Cuts, real or imagined?

Understanding Health Minister Andrew Little’s insistence changes to previously announced Dunedin Hospital plans do not constitute cuts takes some mental gymnastics.

Maybe they are Claytons’ cuts; the cuts you have when you are not having cuts.

Just before Christmas the Government announced it would be spending an extra $110 million on the project to help offset a $200 million budget blow-out, making up the difference with design changes.

This would mean that whenever the hospital eventually opens it would have fewer beds, fewer operating theatres and fewer scanners than previously stated.

When Mr Little says these changes are not cuts, perhaps he is comparing the proposed hospital with the existing hospital’s woefully inadequate capacity.

Whatever his reasoning is, clinicians involved in the tortuous process of thrashing out the details of the business case for the new build, with the inevitable compromises, might now be wondering why they bothered.

Holding out the carrot of providing shell space so amenities can be installed later is not convincing.

As many have pointed out, this seems like false economy, given that costs will continue to rise, giving future bean counters more reason to procrastinate.

Also gone in the changes was a pavilion building intended to provide collaborative staff work spaces and other staff amenities, and the loss of many non-clinical spaces.

As unions representing clinicians have pointed out, this loss of non-clinical work spaces means a more stressful working environment for staff. With health professionals in short supply, this is not a good look. The unions are not swayed by the assurances being given about the distribution of non-clinical work spaces in the inpatient building.

Will we see nurses wanting to have mask-free time with colleagues commandeering patient lounges for part of the day the way they have to now in the existing hospital?

The chopping and changing of previously agreed plans might encourage health professionals who have been hanging out for the new hospital to desert the creaking Dunedin Hospital ship now rather than wait around.

Uncertainty over the new hospital, which will serve as a major teaching hospital for the University of Otago’s School of Medicine, will not help attract top-notch medical academics to the city either.

The new hospital’s local advisory group chairman, Pete Hodgson, has entered the public relations battle with a two-part article on the issue, the second part of which is published today.

Whether his arguments will be accepted is questionable.

For instance, the reduction in planned operating theatres is put down to the growing trend towards 10-hour surgical days rather than eight-hour ones. We would be surprised if this trend has only emerged since 2021 when the business case details were decided.

This week, the Dunedin City Council will consider a notice of motion from Cr David Benson-Pope and seconded by Mayor Jules Radich supporting the new hospital being built to the specifications in the final detailed business case approved by Cabinet, and stating the council will not accept changes that reduce the long-term capacity of the new hospital or compromise in any way the clinical services available to residents of the city and wider region.

The motion also seeks the commitment of all parliamentary parties to adequately fund that work, possibly because although local list member of Parliament Michael Woodhouse has talked big in his criticism of the changes, he has not been able to offer reassurance that a future National-led government would build the hospital according to the original detailed business case.

The notice of motion asks the council to commit to fund a public campaign of up to $130,400 and seek support funding from other sources.

Mr Radich has already written to Mr Little expressing concerns about the changes and alerting him to a mood for public protest, after initially misreading the seriousness of the issue. He has the backing of southern mayors.

Public protest could become a reality soon if the council votes for the notice of motion this week.

We hope the Government is paying attention.