At a board hospital advisory committee meeting he referred to a recent situation when the hospital had 32 patients waiting for acute surgery. This was resolved when elective operations were severely reduced, but a significant part of the problem was the directive that elective volumes had to be maintained at all costs, he said.
If the board did not meet its elective targets it affected funding and the way it was paid.
Mr Bunton said he understood the political and financial implications which resulted in an understandable reluctance to cancel elective surgery, but cancellation was often the most appropriate action.
He pointed out that during the past few years, if the number of acute and elective operations were combined, there had been a slow increase in the total number of patients receiving surgery.
During discussion it was pointed out that if patients on the elective waiting list had acute surgery for the same condition, their treatment was not cross-credited as a reduction in the elective list, even though effectively that was what happened.
Mr Bunton said concentrating on overall totals would give greater organisational flexibility, improve patient flow and make better use of the hospital.
Committee chairman Richard Thomson said the measure of productivity which should be taken into account by the Ministry of Health should be the total number of cases dealt with, rather than their source.
The board would have to argue that point, but would also "have to be beaten about the head'' if the total number of operations was not increasing.
Research may be carried out to see why many Otago District Health Board staff are not having free flu vaccinations.
At this week's committee meeting, chairman Richard Thomson said he was concerned at the contrast between what "we ask of the public and what we ask of ourselves''.
The board was an organisation which cared for ill people, but those working there had a "capacity to make them more ill'' by bringing in the flu.
The board had a duty to improve the situation.
Last year, vaccination rates among health-care workers across the country were only about 30% and Otago's rate was under that. Chief nursing officer Teresa Bradfield said indi-cations were that results this year were similar to last year's.
Committee member Dr John Adams, who is also dean of the Dunedin School of Medicine, said it could be a suitable research project for trainee interns.
