KEY POINTS:
Auckland's public hospitals could save tens of millions of dollars annually, an analysis says.
The series of reports done secretly for Auckland's three health boards is bad news for the Government, confirming Treasury advice that hospital productivity appears to be declining, despite huge funding increases.
The National Party, which obtained the four reports under the Official Information Act, says they vindicate its views on the state health sector.
"The country has put $4 billion extra into health and is not getting much in return," National's health spokesman, Tony Ryall, said yesterday.
"In fact, it is harder to get an operation and tens of thousands of sick people have been data-cleansed from waiting lists."
Auckland's three health boards receive about $3 billion a year from the Government.
The latest of the reports, dated last July, points to possible annual savings of $35.5 million or 13 per cent of the relevant budgets.
This would be possible if the hospital departments studied had the same efficiency as the most efficient in each category.
The analysis cannot show which is the most efficient hospital - although it may be Middlemore and associated facilities - because it compares just eight departments from each hospital against the same eight at the others.
Measuring declining productivity, the 2005 report found that nurse and doctor costs for a typical patient treatment episode rose by between 7 and 15 per cent in a year.
A year later, the author, consultant Andrew Gaudin, noted "relative stability in overall doctor and nurse productivity over the last two years ... . Doctor productivity has continued its decline over time - 13.5 per cent [rise] in doctor fulltime equivalents while the measured outputs have increased by 3.9 per cent."
In 2004, he reported "doctor salary inflation, [of] 36.1 per cent over last four years".
Politically, the most corrosive aspect of the analysis is that it includes outpatients.
There were doubts about Treasury's concerns about declining productivity because outpatients were not included in national figures until July last.
Health Minister Pete Hodgson declined to comment last night because he had not seen the reports.
Factors which partly explain declining productivity include:
* Pressure for increased staffing levels to improve the quality of patient care in some areas.
* Non-clinical time for senior doctors, enshrined in their collective agreement.
* The 20 per cent "pay jolt" for nurses.
Auckland District Health Board chief executive Garry Smith said in a letter when releasing the reports that the "efficiency gap" they found was significantly overstated.
The Auckland board's relocation in 2003/4 and Waitemata's opening of the expanded Waitakere Hospital created temporary inefficiencies.
The Gaudin analysis did not take into account the higher costs of the Auckland and North Shore hospitals having to cater for their cities' higher caesarean birth rates than Counties Manukau's; nor Waitemata's extra costs of running emergency and maternity departments at North Shore and Waitakere despite relatively low patient numbers.
The deputy chairman of Auckland's three boards, Ross Keenan, said he was disappointed productivity had not consistently improved.
"The reality is, yes, we accept decline in productivity is a huge concern given the huge increases in resources this Government has thrown at health."
