KEY POINTS:
Private hospitals perform more than a 10th of the elective surgery funded by Auckland's three health boards.
Private contracting has become a campaigning point for National and Labour, but the policy differences are more subtle than whether or not to offer the work, which compensates for lack of public capacity.
In 1999-2000, when Labour took office, the Auckland DHB contracted just 0.1 per cent of its elective surgery (the number of procedures weighted by their complexity) to the private sector. Counties Manukau and Waitemata DHBs contracted out none.
But in the past financial year, the three contracted out 10.6 per cent.
This cost taxpayers $8 million at Auckland DHB, $6.4 million at Counties, and $4.9 million at Waitemata - a total of $19.3 million.
Last year, 1308 Auckland DHB patients had elective surgery in the private sector, 1819 from Counties and 684 from Waitemata. The boards differ on whether they contract out mainly complex and expensive or more straightforward, cheaper surgeries, procedures and investigations.
The big increase came after 2005, following the start of big Government cash injections for hip or knee replacement and cataract surgery.
At Counties, 805 people were given cataract operations last year in private facilities, 143 received hip or knee surgery, 72 had obesity surgery and 128 had tubal ligations. Waitemata contracted out 236 colonoscopies and 242 hip or knee replacements. The largest groups from Auckland were 188 hip or knee replacement patients, 179 children who had grommets put in their ears, 144 cataract patients, and 132 who had cardiothoracic surgery.
Counties' chief operating officer Ron Dunham said yesterday that his board was aiming to contract out 10 per cent of its case-weighted volume this financial year, but the first quarter's trend was above the target, partly because of a larger than expected number of acute cases.
National's policy is to offer a smoother flow to private hospitals, so as to obtain lower prices and ease the pressure on the public system.
Private hospitals have long argued they would expand capacity if offered set volumes well in advance.
Labour paints National's health policy as offering work to its friends in the private sector.
National's health spokesman, Tony Ryall, said the party was committed to expanding the public health sector. Labour was clearly already close to the private sector itself with 14 per cent of Counties' electives being contracted out last year, he said.
"These clumsy ad hoc catch-up contracts are wasteful. If they had smarter, better planned arrangements, more New Zealanders would have got the vital surgery they have been waiting for."
Health Minister David Cunliffe said he had always been happy with a complementary relationship between private and public medicine.
"The ratio of public to private is about as high now as I am comfortable with. The last thing we need is for private medicine to suck any more capacity out of the public system."
THE NUMBERS
How much elective surgery did district health boards contract to the private sector in the latest financial year?
* Auckland 8.3 per cent.
* Waitemata 9.6 per cent.
* Counties Manukau 14 per cent.
Note: Based on number of procedures, adjusted by the complexity of each one.
