New Auckland hospital way off savings target

Residents of Auckland City receive less treatment than other New Zealanders on a range of surgery measures, despite hosting the country's most sophisticated hospital.

Some doctors blame this on too few beds and staff at Auckland City Hospital, which opened in 2003. It was designed to deliver more efficient healthcare, with fewer beds, but it is struggling to meet its savings targets even as treatment levels fall compared with other hospitals.

The hospital treated slightly fewer inpatients in the year to June than in the previous year, but general manager Nigel Murray said yesterday that it had treated the numbers it was contracted for. He added that more outpatients were being seen than before the new hospital opened.

The Grafton hospital - which replaced three others - plus the Greenlane Clinical Centre and other new facilities cost $550 million. Paying for the development and the failure so far to secure all the promised savings have contributed to the board's huge deficit.

The Health Ministry says many of the 21 boards will be out of deficit this year, but the Auckland District Health Board remains in the red. The national deficit is expected to reach $100 million, most of it at Auckland, which receives more than $1 billion a year in taxpayer funding.

Better patient care was promised with the new hospital and clinical centre, plus savings of $45 million a year, partly through a 10 per cent cut in the number of jobs.

The board's average number of hospital beds in use dropped to about 980 after the changes, from 1062 previously. The number of staff has actually increased to 7203 fulltime equivalents, from 7124, as services have been added or expanded. The annual savings have climbed to $31 million and are soon expected to reach $36 million. The new hospital has been dogged by problems in its instruments sterilisation department, theatre nurse shortages, and a slow computerised records system.

It has remained overcrowded and, like many, is struggling with waiting lists for elective surgery. Managers maintain its teething problems are being overcome and while some doctors agree, others are less sure.

Dr Murray said it was too soon to judge the hospital over the savings because aspects of the scheme were not yet finished and the day-surgery clinic at Greenlane, which would produce efficiencies, had just opened.

He expected the number of inpatients, down 2 per cent last year despite population growth, would reduce further.

He suggested Auckland's below-average showing on the surgery league tables was because of historical over-funding of South Island hospitals and increasing primary care, and possibly because Aucklanders needed less surgery and made greater use of private hospitals. But one doctor said it was because Auckland Hospital was too small and under-funded for its population and efficiency targets were unrealistic.

However, Professor Stephen Munn, of the liver and kidney transplant service, disagreed: "We like the new hospital. Even though there were some infrastructural glitches, our service is doing well."

Surgery rates

Auckland City residents receive fewer operations per head of population than the national average for 13 types of surgery.

Tonsils and adenoids surgery is among the lowest, at less than half the average. Only cataract surgery is slightly above the average.

Source: Ministry of Health