Savings of $10m 'tough but possible'

There's "no point whatsoever" trying to go back to the Government to argue there's not enough funding to meeting existing and new health targets.

So says Hutt Valley District Health Board chairman Peter Glensor, who believes it will be "tough" but "possible" to make savings of $10 million in the financial year beginning July 1, to enable the board to finish that year with a budgeted deficit of about $3m.

He's sticking by his view the savings can be made without cutting services to patients. Last week's HVDHB meeting got off to an unusually terse start when David Ogden demanded that Hutt board members get to see all minutes, including "non-public", of Capital & Coast and Wairarapa DHBs if there's to be greater regional co-operation. His inference seemed to be that Hutt board members weren't getting the full picture, but he was assured that board papers "inches thick" were there for his perusal.

After some more sparring with Mr Glensor over "non-public" items on the HVDHB agenda and the funding shortfall, Pat Brosnan commented "it must be election year". He apologised for the quip when he saw that Mr Ogden wasn't at all amused.

The main point that Mr Ogden, a chartered accountant before he was mayor, wanted to make was that the "strictures" placed on the board, at the same time as new demands for progress on health targets, were "unreasonable".

The HVDHB's funding in the current year for primary and hospital-based services is about $322m but acting chief executive Michael Hundleby confirms DHBs won't be getting the same level of increase as in past years, thanks to government belt-tightening.

It hasn't yet been made public (and won't be until the 2010-11 district annual plan is finalised) exactly how much less funding will be received, but HVDHB is budgeting for the need to find $10m in savings. Mr Ogden argues that the board, running to a $4.6m deficit this year, is already a lean operation. To say that $10m in savings can be found without service cuts, on top of increasing demands, implies current inefficiency. He doesn't accept that.

Tackled on that point by the Hutt News later, Mr Glensor put the case that any organisation, "public or private", tried to do things better and smarter.

"The pressure on us is shared by every district health board; it's just a fact of life."

Funding is allocated on a population basis (Hutt Valley = 3.8 per cent). The Government has allocated Vote: Health and the ministry "is not going to somehow negotiate something different for us".

Some savings might be found in HVDBH initiating extra services here, cutting the cost of the 40 per cent of Hutt patients currently going to other DHBs (mainly Capital & Coast).

However, Mr Glensor says that's more complicated than it might appear. It is more likely that with the emphasis on clinicians from various boards talking about better ways of doing things, "in common" specialist rosters will develop. For example, as part of a C&C roster, their staff might come to the Hutt one or two days a week to deliver the service. Savings for both boards could result, and it would be more convenient for patients.

Some services for cancer patients, for example, are already being delivered by C&C staff but at Hutt Hospital.
Regrettably, the financial pressure won't ease when the expanded Hutt Emergency Department and extra operating theatres come on stream at the end of 2011.

''In a way it's a rod for our own backs because we're taking on $60 million of debt,'' Mr Glensor says.

The business case requires that to be offset by generating more income, by greater local input and also handling higher patient caseloads from other DHBs; a prime example is additional plastic surgery.

But while there may not be significant financial gains from the expansion, ''it will be infinitely better for patients and our staff,'' he says.

Mr Hundleby says he's delighted with the way staff across the hospital are reacting to the call to make savings not with cynicism or despondency, but a willingness to look for better ways of doing things.  He told the board that research indicated a frequent ''side effect'' of implementing best practice was savings.  The hospital is already seeing this with high day surgery rates that the new 'clip-on' theatres allow.

Staff are asking for cost data to inform their clinical decisions, and it's being posted on the hospital intranet, he says.  One type of syringe costs five cents,  another $2.50; a cleaning cloth suitable for equipment costs three cents but one for patients costs 13 cents.  The tendency at the moment might be to reach for whichever is closest.

It all adds up.  A change of behaviour across the hospital ''can amount to $50,000 or $75,000 annual savings''.

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