Spending rises but surgery falls at city hospitals

Aucklanders face waiting lists and long operation delays.

The Auckland health board's elective surgery numbers are lower than five years ago and it has been given a stern Government warning about the lack of transparency of its waiting lists and lengthy operation delays.

Fewer people are also having elective surgery in Wellington and Christchurch than five years ago, according to figures released by National MP Tony Ryall yesterday.

They reveal that despite significant extra spending on hospitals, the Government had failed to improve hospital waiting lists, he said.

Auckland's position was particularly serious because, although its population had grown considerably in five years, fewer people were having operations, he said.

The figures for all district health boards show national elective surgery numbers have risen from 99,256 in the 1999-2000 year to 107,208 for the past financial year.

Health Minister Annette King wrote to chairman Wayne Brown last August saying the board had had several years to comply with the elective surgery waiting list policy and she was "concerned and disappointed" it had still failed to comply in several areas.

Mrs King's "strong view" was that chief executive Gary Smith should have his performance agreement - for his $400,000-plus salary - altered to make the district health board comply, the letter said.

Mr Ryall questioned Mr Smith and Mr Brown about the Auckland figures and the letter at a select committee last Wednesday. They show that in the 1999-2000 year, the board recorded 12,806 people had elective surgery for non-urgent conditions.

The number had dropped to 11,693 by the last financial year.

Mrs King's letter said the board was aware elective surgery was "one of the Government's key priority areas" and the policy was based on clarity, fairness and timeliness for patients.

But clarity and timeliness were not being provided to patients seeking elective services, the letter said.

"With regard to the principle of fairness, this is addressed by ensuring that: to the best of a clinician's ability each patient is prioritised against other patients with the same condition and; patients are then treated in order of the priority given. There is considerable room for improvement in your DHB."

Asked by Mr Ryall why Auckland's rates were so low, Mr Brown said it was "partly due" to the fact that several other DHBs in the region were now offering the services it had previously provided.

It was a "close to home thing", he said.

Mr Smith said Counties Manukau and Waitemata had picked up many of the services.

Mr Ryall's figures, provided in answer to parliamentary questions, show elective surgery discharges from those two boards have risen significantly in five years.

Asked what the elective surgery rate would be this financial year, Mr Brown said "on the trends it will probably drop but the number [getting surgery] from within our own district will rise".

"People from our own district have partially paid the price of pressures on ADHB. We've tended to have under-served people from Auckland City at the expense of many of the requirements of the rest of the population and that is a trend we are reversing."

Mr Brown said yesterday that the board was now delivering more services than it was being funded for.

He believed Mrs King's letter was a little "harsh".

Last year "we managed to do everything we had to do, as well as shift 4000 patients and staff" from the old Auckland hospital to the new one, he said.

The move had resulted in the board getting a "a bit behind" in completing its reporting.

"Some of what she was talking about was the reporting, not meeting the target [itself]," he said.

Asked if the targets were being met now, he said: "We haven't met them all, but we're steadily getting better at it." He was "pretty sure" Mr Smith now had reaching the targets as part of his performance agreement.

Surgical cut

Health spending has risen from about $6.6 billion a year when Labour took office to about $10 billion.

Extra targeted elective surgery funds have gone into joint and cataract operations.

But most of the extra spending has gone into rolling out the Primary Health Organisations.

$549 million was spent on the nurses' pay settlement last year.