Waikato Hospital's emergency department is so overloaded the DHB is having to pay to send patients Anglesea Medical Clinic for treatment.
In the 2012/2013 financial year the health board spent $13,407 on vouchers for the clinic at times when the emergency department was either too busy to deal with them or the hospital was unable to perform X-rays.
The revelations from the health board, made in response to a request for information under the Official Information Act from the Waikato Times, has also revealed the hospital paid for 66 taxi trips, valued at a total $1478, during the same time.
However, health board officials say shelling out thousands on taxis and vouchers was still a sensible move, and the practice has been in place for several years.
"The $13,407 for service to Anglesea does represent good value for money," communications director Mary Anne Gill told the Times. "That means the average cost of the voucher per patient is $47.54, whereas the cost of providing triage 4 or 5 services in our emergency department at Waikato Hospital is about $260 per patient.
"We monitor the use of these vouchers very carefully. There were 282 occasions in the period July 1, 2012 to June 30, 2013 where we used the vouchers at Anglesea. In the same period there were 67,335 presentations (21,856 of them triage 4 or 5) to Waikato Hospital Emergency Department."
The number of people going to the emergency department has increased exponentially in recent years, from 24,566 in 1993 to 66,678 last year.
The board was unable to say exactly how much was spent on taxis to take people to Anglesea Medical, because they did not differentiate between patient and employee taxi travel. Some would have been sent to Anglesea, though other cabs would have been called for people discharged late at night.
Labour health spokeswoman Annette King stopped short of criticising the taxi fares and vouchers-for-patients approach.
"[The health board] have my sympathy. They are doing the best they can with the limited resources they have," she said.
"Their emphasis is on keeping costs down and, like every other DHB in the country, Waikato are doing their utmost to stem the tide. It is going to cost a hell of a lot less for them to shell out on a few taxi chits and vouchers than it is to employ a few more people in their ED."
The fact so many people were attending the emergency department in such high numbers was symptomatic that many could not afford preventative health care or visits to their GP, she said.
"Few are able to access low-cost health services, particularly those on fixed incomes.
But Mrs King said the DHB needed to be careful not to let people abuse the vouchers and taxi chits by deliberately turning up when they knew the ED was busy, knowing they would likely be sent to Anglesea.
"Any of these things are open to abuse by some. That's just something [the emergency department staff] will have to judge."
Anglesea Medical Clinic general manager Andrew Campus said redirecting patients from primary to secondary medical services was not something new.
"It's done all around the country. It's not something peculiar to Hamilton," he said.
It's about working in partnership. From our perspective being seen here makes a lot of sense. "We are not an institution like the hospital that is publicly-funded. We have to pay our own way.
"The voucher system works quite well for us. The figures Mary Anne quoted - $47 versus $260 up at the hospital - are probably quite accurate. Itt's a far better deal for both patient and hospital."
The Waikato Times approached Health Minister Tony Ryall, the Ministry of Health and Midlands Health Network communications advisor Charlotte FitzPatrick for comment on the issue. All declined.
- Waikato Times