Downgrading of hospitals possible

By MARTIN JOHNSTON health reporter

Auckland health chief Graeme Edmond is fuelling doctors' fears that the merging of the four big hospitals under his control will downgrade the treatment they provide.

Mr Edmond, the Auckland District Health Board's chief executive, yesterday urged New Zealanders to debate just how high-tech their hospitals should be - and how much they are prepared to pay.

His comments follow the board's partial backdown on Monday on the renaming of the Starship children's hospital.

Board members led by chairman Wayne Brown had renamed it Auckland City Hospital Children's Services, to reflect its administrative integration - along with the imminent relocation of Auckland, Green Lane and National Women's Hospitals - into the new super-hospital to open at Grafton progressively from October.

But after a public outcry and Government warnings, the board altered the name to Starship Children's Department of Auckland City Hospital - although hospital staff and the fundraising Starship Foundation say this is still unsatisfactory.

Most board doctors have been banned from talking to reporters on the issue but some have done so anonymously.

One said the board framed the Starship "problem" as being a hospital providing tertiary (highly specialised) services for which it was not adequately funded.

"Because of that they would rather not have it."

Another said the board's solution to money shortages for high-tech services for the region and the nation was a "downgrading and dumbing-down of services".

Mr Edmond said these views were an over-reaction. The board had no intention of cutting any services.

But with a $55 million deficit forecast this year and a Government directive to end financial losses by July 2006, the board must add a review of its levels of medical specialisation to other money-saving plans, such as a GP scheme to keep people out of hospital.

He agreed with the doctors that the Government paid too little for many of the board's tertiary services. A kidney transplant, for instance, cost the board about $65,000, but it received only $18,000.

The Health Ministry is leading a review of hospital treatment prices, but any changes will not take effect until July next year - 12 months after the shift to population-based funding under which boards will have to buy specialised treatment from other boards.

"Clearly for Auckland DHB in the current scenario of pricing and our deficit and the level of services we provide to other DHBs, it's pretty compelling that we can't afford the extent of specialisation that we have got," Mr Edmond said.

"I would like the country to be able to afford to pay the prices for the levels [of specialisation]," he said, but people had to decide whether more should be spent on things like immunisation or early detection of diabetes.

Any proposed cuts would be publicised and were ultimately for the Government to accept or reject.

Health Minister Annette King said, through a spokesman, that health received enough funding.

"There will not be any more money spent on health than the 20 per cent of Government spending it now is. If any more was spent on health it would have to come off education or other areas."