DHB to cut elective surgery

BY NAOMI ARNOLD

Patients in Nelson and Marlborough may wait longer for elective procedures as the region's health board looks to perform operations on patients from other districts to make money.

The first-quarter national health target report released yesterday showed that Nelson Marlborough District Health Board had performed more procedures than it needed to between July and September, doing 1690 when it had aimed for 1510.

The report ranked it third behind Auckland and Waikato DHBs for its performance with elective procedures. Eleven other health boards nationwide also exceeded their own targets.

District health board planning and funding manager Sharon Kletchko said the overperformance was a "significant concern".

"We are delivering way more elective procedures to our population than the New Zealand average," Dr Kletchko said.

The health board will aim to reduce the number of procedures to its goal of 1510 per quarter, or 6040 a year.

Dr Kletchko said it already performed proportionately more elective procedures than other DHBs and that was why it had to stick to the target.

She said the health board bore the cost of operations performed in its own district. However, if its surgeons did the procedures of patients from other provinces, or travelled to assist other DHBs, that province's health board would have to pay Nelson Marlborough DHB for the procedure.

"If we can help other district health boards and get paid for it, that's good," Dr Kletchko said.

She had no way of predicting how much money the scheme could make, but said it would be used to pay off the DHB's existing deficits.

The deficit for the planning and funding arm of the DHB was projected to be almost $7.5 million this year. The provider (hospital) arm of the DHB had about a $500,000 deficit, she said.

She said the Government had said there was not going to be much more money in the future and the health board could not afford to be overperforming.

"We get the same funding as everybody else and for us to deliver more on that means we've got to cut back on other things or we run into deficit.

"If we don't live within the funding we've got, it puts our ability to deliver a whole range of services at risk."

Who would receive the procedures would be decided by clinical priority assessment criteria, which had been in place for about 14 years. In the past Nelson Marlborough had been "liberal" with that, Dr Kletchko said.

"We haven't applied [the criteria] as rigorously as we might because we could afford it, and up until this year we've been able to manage.

"The reality is that now we're going to have apply the criteria quite stringently. We're hoping to stay around the 100 per cent mark and not oversubscribe."

She said clinicians would decide who received procedures, not hospital managers.

The Government targets for hospital waiting lists were no longer than six months, with certainty given after two months. Dr Kletchko said the health board was "delivering pretty well on that".

Have you been on a waiting list for an elective procedure?

Email us at chiefreporter@nelsonmail.co.nz or phone Naomi Arnold on 5462843.

ELECTIVE SURGERY

Nelson Marlborough District Health Board's elective procedures:

2475 people were on waiting lists for treatment at Nelson and Wairau Hospitals in October.

462 people were booked for procedures and a further 1331 were given certainty.

A record number of elective procedures were performed last year with 6396 patients treated compared with 5823 the year before.

Elective procedures cover planned, non-emergency procedures, either medically required or optional. They include prostate procedures, hip and knee-joint replacements, cataracts and dental procedures.

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