In a paper presented as an appendix to the recently-released report of the clinical advisory group considering options for future health care in the Wakatipu, Dr Millar suggests the estimated annual spending of $6 million on the hospital was "incredibly cheap", considering the service provided.
The idea the hospital could be be clinically and financially sustainable at decreased cost was a "dangerous misconception" unlikely to support development of rational policies, he said.
The report, to be considered by the Southern District Health Board next month, gives majority support for a model involving a combined Dunstan Hospital and Lakes District Hospital workforce under Central Otago governance.
Lakes District Hospital is run by the DHB while the board funds Central Otago Health Services Ltd to run Dunstan Hospital at Clyde.
Yesterday, chairman of Central Otago Health Services Russell McGeorge, who had some input into the advisory group's process, said he had not yet read the report and it was too early to comment.
The report asks that its preferred option be costed, along with the status quo, and an option supported by three members, combining Queenstown Medical Centre accident and medical services with the existing hospital emergency department under a new community trust service in the new Queenstown Health Campus at Remarkables Park.
The advisory group also recommends keeping the existing Lakes District Hospital service until research into population needs and tourist effects on services is undertaken, new funding models are researched and strategic planning undertaken for service development.
The group was told by one of its members, Queenstown Medical Centre director Dr Hans Raetz, that the new-site proposal had been agreed between GPs and Lakes District Hospital clinicians, nurses and managers.
And while the deliberation over the issues continues, Dr Raetz, in his report, criticised further delays, saying the centre would be starting construction of a new comprehensive health care facility in March. Dr Millar said the claim the existing hospital was clinically unsustainable would get support if it could be shown other comparable hospitals in New Zealand operated at lower total cost or lower cost.
No such information had been provided to the group, although he noted it had been disclosed the contract between the Southern District Health Board and Dunstan Hospital was worth about $7.5 million.
The controversial proposal from Cranleigh consultants, which proposed revamping the hospital and turning it into an integrated family healthcare centre with general practitioners acting as gate-keepers for emergency care, was rejected by the advisory group.
Dr Millar said in all the discussions over the future of the hospital there had been no suggestion clinical services should be reduced and the Cranleigh proposal suggested adding new services.
The requirement to be both clinically and financially sustainable was probably impossible in practice because the two were in competition, he said.
Clinical Advisory Group recommendations on options:
1. Cranleigh model - one-stop shop in revamped Lakes District Hospital - rejected. Not supported by the community or general practice.
2. The status quo - should continue until a superior model confirmed. Should be costed.
3. Variation on Cranleigh model - rejected because of limited opportunities for service development.
4. Trust provider/company operating Lakes District Hospital on existing site - rejected because it would be in direct competition to Wakatipu GPs.
5. Combine Queenstown Medical centre with Lakes District emergency department on a new site at Remarkables Park - minority support and should be costed.
6. Combined Dunstan and Lakes District Hospital medical workforce under Central Otago governance structure - recommended by majority and should be costed.
Advisory group members: Prof John Campbell (chairman) Cathy Gilmore, Norman Gray, Jenny Hanson, Dr Jennifer Keys, Alasdair Millar, Dr Val Miller, Dr James Reid, Dr Garry Nixon, Dr Hans Raetz, Kate Te Paa, Nora Thompson, Mary Whitham.
