Pay claims put pressure on rural hospitals

SOUTHERN rural hospitals are concerned their unusual status means they may have a precarious future as the Government settles outstanding pay claims.

Twentyfour hospitals are classified as ‘‘rural’’ in New Zealand, six of which — Oamaru, Maniototo, Dunstan, Lakes, Gore and Balclutha — are in the former Southern District Health Board region.

However, five of those are owned or operated by trusts or local bodies, and are largely dependant on income from government contracts for their survival.

Clutha Health First chief executive Ray Anton said that meant hospitals, such as the one he manages at Balclutha, were worried health officials negotiating pay equity and pay parity claims might overlook the fact trustowned hospitals could not draw upon extra government funding to cover the increased wage bill that would entail from the expected settlements.

‘‘We will be under huge pressure to pay our staff equitably and it is not clear that the funding will be passed on,’’ Mr Anton said.

‘‘If they do it on the basis of ‘we will sort this out in a year or two’, can we actually survive and deliver a range of services when our nurses leave, our clerical staff leave, and we have difficulty replacing them.’’

Mr Anton, who is also treasurer of the Rural Health network, said there remained a degree of uncertainty for most small, isolated hospitals about what the scrapping of DHBs and centralisation of many aspects of the health system would mean.

‘‘I think rural hospitals haven’t yet completely discovered their role in the new system but there are some indications that they are considered part of localities and will align more with primary and community health in the future,’’ Mr Anton said.

Localities are being trialled in several locations, although not in Otago or Southland.

‘‘As those form, they will kind of act as a health hub in their rural area to deliver on the demands that localities require . . . but there is a lot of confusion in between.

‘‘I am not worried that rural hospitals will not have a role. I am convinced that we have a good strong position, particularly after the legislation was amended at the last minute to include a rural emphasis.’’

Covid19 had further emphasised the important role rural hospitals played in their communities, Mr Anton said.

‘‘We are vital but we are struggling: our staff turnover is high, recruitment and retention is hard, and shortages due to Covid and other things have been causing us grief.

‘‘Before the pandemic we had aggressive programmes to reach out into the community and deliver preventive health care under our healthcare homes banner but we have had to put a lot of that on hold . . . it is a difficult period that we have been going though, but we have finally succeeded in recruiting two American doctors.’’

A Te Whatu Ora Health New Zealand (HNZ) spokesman said the organisation was ‘‘conscious of the vital role rural hospitals play in supporting communities’’.

Rural hospitals were responsible for working with staff and unions to negotiate their own terms of employment, and HNZ was aware of relativities between HNZemployed staff and staff employed in rural hospitals, the spokesman said. ‘‘These relativities are carefully considered by Te Whatu Ora when we approach funding decisions, and as we look to how we can better support our rural hospitals into the future.’’