GPs to triage patients, robots to replace staff in Waikato DHB deficit savings plan

Waikato District Health Board is trying to reduce a $32 million deficit. Photo / Christine Cornege.

A cash-strapped district health board is considering using robots to replace staff and making GPs triage patients at medical centres in a desperate effort to claw back savings.

Waikato District Health Board is $32 million in deficit, and even if it breaks even there will be no room in the budget to increase services.

It follows revelations last week that district health board debt collectively has ballooned to $117m for the past 12 months, more than twice the $58m forecast in October 2016.

And the estimated deficit of the country's 20 DHBs is predicted to climb to more than $160m for the current financial year.

Waikato District Health Board member Dave Macpherson said Health Minister Dr Jonathan Coleman was wrong to say last week the DHB had found savings to break even on its $32m 2017/18 draft budget deficit.

Macpherson said the board was still considering options to make the savings and would not sign off the budget until next month.

The savings plan includes:

• Convincing GPs across the region to triage patients at medical centres to avoid clogging Waikato Hospital with specialist assessments, a savings of $10m;

• Making data entry and other staff redundant and replacing them with robots and automated systems to reduce salaries to save $7m;

• Freeing up $10m in better theatre management;

• And speeding up patient flow through Waikato Hospital's emergency department, consistently one of the worst performing EDs for the Government's 6-hour wait target, to cut costs by $3m.

The details come one day after the Herald revealed an office building renovation being undertaken by Waikato DHB has blown out to almost double the cost, from $7.7m to $14.7m in one year, and now requires Ministry of Health approval.

It also comes at the same time the DHB's chief executive Dr Nigel Murray is under investigation for alleged unexplained spending of taxpayer money, and the DHB is being audited over its handling of the situation.

Macpherson said a board workshop earlier this month to address the deficit heard not all of the savings could be made in the current year.

The GP initiative in particular would take a major "cultural shift" in the way GPs and hospital specialists worked and would take some years to achieve.

"I feel Waikato DHB has been used as a political pawn in the current election campaign by the chairman and the Minister [of Health] to bolster the Minister's argument that some DHB's can break even, so why can't they all?" Macpherson said.

Another board member, Mary Anne Gill, said the challenge to overhaul the budget would be huge.

"It'll be like turning the Titanic around."

Acting chief executive Neville Hablous said the DHB would be working toward break-even but it was incredibly challenging.

"As like many DHBs in New Zealand are finding, the acute demand that we are currently seeing in our hospitals is stretching our resources, and costs are also rising significantly."

Hablous said the DHB was "absolutely not cutting services".

Around GP triaging he said the DHB was reviewing Primary Options, a scheme that gives GPs access to a range of services to treat patients in the community rather than sending them to hospital.

On technology, Hablous said the DHB would look at how it could be more efficient.

"For example using computer code to automate data entry that speeds up processes or moving to electronic ordering for laboratory tests rather than a paper system, to make life easier for our doctors."

Board chairman Bob Simcock did not return calls.

Dr Coleman said he was not surprised at Macpherson's comments given it was "election time".

"I talk with Mr Simcock regularly and it's fair to say that there are pressures that the hard-working staff at Waikato DHB are dealing with."