Southern health managers are worried proposed cuts to the new Dunedin Hospital could undermine public faith that they will receive a well-functioning, adequately sized hospital.
Planners managing the $1.47 billion project are trying to constrain an anticipated budget blow-out and have been asked to try to find $100 million worth of savings through a "value management" exercise.
The Otago Daily Times was leaked a copy of Te Whatu Ora Health New Zealand — Southern’s response to that health agencies proposed cuts: the document’s authors warned that many of the proposed cuts would likely end up costing more money in the long run and that some could jeopardise the new hospital’s meeting of the targets set for it in the detailed business case considered by Cabinet when it approved funding for the project.
The document also revealed that the southern region management of the national health agency were deeply concerned by ongoing uncertainty about the size of the new hospital and the scope of services which will be provided within it and how that could affect community support for the project.
"The need for a new hospital has been well interrogated and public interest in the new Dunedin Hospital is high," the report said.
"Social media sentiment indicates that there is already scepticism that the new hospital will be large enough to meet the needs of southern’s growing population, and compounding this is a lack of clarity or confidence about how services in the community will be provided."
The detailed business case for the new hospital was predicated on GPs and community health providers treating a greater percentage of current hospital patients than they do now.
Among many other options, the value management plan proposes cutting one ward, an older person’s mental health ward and two operating theatres, moves which Southern’s response said would greatly compromise the level of care provided to the region if confirmed.
The report emphasised that the new hospital was seen as a southern facility, not just a Dunedin one, and that any cuts to size or services could fuel widespread public perception of unfairness or inequitable geographic access to health services.
It also highlighted that medical staff might also lose confidence in the design process and become unwilling to take part.
"Staff have also expressed anxiety around excluding services or facilities from the scope of the project and assuming that alternative funding will be found to provide these elsewhere," it said.
"The health workforce is well aware of the pressures on health dollars and the historical difficulty in achieving budgets for health projects, however well-supported or needed.
"Therefore staff feel there is significant risk that sufficient funding will not eventuate to offer these services in suitable facilities and the community will suffer as a consequence."
There was also a risk staff would approach the media with their concerns, further fuelling public perception that the hospital would not meet the needs of the community, the report said.
Any change to the size and scope of the hospital would have a widespread negative effect, the report concluded.
"It will be perceived as a ‘broken promise’ if less is delivered than was promised in the detailed business case.
"The knock-on effects are likely to result in poorer outcomes for the design and clinical services for the people of Te Whatu Ora Southern district."
