- Date published:
8:29 am, July 17th, 2015 - 75 comments
Categories: class war, health - Tags: cuts, dunedin, health, Southern DHB
Last month the Southern DHB were sacked – scapegoats for systematic underfunding of the health sector. A commissioner has been appointed to cut spending. Cuts don’t apply to the commissioner of course:
Southern DHB commissioner called in to cut costs gets pay increase – to $1400 a day
That’s a lot of hip relacements, as the saying goes. But it’s not even the most interesting part:
The Government-appointed commissioner at the Southern District Health Board has had her pay boosted to $1400 a day because the cost-cutting measures she’ll embark on put her personal and professional reputation at risk.
If taking certain actions is putting your personal and professional reputation at risk, isn’t that a pretty clear indication that those actions are – you know – completely and utterly wrong?
Blood money…. in the health sector.
We are Greece.
Key is Merkel.
Lets take away money to help the sick to enrich commissioners. My what a strategy being seen taken by the Nats across all sectors. Cronyism and privatisation by stealth yet again.
living in la la land
The SDHB covers the largest, most sparsely populated area and has to find a way to provide accessible services to a population who don’t all live conveniently clustered around Dunedin but who may have to travel 3-4 hours to access care. They’ve already merged with the Southland board, gutted services in Invercargil and smaller towns and made significant cuts across the board. They operate out of an old, poorly designed building and maintain a high level teaching programme alongside their ordinary programme of care. They deserve support but are going to get more of the same old slash-and-burn. That this woman is being established with the acknowledgment that her actions will damage her professional reputation is appalling. Here’s an idea: how about giving her the resources to help the Board to meet their obligations to the community they serve? Then her precious reputation would be safe (& so would the population of Otago and Southland).
And it’s an ageing population as well.
Is that the answer, get rid of the medical school and its overheads drop
And who’s going to teach the Medical staff? Or do you reckon we should go back to the 1300’s where there were fuck all doctors, and a disease bourne on the Fleas, riding on a Rat, could wipe out up to 75% of the population. Or the early 1900’s where the Flu had a devastating impact on the world population.
Maybe it’s the Rich pricks medical version of “Let them eat cake”
Imagine trying to deal with things like this, with a depressed health sector. You Can’t.
You need the Medical Schools!
Obviously they identify the overhead due to medical training and ask the university to ‘pay for it’
Many years ago up in Auckland, I was surprised how much time was spent by regular staff in ‘research’. These werent medical staff who were both professors and surgeons but run of the mill registrars and consultants.
Even nurses are onto the research bandwagon
Future research is obviously good but this was for the most part ‘file and forget’ research.
For me , I would restrict research to clinical staff who were good at it, and was had some real benefit to NZ and wasn’t being done elsewhere. There are certain areas that would be unique to NZ.
yeah, lots of staff wear multiple “hats”, even down to 0.2EFTE – not just between uni vs DHB, but to between departments within either organisation (e.g. 0.4 clinician, 0.4 teaching, 0.2 uni research project).
It actually makes it worthwhile to bring some staff down – the DHB gets a clinician, the university gets an academic, and the person gets a decent whack of varied work.
And some of them work insane hours, because the HR department for each organisation have plausible deniability so let them work 60/80 hours per week even after their time as a registrar. Fucked if I could be bothered with that, but I’ve never been cursed with ambition or self-discipline.
Actually get rid of the medical school and they will not have as many cheap student doctors on call to cover all the shifts. Having to employ fully qualified doctors would very likely mean costs would go up by quite a lot.
What services have been withdrawn from Invercargill?
self-justification is truly a sight to behold….. the things people, especially politicians like Nick Smith, bring themselves to believe is sometimes so bizarre they become a laughing stock.
Of course all this does is make matters worse. Before she could have claimed she was implementing unpopular measures that she genuinely believed were nonetheless the right thing to do.
Now she’s just made it plain that she knows they are wrong and had to be paid to do them.
And everybody knows.
yep – so the framing has made the situation worse and she has backed herself into a corner – I really don’t think anyone is worth that daily amount – no one is that valuable even if they are driving through unpleasant, unwelcome and ultimately unwanted changes.
Of course the construction of this frame may be even darker. After several months on what must be a very unpopular and unpleasant job – perhaps she went back and either demanded more pay or threatened to resign.
