Board urged to be upfront about rebuild

Richard Thomson
Richard Thomson
A Southern District Health Board member is imploring the board to be upfront about the strings attached to rebuilding Dunedin Hospital.

Speaking at yesterday's meeting, Richard Thomson said the board might need to find an additional $30 million a year for the charge on the capital. He was not sure how the deficit-ridden board would do so. It seemed ''almost impossible''.

Board members were also given an indication of the timeframe for the rebuild. A completed hospital was five to seven years away, finance director Peter Beirne said.

Mr Thomson said health board staff and the public needed to understand the implications of the cost of the rebuild.

He wanted to know to what degree affordability concerns influenced the design of the rebuild. The board should be transparent and open, and must not leave the issue ''lurking in the background''.

Board member Dr John Chambers reminded members of recent controversy on the West Coast, where a group led by clinicians devised a Grey Base Hospital rebuild plan, and then discovered the National Health Board had been planning a cheaper alternative.

Chief executive Carole Heatly said lessons were learnt from other places, and the board was working closely with Wellington health and finance officials.

The new hospital would be designed after assessing future health needs and the region's other facilities, including rural hospitals.

Mr Beirne said the board had a productive meeting on Monday with Wellington officials, where some timeframes were agreed.

He said the leaking surgical theatre suite was a separate issue, and would be fixed as soon as possible.

Chairman Joe Butterfield said Mr Thomson had made a ''fair comment'' about the rebuild.

The board would need to cut costs further to finance the capital charge, he confirmed. Contacted afterwards, Mr Butterfield said the cost was likely to range from $250 million to $500 million.

He believed it would be at the lower end of the range, but emphasised the project was in its very early stages.

''There's always compromises when you build. You never build gold-plated.''

Asked if the board would be upfront with the community, he said: ''Yes, but I've got nothing to tell them right now. It's too early.''

He said the board must become more efficient in how it provided care, including keeping patients away from hospital.

''Hospitals are very expensive places to look after people. If you can do it in primary care, it's cheaper, and often, incidentally, better.''



Capital charges?

Why do hospitals have to pay this, or even pay any financing? Surely this is a cental government function. Health is paid for by taxes; why should we have to pay with what will end up being reduced savings? If the government was going to fork out for $500m to $1b waterfront stadium in Auckland for the rugby World Cup and is looking at $300m for a stadium in Christchurch (the support they gaves us was a mighty $15m, oh the generosity) , then surely they can fund entirely a new hospital , especially when it also function as NZ's teaching Hospital.

The funding model itself is flawed when it comes to Otago. Factors not sufficently accounted for under population-based funding are The Health Board 

- The health board has the largest area to cover
- Within that area it has a much higher percentage of elderly and retired people which tend to require more expensive services and more often
- The area includes Queenstown, which has over 1 million visitors a year, a large percentage of which are here to visit the "Adventure Capital of the World" for activities including skiing, which is second only to rugby in ACC claims

to name just a few items.

If the Health board has to carry the cost for budgetary reasons an increase in budget to cover the addittional cost is surely warranted.  Or is this another way to force movement north of services and an example of double standards by the government when it comes to the South?

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