2 Oct 2020

Cash injection will not fix Canterbury DHB issues - ex-board member

7:08 pm on 2 October 2020

A former Canterbury District Health Board member, who went on to set up Canterbury's Charity Hospital, says the injection of $180 million to wipe the board's deficit will not solve the board's deeper problems.

Christchurch Hospital.

Christchurch Hospital Photo: RNZ / Karen Brown

The Health Minister yesterday announced that the Canterbury District Health Board had been given a $180m equity injection to cover its massive budget shortfall.

However a Canterbury health stalwart says the problems will not be fixed by one lump sum of money.

Surgeon Phil Bagshaw was the chair of the New Zealand branch of the Royal Australasian College of Surgeons, on the Canterbury DHB, and he also went on to set up the Canterbury Charity Hospital.

He said the money would not fix Canterbury's long term funding issues.

"People in Canterbury are acutely aware that the population funding model doesn't serve us too well here, and we've been in difficulty meeting our costs on that basis for some considerable time," Bagshaw said.

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Phil Bagshaw set up Canterbury's Charity Hospital. Photo: Supplied

He said the board's problems go deeper than just the financial issues, and until the governance changes the problems will remain.

"The other worry that we have locally is that there has been a lot of bullying going on, it has been a very intimidating atmosphere working at the hospital with people being treated badly and we are worried that given the current regime that sort of activity will persist."

In his letter to the CDHB confirming the $180m bail-out Health Minister Chris Hipkins said he expected the board to ensure any increases to its costs are only approved if unavoidable.

Hipkins said he expects the board to tighten its delegations of financial authorities to ensure the CEO is responsible for certain items, including recruitment of new personnel, increases in contracts for community providers, and approval of capital expenditure.

Hipkins said in the letter that in granting this approval he reminded the DHB of his expectation that it will manage with its allocated funding.

The executive director of the Association of Salaried Medical Specialists, Sarah Dalton, said while it is a relief that Canterbury's financial difficulties are finally being acknowledged, the funding injection just highlights that all district health boards are underfunded.

"All of the DHBs could do with more money, and it's not just that they want to flagrantly throw tax payers dollars around. If you look at the growth rates of acute demand it's rising much more quickly than the rate of population growth, we've got a lot of poverty and we've got a lot of unmet need and we've got specialist workforce shortages."

She said other boards also under stress include the Northland DHB which is still waiting for a long-overdue hospital rebuild.

Or Southern DHB which is living with a cramped hospital in Invercargill - desperately in need of a rebuild, and trying to build a new hospital in Dunedin.

"Our health system is not supposed to be some kind of provincial Hunger Games. One fighting the other," Dalton said.

"I think we need to have a long conversation about the actual cost of providing the kind of healthcare that New Zealanders expect and need, and we need to put our hands in our pockets and meet that cost. It shouldn't be competitive in that way."

In a statement the Southern DHB chief executive Chris Fleming said his board has incurred operating deficits over a long period of time, and has received equity injections on a number of occasions, including $80m in the last financial year.

He said the provision of an equity injection addresses immediate cash flow requirements for a DHB, however it does not address the underlying operating deficit which gave rise the cash flow situation.

"Like Southern, the underlying operating deficit in Canterbury DHB remains an issue that they will need to address."

The acting chief executive of the Canterbury District Health Board, Peter Bramley, said the DHB welcomed the confirmation of the $180m equity support

He said the money will go towards such things as payments to suppliers, heating and lighting for buildings and staffing costs.

Bramley said the DHB is still working towards financial sustainability.

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