And the framing of this announcement is a public pay-back?
hmmm yep one must never discount that style of interaction – could be some blowback now the numbers are in the public arena
Isn’t that the same daily rate (outside all state sector remuneration formulas) that Brownlee decided to bestow on Jenny Shipley for her advice on ECan?
Once again the solution from the left seems to be throw more money at the issue. That is what led to the problems in Greece as previous governments just spent money without regard to controls and checks.
Bollocks…an internal trade imbalance within the Eurozone caused Greeces problem and the powers that be simply looked the other way until circumstances forced them to turn their heads and acknowledge the fact, and even then they deliberately misdiagnosed….somewhat akin to whats happening to the regions within NZ
ha ha that is very funny
You mean like throwing $1400 day at the problem?
Not really just wealthy people. Pretty much anybody who could get away with it. However the overspending the Greeks did was as bad. They didn’t keep track of how much they actually spent, only how much they were planning on spending. In that sense they had a situation similar to the Southern DHB as they spent far more than they originally planned to do.
You’re obsessed man… and losing sight of shitloads of realities about the situation….. damaging the credibility of your views
I really don’t get all these stupid people down south, why do they insist on being sick and in need of more service than the DHB have planned for?
on the contrary, the commissioner is an excellent idea, because the DHB keep planning on providing services it can’t afford, like clinics and leak-free operating theatres. Bad management is the problem!
Indeed. Hospitals perform far better without patients.
get back on topic gosman.
Once again the tiresome apologist for the fascists delivers his unthinking diatribe. The southern region is very productive – munting it will prove very costly indeed. But when did these wreckers ever care about the damage they do.
No, Gosman, that parroted cliche only works if you’re “throwing money” at;
* CEOs, with their multi-million dollar bloated salaries,
* tax cuts at the wealthy,
* corporate welfare to Rio Tinto, Warner Bros, Saudi businessmen, South Canterbury Finance, et al,
* MoBIE fit-outs
Spending on healthcare is an investment. Like, you know, preventing people getting sicker and sicker until they drop dead in the streets, or just don’t wake up in their beds.
It helps if you think through your really stupid comments before opening that mouth of yours. Parrots talk, but haven’t a clue what they’re saying.
How would you fix the problems at the Southern DHB then Frank? I don’t even mind if it involves taking money from the Commissioner but there has to be some other place you can find it.
Hold on, I thought we sold a whole lot of assets to build new hospitals. Where are they then?
ghost hospitals? ghost schools?oh yeah ghost surplus
Of course we won’t mention the billion that was lost because of the futile attempt by the left to sabotage the sales
Who but a fool would try and sell 3 power companies in a row ? Thats what depressed the price.
Sales that made no real long term economic sense. For a quick money boost to their books to try and make it look like they had a surplus, National sold of assets that made the NZ tax payer a lot of money. Now a lot of money that used to go back into our economy is instead going overseas.
well i don’t know, how bout establishing an appropriate amount of funding to supply adequate services? sdhb has been chronically underfunded for years because of continuous slashing cuts. there hasn’t been any fat to trim for years, but they keep on cuttin’
The big problem is our Treasury morons never balance their books. You let in foreign workers you lose the money that would’ve been spent in the local economy by local people, nevermind the income tax.
The staff in Otago are world class, they can double their pay just by crossing the ditch, and most of them can earn 5-10x as much in the States if they choose. But pretending to be a business instead of a government, the kleptocrats send in an overpaid hatchet-wonk. If they collapse the med school they’ll claim it as a victory. It’s rather like the stupid push to seize meals-on-wheels: fuck with the people and the volunteers will withdraw the free delivery.
I keep hearing that the Gnats are economic experts – well they ought to have plenty of money then. Fact is that they are always broke. Their economic pretensions are as threadbare as Gosman’s arguments.
Labour are infinitely better economic managers, and Labour are nothing special. These fools really suck.
Indeed. Squandering money away on sick people and medical resources in the provinces (as opposed to lavish pensions, tax avoidance and corruption that got Greece in trouble), is the way to go then? And why not punish the children too… Hold on, we’re on track with that one. And don’t forget the $25m on the flag is really, really critical to our nations health and well being…..
its cheaper to let people die and suffer from disease gosman?
