The acute case for new hospitals
OPINION: All of us need good hospitals near us so that when accidents happen or we get sick, we can access both acute and planned healthcare provided by well-trained doctors and nurses working in modern facilities.
A number of our hospitals are ageing and require significant maintenance, and in some cases need to be replaced by new facilities.
Over recent years there has been a limited amount of capital available to build new hospitals, particularly with the rebuild of Christchurch hospitals at a cost of well over $640 million.
At present the process for deciding about new hospitals starts with district health boards (DHBs), which evaluate and plan for future services and how to provide those.
They seek support from neighbouring DHBs, which endeavour to agree regional priorities. Political influences are at play here too. The Ministry of Health and the government make final decisions on spending depending on available funds.
Once hospitals are built, DHBs have to pay for those hospitals by means of a capital charge, which is a charge on their budget amounting to millions of dollars to pay for the use of public money from the Health Budget to build the hospital, and depreciation, which often amounts to large sums set aside for future building replacement.
These two charges place an unfair burden on DHBs that build new hospitals, evidenced by current problems at the Canterbury DHB, which is facing a $54m funding deficit.
What we need is a better way of national long-term planning for hospitals around the country. Instead of a system that results in individual DHBs having less funding available for health services, a national solution is required that takes the burden off DHBs.