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Rural hospital managers are not convinced by the Otago District Health Board's insistence that centralising health staff who co-ordinate community care packages for the elderly will improve services.
Clutha First manager Ray Anton said the move was clearly to ensure planned cost cuts were carried out correctly.
The board is cutting funding for housework for the elderly, except for those in exceptional circumstances, starting next week.
From Monday, health staff who put together service packages for the elderly will be Dunedin-based.
Staff were previously based at Balclutha, Oamaru, and Dunstan hospitals.
Needs assessors remain at rural hospitals.
Mr Anton said Clutha First would have been prepared to make the spending cut decisions, if forced.
He understood why the DHB would want to centralise staff.
Arguments that the move was to improve services did not wash.
The DHB needed to save money by cutting services, and did not believe the rural hospitals were able to make the cuts, he said.
Clutha First was in the best position to know which elderly in its community were the most vulnerable and should receive housework help.
One positive was that a staff member had transferred to Dunedin and would commute from Balclutha, spending a day in Balclutha each week.
The DHB insists that centralising staff is unrelated to the $3 million saving it hopes to make in elderly care in Otago.
ODHB group manager Elaine Chisnall said the move was not to cut costs, but to improve services.
"A centralised system means we will have consistent practice in the allocation of packages of care.
"Whether you live in Dunedin, Dunstan, Oamaru or Balclutha, people will receive the same level of access to services, irrespective of location."
The timing was coincidental, and it was planned well before the housework cuts announced last week.
Some cost savings might result from a tighter service, but that was not the focus.
Public Service Association organiser Julie Morton said three workers had been made redundant at rural hospitals.
Oamaru Hospital general manager Robert Gonzales said it was inevitable that clients would now have less face-to-face interaction with service co-ordination staff.
Getting the right services in place for elderly was vital.
However, he was pleased that a service co-ordinator would visit Oamaru at least once a week.
Central Otago Health Services general manager Dr Carol Horgan said she was prepared to give the new service time to bed in, but the DHB would be hearing from her if there were problems.