Healthcare outlay is an investment, not a cost

ASMS executive director Sarah Dalton. PHOTO: NZHERALD/SUPPLIED
ASMS executive director Sarah Dalton. PHOTO: NZHERALD/SUPPLIED
The new Dunedin Hospital should be a shining jewel in the New Zealand health system, Association of Salaried Medical Specialists executive director Sarah Dalton writes.

Making do with less is fast becoming a mantra for healthcare workers striving to treat patients.

So, it is uplifting, though a shame it is needed, to see Dunedin people demand that their new hospital be built to the original design.

Build it once. Build it right. Build it to the spec our health workers and patients need.

New hospital builds are a once-in-a-lifetime event. It is important everything that can be done, is done, to ensure they are fit for purpose not just for today but for 10, 20, and up to 50 years into the future.

No easy task, but much effort was put into the original design for Dunedin’s new hospital — to canvas the needs of staff and hatch a design that would suit the model of care for Dunedin. Those involved in this process add the caveat that the original build relied on "a high efficiency" model meaning there was very little fat to trim. The consensus from ASMS members is the original design worked.

Then the project was delayed — aggravating.

Then the project ran over budget — frustrating, but not surprising.

Then came the cuts along with the bill for redesigning the project due to the cuts — infuriating.

Costs will always rise — this only means it will never be cheaper to build the hospital in line with the original plans than it is today.

Would it not be great to be able to say to Dunedin hospital staff and the community that they will not have to just make do with their new hospital for the sake of saving a few more of those dollars?

It helps to think of healthcare spending not as a cost but as an investment. Investing in the original design is investing in reduced waiting times for acute admissions. It is investing in timely provision of planned care.

It is investing in decent clinical and non-clinical workspaces for all the health workers patients seldom see: pathologists, scientists, technicians.

All these people provide essential clinical services. They need working conditions that are top notch and which interlink seamlessly with medical wards and surgical theatres.

All gained for a few extra dollars. Now, a $90 million shortfall is more than just a few dollars. But, seen in a holistic context it equates to about 5% of the total project budget. The question we need to ask is how much we sacrifice to save that 5%. Running 95% of a race gives a much different result than crossing the finishing line.

Let’s stop for a moment and make sure we invest fully in this hospital build, before irreversible decisions are made. Just because a redesign process was undertaken, does not mean it has to be implemented. There is still time to dig deep and find that finish line.

Already there has been too much compromise in healthcare. Doctors are telling us they are preparing to make the best of a bad situation in regard to the Dunedin hospital. In other words, they will manage to make do with less.

Results of Te Whatu Ora’s own Pulse survey of staff show the extent of this making do and the frustration it causes.

On a national level, only 33% of hospital staff feel they have the resources, budget and facilities to perform their jobs and only 56% believe the changes being made at Te Whatu Ora will enable them to better meet the needs of their communities.

Its time we gave more to our healthcare workers instead of asking them to make do. Already they have borne the brunt of the public pay sector salary freeze during a time of the skyrocketing cost of living. At the very least, they deserve the facilities they need to do their jobs as best as they can.

The rallying behind the Dunedin hospital from local politicians, newspapers, and community leaders represents a groundswell change that shows that, when it comes to health, making do is no longer good enough.

Te Whatu Ora has a real opportunity to capture that energy and turn the Dunedin hospital project around. In a way, it is a symbol for our health reforms.

And that is worth a few dollars more.

 - Sarah Dalton is the executive director of the Association of Salaried Medical Specialists.