Starship cutbacks threaten sick kids

By MARTIN JOHNSTON and FRAN O'SULLIVAN

The number of young cancer patients treated at the Starship is under threat as hospital managers are instructed to plan cutbacks.

The belt-tightening, a response to a $72 million budget blowout, may also affect its plans for more specialised services.

Auckland District Health Board executives have told leaders at the Starship, Auckland, Green Lane and National Women's Hospitals to draw up plans for cuts.

Chief executive Graeme Edmond has directed Starship managers to develop urgent plans to contain cost blowouts in areas ranging from cancer to treating ear infections.

Cancer treatment accounts for one-third of the $6.5 million deficit it is estimated that the Starship will run up in the June 30 year.

Treating gastroenteritis, ear infections and airways diseases are high up the list of 69 clinical areas where the children's hospital has exceeded its budgeted spending.

Mr Edmond has questioned the development of ever more specialised services there, such as the planned shift of children's brain surgery from the adjacent Auckland Hospital next year.

But he emphasised that the board had yet to take decisions on the Starship's finances.

"We have got a full two months of review to go through yet."

His instructions have thrown the clinical team into a spin. They are anxious over where to make cuts so the board can live within its contracts.

The hospital has about 200 cancer patients in treatment. Clinical leader Dr Scott Macfarlane said it would be unrealistic to treat them elsewhere, as the other paediatric cancer units, at Wellington and Christchurch Hospitals, were also stretched.

He interpreted the Edmond directive as requiring clinicians to show how they could avoid doing the volumes that demand seemed to indicate.

Dr Macfarlane said he had indicated to Mr Edmond that Starship chiefs would face difficulties without "a very clear mandate from the public which says they are prepared to suffer that shortfall of care both in terms of quality or volume".

The Government has already tossed back the business plan for a separate, $33 million children's heart unit and expanded intensive care facility at the Starship approved by the previous board. New chairman Wayne Brown is insistent that the proposal be rigorously re-examined.

In Parliament yesterday, Health Minister Annette King showed no willingness to help. She rejected Mr Edmond's suggestion in yesterday's Herald that New Zealand might be able to afford only a "Second World" health system.

"I believe we provide a very good health system. But Auckland needs to do better."

Mr Edmond said part of the Starship's problem was under-use of some high-tech equipment, which required extra operational spending without cost-efficient results.

He highlighted the $1.7 million CT scanner bought in April by Starship Foundation fundraisers.

It cost about $100,000 to run, but performed the equivalent of only 2800 scans a year - 20 per cent on adults - compared with the main Auckland Hospital CT scanner, which performed 12,000 last year.

"The point I'm making is that when capital is scarce, we have to make very wise use of investment and that's going to require as much sharing as possible."

Mr Brown said there was no problem with the quality of care at the board's hospitals.

Both the chairman and his chief executive stressed that while the squeeze forced them to examine unpalatable tradeoffs, they wanted public input into the board's forthcoming strategic plan.

nzherald.co.nz/hospitals