Actually, the way I understand it, Gosman, the SDHB has lost a lot of funding due to the stringent application of the “population-based funding” model, and that has seen resources sent up North to more densely-populated areas. At first glance, that seems logical (put the resources where most people can benefit from them), but it ignores the special challenges of operating within such a large and challenging geographical area, with such run-down facilities. While the formula claims to be adjusted for “rural populations” the fact is that this doesn’t account for the needs of people in Invercargill (for example), who aren’t “rural” but are still more than 3 hours away from Dunedin. I also seem to recall that when the two previous health boards merged, there were debts from the Southland Health Board (originally a stand-alone body) that were then imposed on the new Southern District Health Board. Unsurprisingly, they have never been able to free themselves of the burden of this debt.
I have dealings with multiple hospital departments on an all-too-regular basis, and I can tell you that we’re not living lives of luxury down here.
I don’t mind the idea of a commissioner, if it’s a truly independent person with trusted expertise in a problem-solving role and if there’s a commitment from government to front up with more funds or forgive some debt if the commissioner deems it necessary. We always knew that it was unlikely that the commissioner would actually have this status or function, though, and the latest announcements have made that very obvious.
Once again the solution from the Right seems to be to suck more money away from the needy. ‘Cos it’s not like THAT’S ever caused any problems in NZ or the wider world, is it..?
Population-based funding adjusts for proven health determinants like poverty, ethnicity and age – not density.
Given that some other DHBs around the country manage with dispersed populations, I still have not seen any reasoning why SDHB is so unable to meet its budget compared with all other similar organisations.
Can you name a DHB in a similar situation Sacha?
Bear in mind a geographically large DHB like Waikato serves a massive number of inter-district patients, which increases revenue.
Southern does seem to have some unique challenges. Do you dispute that?
I haven’t seen anyone describe what those unique challenges are. Links welcome. I do know inter-district flows were certainly not regarded as a bonus by Auckland DHB, which has most of them.
here is a reasonable summary of some of the issues.
Well perhaps you aren’t conversant with the DHB’s characteristics, but they aren’t a big secret. They include a land mass of more than 60,000sqkm, two base hospitals, a high-volume tourist area, multiple rural hospitals, a tertiary hospital with low inter-district in-flows but high out-flows, and PBF adjusters that yield less for its rural and aged aspects than other rural-based DHBs with older populations.
Can you please give examples of the DHBs you claimed were doing well with dispersed populations?
Maybe your poster child of a dispersed population is West Coast DHB – it certainly is dispersed. It’s also a long-time basket case that’s now under the wing of Canterbury.
I was thinking more of MidCentral and Tairawhiti, but they don’t have the same hospitals configuration I guess.
Yeah, they’re not the same – especially Tairawhiti – it only serves 46,000 people.
You also compared Southern with Auckland, in that the latter didn’t look favourably on inter-district flows. You can’t really compare them.
In Southern, the extra patients might spell the difference between a specialty being able to sustain a clinically safe level of staffing (3 specialists) compared with a clinically unsafe level (2).
Obviously AK doesn’t have specialties at risk in that way. But the key point is that if it did – it’s a stone’s throw away from a number of other DHBs on its doorstep.
You’re right on PBF. Areas with rapidly growing pops accrue funding regardless of their actual costs, while DHBs with stagnant pops face a vicious circle — stagnant funding + consistent overheads (and quite possibly growing demand despite pop numbers).
It’s not like the community suddenly expect fewer services because there are fewer people!
Sacha’s repeating the political spin deployed by National and Labour (except when either of them are in Opposition).
The CTU has released projections showing the whole health system has been underfunded year after year. I believe that is not OK.
What’s your point?
Are you suggesting all DHBs are faring equally because of the underlying under-funding?
Other DHBs are managing restricted budgets. I do not believe any of them should be under that much pressure. That’s where my own view might diverge from the political parties you cite.
You’d probably be surprised by how much DHB spending is set by things like national employment agreements – there’s not that much you can change without withdrawing services. I doubt southerners are wildly over-treated – but then I guess we’ll know more next year when the new ‘unmet need’ figures they’re collecting start to filter out.
No-one can say any area is fairly funded compared with the others, because the Ministry of Health won’t release the workings of the PBF formula, which seems to have weird anomalies between regions.
