ASMS

We are the union for salaried doctors and dentists.

We promote, protect and support the interests of our members in all aspects of their working lives. We are working for an equitable, accessible public health care system that meets the needs of all New Zealanders.

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Don’t let your health be treated like an exercise in practical accounting

29 June 2020 ASMS comment piece

ASMS has expressed concern about the relentless focus on cost-cutting by the the Canterbury DHB along with the Government’s punitive capital charge regime which may lead to staff cuts. It’s not the only DHB under pressure to slash staffing costs.  ASMS Executive Director Sarah Dalton wrote an open letter to the people of Canterbury published on Stuff and in The Press. 

If you don’t know this already, you need to, because it concerns your health and the health of your friends and whānau. Due to some pretty complex accounting, your DHB continues to pay an unfair price for the Christchurch earthquakes and rebuild.  To make matters worse, you now have a health board which is more worried about getting a gold star for financial management than it is about providing the quality health care and facilities you deserve.

After the earthquakes, the Government of the day decided that it would be okay to fund hospital rebuilds using deficits.  Basically, it was agreed that running up an enormous mortgage would be reasonable because, after all, people need hospitals.

The result is your DHB has a massive deficit, made up mostly of earthquake debt, for which the Government essentially imposes financial penalties. And it is not even for actual buildings or services.  Put in the simplest terms, bank fees are crippling your health system and the Ministry of Health has just asked for another $12 million in capital charges on insurance payments.

Successive governments, as a matter of policy, have corralled DHBs into running deficits. It is affecting other DHBs, but Canterbury is where the rubber is really hitting the road.  Firstly, the health pie is simply not big enough and there are not enough pieces to go around. Secondly, as we all know, your DHB has taken multiple hits courtesy of the earthquakes and having a deficits approach to the rebuild means you are repeatedly being punished for having a natural disaster.

In your favour is that you are the recipients of one of the most efficient, productive, and innovative DHB systems in the country. Our members – senior hospital doctors and dentists – work closely and effectively with senior managers, nurses, and allied health. Together, they have developed an integrated, responsive, lean system.

But here’s the rub.  Your DHB has a new Board, plus a Crown Monitor, both of which are utterly fixed on your bank balance, and what they see are the red numbers smeared all over the page.

They don’t seem very interested that your new Hagley Building has not been built on time or to specifications (so it’s not open yet). Nor is the Board very bothered that current demand for hospital services means Hagley will be at (or beyond) capacity on the very first day the doors do finally open.

It has also opted for a cheaper version of a third tower on the new building, against clinical advice.

This Board is relentlessly focused on cutting costs and making the books look pretty. The result of this focus, alongside the Government’s punitive capital charge regime, means DHB management is being forced to look at slashing people and services.

80 percent of the costs of running your DHB are tied up in people. So, guess where the money will have to be found – guess what happens next?

You need to ask what business any government has, or a Crown Monitor from Auckland, or a Board whose expertise does not lie in health, to force your high-performing DHB to look at laying off 500-600 of its staff, to please the bean-counters.

Putting numbers ahead of the people is not a responsible governance strategy for any DHB.

Your health should not be treated like an exercise in practical accounting.  The Board needs to think about its purpose which is overseeing healthcare for those who need it.  It needs to show some courage and speak up for the people of Canterbury instead of turning against you and forcing cuts to your health services and facilities.

Stand with us and let your Board know where its priorities really lie – something most of us already know and understand – he tangata, he tangata, he tangata…