DHB disputes Ryall's claim

LINDY ANDREWS AND NZPA
Wait a minute, Mr Ryall - you're not comparing apples with apples.
That was the message, loud and clear, from Hawke's Bay District Health Board today as it reacted to National's health spokesman Tony Ryall's claims precious health funding was being gobbled up by cumbersome management structures.
Mr Ryall yesterday released figures showing the number of managers and administrators had risen by 23 percent since Labour came to power in 1999 - and the cost had gone up by 35 percent to $513,647,000 this financial year.
Mr Ryall accused the Government of fattening the bureaucracy while it cut people from hospital waiting lists. But HBDHB CEO Chris Clarke said he was confounded by Mr Ryall's statement, as he was not comparing apples with apples.
The Crown Health Enterprises of 1999 focused solely on the provision of hospital services, whereas the DHBs implemented in late 2000 were also responsible for primary health care, aged residential care and disability support services.
More than half HBDHB's annual budget was spent outside the hospital.
"We now plan and monitor services right across the district," Mr Clarke said.
"Overall staffing has increased because we're doing a lot more surgery, more clinics and a lot more public health work."
Clinicians and surgical staff needed to be kept free of day- to-day administrative tasks - such as booking theatres, writing up notes and organising clinics - so that they could see more patients.
Having more clinical staff meant more administrative staff were needed.
"It's a hoary old chestnut, raising management numbers," Mr Clarke said.
"Looking ahead at this year's budget I can see significant increases in medical and nursing numbers, well ahead of any increases in management and support."
Board chairman Kevin Atkinson said HBDHB constantly monitored the ratio of management and support staff to clinicians and nurses.
Three years ago it was sufficiently concerned to contract a firm of chartered accountants to measure whether the board was getting value for money.
As a result, 30 management positions were disestablished. However, Mr Atkinson said board members remained worried. "If you watch our figures over the last couple of years, the growth is in nurses and clinicians, but we're doing no more work.
"We're not convinced we're doing things absolutely right, which is why management is looking at restructuring."
The board would further examine the situation at a special meeting - which will be closed to media and the public - this week.
Nationally, the proportion of health sector managers and administrators in relation to doctors and nurses was dropping rather than growing, Health Minister Pete Hodgson said.
While the number of administrators had grown by about 3.5 percent a year under Labour, the number of nurses had grown by about 4 percent and doctors by 5 percent. But Mr Ryall said he believed there must be room to cut some of the 2000-odd extra administrators to free up money for operations.
"You don't need an extra manager for every two nurses you employ," he said.