‘break-even’ budget for the 2017/8 year.

Dave Macpherson, an elected member since October 2016, said the Board he was a member of had been “presented in late July a draft Budget showing deficit of $32.5 million”.

“Speaking as an individual member, I can say the Board will not be deciding on the final figures until a Board meeting on 27th September, so Minister Coleman and the Board Chair, Bob Simcock are quite out of order to claim publicly that we will have a break-even budget,” said Macpherson.

“This figure has been presented to the Ministry of Health on at least two occasions, and I have to assume that they have advised the Minister of the correct figures.”

“While we have asked DHB management to come up with savings and other efficiency programmes to reduce the deficit, the proposals presented to our Board will clearly not achieve the level of savings needed in this financial year to reduce this deficit to zero, or even to half the starting figure,” he said. [see list of proposed savings below]

“We were told the $32.5M deficit budget was a ‘business-as-usual’ budget, that only allowed for the same level of service as the previous year, and did not provide either for any new services, or for what we believed was the actual population growth happening in our region.”

“There was a lot of discussion at a Board workshop as to whether we should ask staff to try and find further savings, or whether the Ministry should be advised that this was the budget and could not be cut further.”

On 4th August a Board workshop was held, at which staff proposed for discussion 5 initiatives to make savings of a total of $32M. This was not a formal Board meeting, and only 8 (of 11) Board members were present. The initiatives and proposed savings were:

• $10M – ‘Theatre Management’; making more efficient use of the current operating theatres and surgical staff. It was stated that this work had already started, and it was believed the $10M saving could be achieved, although savings at that rate were not yet happening.

• $10M – ‘Acute Demand Management’; where GPs around the region would be convinced and organised to ‘triage’ patients at their medical clinics to avoid sending as many as possible to specialist assessments at Waikato Hospital, thereby saving on Hospital resources and freeing up specialists to perform more acute and other work at the Hospital. It was agreed that this would involve a major ‘cultural’ shift in the ways GPs (and specialists) worked with patients, and would take some years to achieve. It was openly agreed that the proposed $10M savings would not happen in the first year, and there was discussion about whether ANY of those savings could be achieved in the first year.

• $3M - ‘Patient Flow Optimisation’; a project already being worked on, which would move patients arriving at ED and other initial entry points, through more quickly into the correct specialist areas, and/or triage them earlier, also enabling some to leave earlier. This has been the hope of the DHB for some time, although our ED performance figures in this area have been getting worse, due mainly to outside pressures.

• $2M - ‘Budget Strategy Implementation’; this was described as a “paper exercise” which could save this amount in the first year due to better administrative organisation.

• $7M – ‘Convert Operational Expenditure to Capital Expenditure’; this was perhaps the least detailed of all the proposals, and more information was sought. Two examples given were replacing some data entry staff with robotic or automatic systems to enter data (ie replacing staff salaries with electronic equipment), and ‘resolving points of pressure’. There was a distinct element of wishful thinking with this particular item, and it seemed more a case of how much short of $32M are we? $7M. Right, lets think of a title we can give that savings!

Mr Macpherson said “It was agreed at this workshop that we (Waikato DHB) could not achieve all of the $32.5M savings needed in the first year, and the Chair stated that he believed the Ministry would be satisfied if they could see us moving towards these goals,”

“Therefore, I think it is totally wrong for him to have gone on National media to say that Waikato DHB will have a break-even budget; he knows this is not possible in the 2017/8 year, and he knows that we have not agreed on any position yet.”

Macpherson said he “felt Waikato DHB has been used as a political pawn in the current election campaign by the Chair and the Minister, to bolster the Minister’s argument that some DHB’s can break even, so why can’t they all?”

ENDS

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