Photo: Getty Images Proposed cuts to the size of the new Dunedin Hospital are so severe that the $1.47 billion facility could end up with fewer medical-surgical beds than the current, outdated hospital. The Otago Daily Times has been anonymously supplied with a copy of Te Whatu Ora Health New Zealand — Southern’s response to the Ministry of Health’s "value management proposal" to tackle the expected budget blowout for the new hospital. The southern health team was asked to find $100 million worth of savings by cutting back from the hospital size and services approved by Cabinet in 2021 in the facility’s detailed business case. While accepting that some of the proposed cuts might be feasible, the southern response warned that it was the organisation’s strong opinion that any reduction of any form in the scope of the hospital was ill-advised. "It will increase ongoing operational costs, reduce clinical functionality, decrease the likelihood of us realising the patient flow and efficiency benefits of the new Dunedin Hospital, and lead to higher costs in the medium to long term for Te Whatu Ora," the response said. Sources have told the ODT that the most stringent cuts proposed in the value management plan will probably be rejected, due to staunch resistance from clinicians and the public backlash which ensued after the newspaper revealed the hospital might be reduced in size and scope. However, final decisions have yet to be made and cuts of some kind are inevitable. The document confirms earlier ODT articles which said planners had proposed cutting more than 50 beds from the new hospital. Also proposed were deleting two operating theatres from the detailed business case, not buying a critically needed PET scanner for cancer treatment, not building the proposed logistics building, and severely cutting laboratory and other workspaces. ON the chopping block were 35 adult inpatient medical-surgical beds and a 24 bed inpatient unit providing inpatient services for older people with mental health issues. The plan proposed cutting 56 beds: that would result in the new hospital having 192 medical surgical beds, well below the 227 such beds in the current Dunedin Hospital. The proposal to cut the 35 inpatient beds received "a swift and severe response" from clinical and operational teams who warned that they were critical to ensure acute patients flowed properly through the hospital and that cutting them would also damage the amount of planned care which could be provided. Te Whatu Ora Southern warned that the efficiencies that the value management programme wanted were already incorporated in the hospital’s detailed business case and any further reduction in beds would make proper care unachievable. The proposal to reduce beds, or only build a shell facility to be fitted out later, might be so unacceptable both to staff and the public that their faith in the hospital project might be compromised, the response warned. Southern also resisted cutting the mental health beds, which it said were an essential part of the model of care for older people. The value management plan proposed dropping the new hospital from having 15 fitted and three shelled operating theatres to 14 fitted and two shelled theatres. The southern response said that risked changing the scope of the hospital’s detailed business case, would only provide three more operating theatres than the current hospital which was already at more than 100% capacity, and would mean having outsource more operations something which already costs Southern more than $12 million annually. Clinicians consulted regarding reducing the proposed pathology lab space in the new building from 1300sq m to 180sq m had reacted incredulously, the response said: "we wonder if any clinical staff have been involved in these decisions," one said. Although some extra space would be made available in the old hospital building that was unsatisfactory for a tertiary level training hospital, that clinician said. The board of Te Whatu Ora Health New Zealand met yesterday in Taupo, and health infrastructure projects were on its agenda. It is not known if the new Dunedin Hospital was discussed, but it is understood that the board is considering its response to how to deal with the rising costs of the new hospital. Health Minister Andrew Little has said that the Government would ensure that a hospital which met the needs of the people of Otago and Southland would be built in Dunedin. Mr Little has instructed Te Whatu Ora that he must be consulted before any changes to the size and scope of the hospital are approved. The outpatient building, now being built, is not affected by the cost cutting proposals but the larger inpatient building planned for the former Cadbury factory site but as yet unconsented, is. mike.houlahan@odt.co.nz
