KEY POINTS:
Senior doctors have hit back at hospital efficiency reports which suggest that measures designed to increase the quality of patient care have helped reduce productivity.
The reports, commissioned by Auckland's three district health boards and revealed in the Herald yesterday, find that hospital productivity has declined in the region. This confirms the Treasury's findings on state health sector productivity nationally.
The Auckland reports suggest that $35.5 million a year could be saved in the region.
This is if each of the eight hospital departments studied at each of the three boards became as productive as the most efficient in the same category.
For instance, Counties Manukau's general medicine department was found to be the most productive general medicine department. If Waitemata's and Auckland's matched it, they would make annual savings of $500,000 and $1.5 million respectively.
The health boards say the reports' $35.5 million "efficiency gap" is "significantly overstated", but the findings help their efficiency research.
The reports compare doctor and nurse costs to the number of average-complexity cases.
They point to quality-improvement processes as one factor in the declining output they chart - such as non-clinical time for senior doctors and schemes for accrediting hospitals and credentialling doctors.
The senior doctors' national collective agreement provides for a minimum of 30 per cent of their time to be spent on non-clinical work such as teaching, reading medical journals and clinical audits.
Ian Powell, executive director of the Association of Salaried Medical Specialists, said it was wrong to consider this as a reduction in productivity.
Improving the quality of health care improved safety and outcomes for patients. This reduced the likelihood of re-admission to hospital, improving the effectiveness of the health system.
"By a broad approach to productivity they [quality initiatives] will be included; by a narrow, bean-counting approach they get counted as anti-productivity. The only beneficiary of this seems to be the recipient of the consultancy fee," said Mr Powell.
Health Minister Pete Hodgson welcomed the reports for their contribution to improving efficiency, but cautioned that productivity analysis in health was inexact because the data available was incomplete.
"These studies in general are fraught with information difficulties."
National's health spokesman, Tony Ryall, whose party obtained the reports under the Official Information Act, said they proved National's claims of inefficiency in health and that Labour was not getting much in return for its $4 billion increase in health funding.
Mr Hodgson dismissed this as "arrant nonsense".
He said that among developed countries, New Zealand spent less than the average per capita on health, yet New Zealanders lived longer than the average.
"In that sense there's a lot to be celebrated around our health system."