Otago University researchers even went to great pains to clarify it and failed, and their report would be worth reading (this is a press release, couldn’t find the full report: http://www.otago.ac.nz/news/news/otago033152.html
When National was last in power (back in the dark days), they sacked every AHB in the country and installed commissioners who proceeded to embark on slash and burn programs.
I think Mackasy (sp?) posted a news clipping a week or so ago from 1990/91 about how the commissioner that replaced Auckland’s board was shifting elderly patients from public geriatric wards into private rest homes.
Im guessing we will see more privatisation in the SDHB.
That was the ‘corporatisation’ of the public health service.
It cost hundreds of millions as in some cases a regional based hospital service with small offsite head office overhead was replaced with each large hospital having its own management structure and staff.
Then on top of that there was 3 separate health service ‘funders’ covering large parts of the country, all with expensive managers and consultants to dish out the money.
They implemented a ‘cash registers in wards’ program as the funding shortfalls were to me made up by patients as they left hospital ( much like you would pay for car parking). It was stopped by public outrage.
Um. She’s only been on the job, what, couple of months? Already a pay rise? 1400 a day? RIP SDHB
I’m not sure if $1400/day is the amoutn of the increase or the total amount she gets.
That’s fairly rage inducing news. Time to get back out on the streets Otago and Southland. Remember what happened with neurology?
There’s a doco about rural health care scheduled on TV3 at 9.30pm on August 13 . It covers a year in the life of a rural Otago hospital, and shows how staff work ever longer hours to paper over the cracks created by under-funding… at precisely the time that the SDHB was being pressured to cut budgets even more!
Also, Gosman why try and tie everything to Greece? Are you stupid?sdhb NEEDS money to serve the public, what’s with the right always trying to steal money and cut public services? I’d hardly call providing adequate funding ” throwing money at it”
Weka, the fight for neurology merely postponed the inevitable. Watch as the “commissioner” cuts this and plenty more. Sets the stage for privatisation wouldn’t you say
The fight for neurology showed the mainstream what happens when they mobilise. This govt won’t ignore another 10,000 people marching through the middle of Dunedin (bearing mind we’re talking about a SDHB rohe that includes some big National electorates). Of course they’ll try and get away with whatever they can, that’s what Key’s govt does. Doesn’t mean we have to let them.
i wish i shared your optimism weka, but i think the role of this commissioner is to do as she’s instructed despite any public outcry, hence the pay hike. also along these lines watch the ttp go through despite what is going to be overwhelming opposition from the public. reminds me a little of asset sales?
From the post I,d say 1400 is the total, but oh my gosh! Funny how the right hate “throwing money” at services yet are comfortable with obscene pay checks for the lackeys and lickspittles of the powerfull
Yep, it’s like they don’t even try and hide it now. National want to spend health dollars on high paid CEOs rather than on healthcare.
wayne mapp earns about 250k for a part time job…
Im sure we will see nationals failed Northland candidate get a well funded job soon enough.
is that really what a Law Commissioner gets? Crikey.
The government can simply issue (or borrow, or tax) the money it needs any time it wants, to pay for anything it deems to be a high enough priority.
Meanwhile, there must be a yacht team out there who needs another $30M.
This government is to busy spending money on a flag change we can not afford.
The referendums are only the tip of the iceberg of money that will need to be spent. If to many vote to change the flag in the second referendum we are going to be in for a big cash drain as all the flags at our government buildings and embassies are changed. The shoulder patches on our soldiers uniforms are pulled off and new ones put on. Brand new textbooks printed for schools. Some government forms changed as well as new passports issued. Expensive international advertising to let people in other countries know we have changed our flag.
Then there will be the money that most international trading NZ companies will also have to spend. Any that use the NZ flag in advertising material or packaging will need to spend a lot of money changing it all.
All that money wasted would be far better spent on boosting the funding to our hospitals.
I agree. The whole flag thing is just a cynical Key ego trip. It absolutely stinks.
I actually don’t think it is a Key ego trip. It is more of a smoke and mirrors to make it look like National is doing something and to give their right wing pet so called journalists something to fill the papers with so they can hide all the important stories away from the public eye.
Why print stories about the gutting of the Southern DHB when you can print a story about the flag referendum and what flags are available to pick from.
Hide the stories about the important stuff about Nationals bungling and cutting of services away from the public.
We should all do a write in vote for a red fish on a white background as it is all just one big red herring.