Lack of financial overview identified

Branko Sijnja.
Branko Sijnja.
That no one person was specifically responsible for the bottom line at Southern District Health Board was a factor in its financial problems, papers the board tried to keep secret show.

The board released the papers after the Office of the Ombudsman decided to investigate a complaint by the Otago Daily Times.

The board is holding on to a third paper, which continues to be the subject of an Ombudsman's investigation.

In one instance, someone had forgotten about an agreement to fund 24 beds at Wakatipu Lake Home and Hospital, and it was left out of the budget, the papers revealed.

Only 14 beds were occupied, the January 2015 report said, but the board had to shell out for 24 anyway.

Aged care was a big focus of the board's financial review.

Because of lower incomes in the South, the board has to pay more in residential care subsidies, because more people qualify.

The problem would have a ''cumulative effect'' as the population aged.

The board spent 16.1% of its budget on disability support (including rest-home subsidies), compared with 11.1% at Waikato District Health Board.

While that was largely outside its control, it needed to keep an eye on things like the increased number of aged care beds being provided in the private sector.

It also needed to do more checks to ensure the board was not being overcharged through invoicing errors.

Rest-home stays in the South were longer than the national average, but targeting that would take ''time to show a return''.

In the home-based help service, a staff member who set up a contract left before a system to monitor its cost had been set up.

As a result, there was ''considerable uncertainty'' over its true cost. Finding ways to cut costs has been a major focus at the board for years.

What the review found was that budgets reflected hoped-for savings, rather than showing likely costs.

''As a result, the savings that needed to be found to achieve the planned result were not transparent and, as a result, there is a greater risk that they will not be achieved.''

Responsibility rested with business analysts who reported to portfolio managers.

''There was no one person in finance or planning and funding who was specifically tasked with monitoring the total funder performance against budget and investigating variances.''

Savings identified from getting GPs to change prescribing habits did not eventuate.

It would have needed significant ''cultural change'' from GPs.

The reports were written by Auckland consulting firm Alma Consulting, which was brought in to review finances line by line.

The board posted a $27 million deficit in 2014-15, and with the situation set to significantly worsen, board members were sacked in June and replaced with commissioner Kathy Grant.

Sacked board member Dr Branko Sijnja said yesterday the board decided to be completely open about its financial situation, and that probably led to its demise.

''Late last year, we made a decision to not fudge the workings ... not try to hide it.''

''It killed the board in the end, but it was brutally honest.''

Acting commissioner Graham Crombie said organisations had different ways of managing budgets, and it was not unusual for several people to share responsibility. He said the reports were now ''historic'', and written before his involvement with the board.

''What I'm focusing on is what we're doing now.''

Alma continues to assist the board, which shelled out more than $486,000 for the contractor's first 13 months' work (to the end of July).

The board is trying to recruit a permanent chief financial officer.

The position has been an ''acting'' one for several months.

eileen.goodwin@odt.co.nz

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