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The departing chairwoman of the Waitemata District Health Board has taken a swipe at the Government for not giving her area's 500,000 residents their "fair share" of state health cash.
Kay McKelvie announced her resignation yesterday, saying it was partly because she was fed up with trying to balance the books when the organisation was short-changed.
"I don't think we are getting our fair share," she told the Herald. She will leave the $56,800 job at the end of this month, but remain a director of the Crown Health Financing Agency.
Waitemata, which runs North Shore and Waitakere hospitals, has struggled for several years with the district's rapidly increasing population, despite expanding its services. It hopes to add more than 300 new beds by 2013.
After patients were frequently left waiting many hours for admission, North Shore has added more than 60 beds in the past year and wants to revamp its emergency department. Waitakere's ED has had to cut back services because of lack of funding and staff.
Mrs McKelvie, chairwoman for seven years, said the Ministry of Health had told the board in December that its 2009/10 grant would be $1.074 billion. But that was likely to mean a $35 million deficit - $25 million by not keeping up with population growth and a $10 million shortfall on care purchased for patients with complex needs at Auckland DHB. Without extra funding "we really can't increase the amount of procedures we do".
Waitemata would be home to 12.3 per cent of the country's population in 2009/10, but would in effect be fully funded from Vote Health for only 10.9 per cent.
"We can absorb a lot of that, but at the current rate, you are going to fail a lot of your patients, because you are not going to give them the service they are entitled to.
"Do you go into deficit and give them what they are entitled to, or do you keep the books in the black and not provide good service."
She said Vote Health was big enough; it just needed to be shared out evenly. But doing so would be hard: it would require cuts in over-serviced provincial areas and in complex but unviable services in some city hospitals - and more transfers of patients to main centres.
A sister of Helen Clark's right-hand woman in Auckland, Joan Caulfield, Mrs McKelvie was close to the Labour-led Government and until now has kept silent on funding, even when her chief executives have spoken out.
National campaigned on Waitemata's woes and in 2007 the party called for Mrs McKelvie and other Auckland board chairs to go because of the laboratory contracting row - but yesterday she denied any political element to her resignation.
Health Minister Tony Ryall thanked Mrs McKelvie for her long service and commitment, noting they were reflected in her recent appointment as a Companion of the Queen's Service Order, but he rejected her prescription for the health service and her funding claims.
"This year Waitemata is getting an extra $59 million - a 5.8 per cent increase.
"This Government is maintaining the health spending plans of the previous government, so there's no reduction.
"This Government is determined to run a national health service. It is important to maintain reasonable services throughout the country."
When asked about Waitemata's mismatch between population and funding shares, he said: "That's a reflection of the population-based funding formula that has been in place for at least eight years.
"There are swings and round-abouts in that."
