Likely cost less than alternative

Details of the cost of revamping the South Island neurosurgery service are hazy, but it is not expected it will reach the $3.1 million extra it would have cost to set up a one-site model in Christchurch.

The $3.1 million estimate features in the report of the expert panel and is calculated to be the added cost in the first year of a Christchurch-only proposal.

• More on the neurosurgery service decision

No costings have been given for the new plans, which involve retaining four neurosurgeons in Christchurch and recruiting three for the Dunedin site, two of them University of Otago appointments who would have research and teaching roles as well as their clinical work.

Acting Director-general of Health Andrew Bridgman said yesterday further costings needed to be worked through with the National Health Board and the district health boards.

He did not expect, however, the costs would be significantly different from the existing services.

One cost the panel does spell out for the cash-strapped Southern District Health Board is the $600,000 needed for equipment for image-guided surgery.

This equipment is being hired as required at significant cost, which is not a satisfactory situation long term, it says.

"This is a fundamental piece of equipment for a functioning neurosurgical service and the Southern DHB would have to commit to purchasing it in order to attract surgeons," the report states.

No estimate has been given for the costs associated with the setting up of the eight-member governance board, but these costs will be met by the National Health Board rather than DHBs.

It is proposed that payment for neurosurgery services through the two district health boards will change to a population-based funding model.

Under the existing system, there can be friction between boards about how much money they receive through the "inter-district flows" (IDF) system, which estimates the pay boards receive for the work they do for patients out of zone.