Hospitals have been told to make $138 million in savings over this financial year and some have signalled they'll cut costs through staff vacancies which have not been filled.
It has prompted claims of increased safety risks to patients because of stressed out and tired staff who are not being allowed to take the holidays they are owed.
The detail around the "efficiencies" has come from Official Information Act requests by the Labour Party to health boards. It shows Waikato District Health Board as facing the highest expected saving over the 2015-2016 financial year with planned "efficiencies" of $43.4 million. Of that, the documents show the Waikato DHB plans to save $6.879 million "through holding of vacancies".
Hutt Valley DHB plans to save almost a third of the expected $6.73 million it needs by targeting staff, saving $1.9 million through "holding vacancies in mental health and Regional Public Health".
It was also saving money through "holiday roster planning" and cutting back on the use of temporary staff.
The $138 million efficiency drive for this financial year is the successor to the Government's efforts to have district health boards save money through Health Benefits Ltd. HBL was tasked with achieving savings of $700 million in five years -- but an Auditor-General's report found it responsible for just $71 million in savings before it was canned late 2014.
Labour health spokeswoman Annette King said the move to compel savings from health boards came after years of pressure from HBL. "They've squeezed this lemon so hard the efficiency gains are going to be so difficult to find."
She said health boards targeted personnel costs because the ability to hold back on staff who had left was an area they could control, unlike external costs.
Association of Salaried Medical Specialists director Ian Powell said patient safety would be put at risk by over-stretched staff being placed under increasing pressure.
"This is a short-term solution if it's a solution at all. If you don't fill positions that need to be filled you're deferring the problem and increasing the workload on those who need to provide cover. Freezing of positions is not cost-cutting -- that's just straight cost-cutting."
He said a recent survey by the association had revealed sick staff coming to work when they should be at home, including one doctor who was being treated in the emergency department between seeing her own patients.
Public Service Association national secretary Erin Polaczuk said staff were not taking leave and some were working double shifts to cover roster gaps.
She said she was particularly concerned about mental health vacancies because it meant staff did not have time to provide full early intervention care. Failure to provide proper treatment had the potential to create catastrophic, fatal, outcomes.
Nurses' Organisation industrial adviser Lesley Harry said union members had spoken of dreading coming to work and going home in tears because of pressures at work. She said the latest workforce figures showing an increase in the number of nurses in New Zealand disguised the number who had cut hours to cope with stress.
Waikato DHB's corporate services director Maureen Chrystall said "efficiencies" on vacancies were not intentional but reflected the amount saved in the time it took to replace staff who left.
"There is often a time gap during the process to recruit the new staff member due to recruitment processing, advertising etc. We recognise that this churn means we are never fully staffed."
Hutt Valley DHB chief executive Dr Ashley Bloomfield confirmed "holding vacancies" was part of the plan to make savings. "These are generally managerial and administrative positions not clinical roles, and patient care and safety is always the main consideration."
The papers for Hutt Valley DHB also include plans to "reduce oncology ... admission rate to the national average".
Health Minister Dr Jonathan Coleman would not speak to the Herald but in a statement said the health budget was at a record level of $15.9 billion. He said it was $400 million more than last year and "there have been no funding 'cuts'."
The Government's "careful management of the health budget" had seen health board deficits reduced by $150 million since 2008.