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Dunedin could lose more jobs under moves to centralise health board finance, procurement and administration jobs.
The situation has sparked a call from a Southern District Health Board member to centralise health board jobs in the South, rather than in Wellington or another big centre.
When contacted, Health Minister Tony Ryall said through a spokeswoman: ''You're jumping the gun - there isn't even a proposal [document] out there yet.''
Centralisation of a raft of services is being driven by Crown-owned Health Benefits Ltd (HBL), which has been set up to cut costs.
A move to centralise payroll functions had not been drawn up, but is being considered.
However, HBL's finance, procurement and supply chain project, affecting accounts payment and other roles, will be gradually introduced from early next year.
HBL estimated savings of $10.4 million in 2013-14, $47.37 million in 2014-15 and $67.15 million in 2015-16 from the finance, procurement and supply chain programme.
The number of jobs to be centralised is unclear. When contacted, Southern District Health Board chairman Joe Butterfield declined to comment.
''At this point, issues are still being dealt with internally, and with our staff, and I'm certainly not prepared to comment while it's in that situation.''
The Timaru-based chairman refused to comment on concerns the South is losing too many jobs.
''I don't want to get into the issues currently circulating in Otago.''
However, health board member Malcolm Macpherson, of Alexandra, is concerned about a loss of community cohesion as people move away to find work.
''[A central processing centre] could be in Dunedin or Invercargill, just as easily as in Wellington or Auckland.''
He agreed with the concept of a national processing centre for functions such as payroll, because New Zealand was too small to have separate units in each health board, he said.
''If there's a bit of a head of steam in Otago about saving jobs ... this is a really good example - this service could be provided anywhere in New Zealand.''
In other countries, greater effort was made to share the spoils of centralisation around the regions, Dr Macpherson said.
Eventually, boards would be left with a small team of senior finance people, to advise on strategic matters.''
What would go would be those at the lower level.
"The administrative jobs, doing payroll checking, the human resource aspects of getting people on payrolls and off payrolls. Changing leave provisions, and all that sort of stuff.''
Dr Macpherson said HBL's plans were drawn up largely behind the scenes, without the chance for much local input.
''HBL, with their national mandate, will have made their decision before you've had a chance to influence them.
''The national organisations who are making the calls couldn't care less about Auckland or Dunedin. They just want to save money and put it in one place.''
Dr Macpherson feared the Stand Up Otago initiative launched by the Otago Daily Times would fail, because despite public support, there was no mechanism to effect change.
''It's all very well making a fuss, and whingeing to ministers, and front page ODT. If there's no way of giving effect to that ... then it's just hot air.''
Dr Macpherson was concerned staff might leave while there is uncertainty concerning their jobs.
''That's one of the reasons why organisations like ours tend to pussy-foot around this stuff, and do it in public-excluded [meetings], and keep it below the horizon, because there's a real risk that you lose good people, because they become unsettled and walk.''
Through a spokeswoman, Southern DHB management referred all comment to HBL, and refused to state how many jobs might be affected.
Hutt Valley and Wairarapa district health boards chief executive Graham Dyer said his DHBs would be among the first brought into the finance, procurement and supply chain centralisation over the next nine months or so.
It was not known where the service would be based, and he said staff were yet to be consulted.
HBL had started to look at payroll centralisation, but this was at an ''early investigative stage'', Mr Dyer said.
HBL has also proposed centralising hospital kitchens, which could result in Dunedin Hospital's kitchen being significantly downgraded.
An HBL spokesman referred the ODT to its website, but did not respond to specific questions.
The Public Service Association said it was unable to comment yesterday because the appropriate people were unavailable.