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The Southern District Health Board spent more than $80,000 on consulting advice from a United States-based firm, an Official Information Act request reveals.
The spending helped the board ''stay current in an international world'', patient services director Lexie O'Shea said in a statement.
The $81,358 paid to The Advisory Board Company in February last year was part of nearly $1.3 million spent on a wide range of consultants in 2012-13.
It included more than $639,000 paid to PricewaterhouseCoopers, which advised the board on how to reduce its deficit.
The figures were released last week, but the board did not respond to questions until Wednesday this week.
Asked about The Advisory Board Company, Mrs O'Shea said there were no New Zealand-based providers of ''services of this calibre''.
''SDHB use [The Advisory Board Company] because they have a large number of hospitals in their network, which is good for benchmarking across the world. They are internationally recognised as best-practice providers and use the latest research-based information.
''The Advisory Board Company are also very responsive to requests for information and support, and we have a history of success in using their [information] for programmes, such as the productive operating theatre on the Southland site.
''They have offices in Australia, and being part of this network ensures we stay current in an international world.''
Mrs O'Shea confirmed the board continued to ''subscribe'' to the US-based company, but did not respond to questions about the ongoing cost of the service.
Health board chairman Joe Butterfield said when contacted he did not know the particular circumstances, but considered it acceptable for the board to seek offshore advice when necessary.
The board also released details of more recent spending with Health Partners Consulting Group, which is analysing and assessing future health needs in the South.
In the current financial year, Health Partners received more than $145,000.
Former director-general of health Stephen McKernan, of Auckland, is the company's managing partner.