N.Z. health expectations exceeding funds?

Press, 30 May 1985, Page 5

N.Z. health expectations exceeding funds?

Expectations of the public health system in New Zealand exceeded the amount of money spent on it, the Canterbury Hospital Board’s annual meeting was told yesterday. The board’s chief executive, Mr Ron Parker, said in his annual address that there was a need to redefine the role of the public health system. “We are living in a fool’s paradise,” he said. “We know how much we can spend, yet our expectations are that we can do everything possible within 5 per cent of gross domestic product,” he said. “We cannot do that if hospital boards are to maintain credibility.”

Mr Parker said that New Zealand’s health service was “very economical” compared with other countries. Provisional estimates put last year’s health spending at 5.4 per cent of gross domestic product, compared with 10 per cent in the United States, 8 per cent in

Australia, and 7 per cent in Britain.

Although the Canterbury Hospital Board had a decreasing funding from the Government, the demand for care and treatment was increasing, in some cases by as much as 20 per cent.

Mr Parker said that a strain had been put on the board’s funding in 1983 when the Government ruled that boards could no longer apply for “commissioning grants” for new buildings and services but had to pay for them from within their budgets. This required careful planning of resources, he said.

The medical superintend-ent-in-chief, Dr Ross Fairgray, said that although funding had dropped the standard of care had not.

“No patient with an urgent need has not had that need met,” he said. “General medical emergencies have been dealt with competently and effectively.” The board’s deputy chairman, Mrs June Gardiner,

said that it was still managing to increase its patient admissions and its outpatient services, through the increased efforts of staff. “The cost has been considerable,” she said. “I believe that staff are working to the limit of their capacity.”

A continuing decrease in funding could only result in poorer performance and a further lowering of morale.

The board’s director of finance, Mr D. B. Harman, said that last year’s efforts to constrain spending meant that the board had ended up within budget by $BOO,OOO. These savings, together with $1.5 million from previous years, were invested before March 31.

In the coming financial year, additional expenditure on top of the Government funding of $144 million would include $540,000 on the new physical medicine department at Burwood Hospital. This would be funded from savings. Mr Harman said that

pressure generated from a series of “relatively gentle funding restraints” was starting to have effect.

There was a definite need to measure and monitor accurately changes in workloads, and to compare the work achieved with allo-, cated resources. Mr Harman warned that, without the ability to compare inputs with service received, informed decisions on the allocation of resources were not easy.

This could lead to pressure groups having an undue effect on the decisionmaking process. “I believe hospital boards exist to provide comprehensive health services and have to allocate resources on the basis of need, not on the basis of profits, popularity, or expediency,” he said. Boards were subjected to a lot of pressure groups and not all of them were supporters of the services or of the public health system, but they did have a role to play.