More money, fewer patients

Public hospitals are doing fewer operations, despite bulging waiting lists and massive funding injections into the health sector.

A Treasury report looking at the performance of district health boards for the six months to the end of last year concluded that hospitals discharged fewer surgical patients than in the same part of the previous year, despite a 6 per cent funding increase in the 2003-2004 financial year.

"It is probable that the national outputs of both total surgical and elective surgical ... will be below those seen last year," says the report, obtained under the Official Information Act.

It cites rapidly growing clinical supply and personnel costs as possible reasons.

As a result, Finance Minister Michael Cullen has written to Health Minister Annette King about the decline in productivity as demand for operations continues to grow.

The most recent surgical data on the Health Ministry's website confirms the reports findings, showing that about 2000 fewer elective operations were performed in the eight months to March 1 this year than in the same period last year.

The Auckland District Health Board performed 2 per cent less acute and elective surgery in the first 10 months of this financial year than in the same period last year.

A board manager, Nigel Murray, said last night that the reasons included the shift of many services into the new Auckland City Hospital last October. As well, some Waitemata and Counties Manukau patients had been transferred to their own health boards.

Another was "a general trend for reduced productivity" because of the higher cost of medical staff and technology. "We strive, as we should, to maintain standards of new innovation technology and leading treatments and inevitably those cost more."

National Party health spokeswoman Lynda Scott said the trend would come as no surprise to patients, many of whom were struggling to get necessary operations.

"I get people writing to me who are on morphine because they cannot get a hip replacement," she said.

Ministry figures showed that fewer people were receiving cataract and joint replacement operations now than in 1999.

"I think a lot of money is being wasted on political correctness and bureaucracy," Dr Scott said.

"You now have primary health organisation structures in the community and you have all the hospital advisory boards, which have kicked in."

Ian Powell, executive director of the Association of Salaried Medical Specialists, said the drop in operations could be partly due to high numbers of acute, or emergency operations, which were more complex and time-consuming than elective operations.

Despite funding increases, many hospitals, were also still struggling to employ senior surgeons, anaesthetists and intensive care staff, limiting the number of operations they could perform.

Act health spokeswoman Heather Roy said big staff pay rises were sucking up the funds. The problem was likely to get worse with moves by doctors and nurses towards national or multi-employer contract bargaining.

Health Minister Annette King was overseas and unavailable for comment. However, Pat Tuohy, an Acting Deputy Director-General of Health, partly attributed the drop to hospitals not counting all the operations performed.

The ministry was asking boards to review reporting procedures to ensure they counted operations they paid private hospitals to do and day-surgery patients who were moved to outpatient facilities and then not included in the surgical data.

"As technology develops and procedures become less complicated, we are finding that old ways of measuring service delivery might not be the best or most accurate way," he said.

The ministry would not expand on the statement.



TOTAL OPERATIONS

July 2003-March 2004: 187,238

July 2002-March 2003: 187,842.


- STAFF REPORTER, NZPA