At yesterday's hospital advisory committee in Invercargill, board chairman Joe Butterfield gave management a stern directive they must not deliver too many surgical procedures this financial year.
In 2011-12, the SDHB carried out 258 more elective discharges than its budgeted plan, contributing to a $12.7 million deficit.
"We can't allow it to happen again next year," Mr Butterfield told the meeting, referring to 2012-13.
Member Branko Sijnja pointed out the board risked financial penalties if it under-delivered surgical procedures.
Chief executive Carole Heatly assured Mr Butterfield this financial year would be different.
The executive management team would keep a close eye on each specialty, she said.
The board "blew out" last financial year in four specialties, including ear, nose and throat, and gynaecology.
The health board should have "put the brakes on" partway through 2011-12, but did not, Ms Heatly said.
Board member Tim Ward said the situation was concerning for the SDHB, but "great for the patient".
Much of it was driven by trying to achieve elective surgery targets, for which there was financial incentive, he said.
Mr Butterfield said there was a lack of correlated data showing the exact financial impact of over-delivering elective procedures. Not knowing how much it added to the deficit made governance more difficult.
Mr Thomson pointed out financial impacts of too many surgeries might not be easy to quantify on their own, because of general overheads.
Over-ordering elective surgery contributed to a 49% blow-out in outsourced clinical procedures, which were $2.95 million over budget.
"Caseweights", a more precise measure of surgical volumes than discharges, were 736.17 over budget (5.19%).
