Will there be health cuts?

New Zealand’s district health boards (DHBs) is exactly the kind of story the Government does not want to hear about as it splashes money around on more appealing, vote-attracting projects.

High-speed motorways? Covered stadiums for rugby games and concerts? These are happier headlines.

As for the scale of the problem, health sector sources told Stuff this week that DHBs are projected to be more than $160 million in debt for the current financial year. The Ministry of Health has not released its final numbers but early figures show that more half of New Zealand DHBs – 11 out of 20 – are in debt.

Three stand out. Figures released in May showed that the Canterbury District Health Board (CDHB) had a forecast deficit of $49m, the largest in the country by a long margin. Wellington’s Capital and Coast District Health Board is second with $24.2m and Southern District Health Board in Dunedin is third with $21.9m. Others have much smaller forecast deficits or have even forecast a tiny surplus in some cases.

Will these deficits lead to health cuts and how deep will they go? Health Minister Jonathan Coleman has rushed to assure the public that there will be ‘‘no cuts to services’’ despite these debts in the public system. But his position is in stark contrast to that of the CDHB, which has warned Cantabrians of ‘‘significant service cuts of unprecedented scale’’ if its deficit was not accepted by the Government.

Health in general and mental health in particular has become the election issue few saw coming.

Labour health spokesman David Clark has claimed the ministry is pressuring Canterbury, Counties Manukau, Southern and others to cut costs and reduce spending. His party’s own announcement of an extra $8 billion for health over four years went largely unnoticed before the party’s leadership change. .

Experts in health policy now see signs that relationships between the Government and providers have started to fray. Some are reminded of the health crises of the 1990s. Regardless of which party wins in September, it’s likely that ideas about funding and expectations of performance from our district health boards must be reconsidered.