Will there be health cuts?

One hundred million here, another 200 million there. But why talk about millions when you can talk about billions? We get used to talking about eye-watering sums as though they were small change during the five-week arms race of promises and bribery that is a New Zealand election campaign.

But some skyrocketing numbers are more favourable than others. A looming funding crisis in 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. CDHB board member Jo Kane warned of ‘‘a service failure’’ if mental health funding was not increased in Christchurch. That comment followed the Government’s refusal of a request for the relatively minor figure of $7.2m.

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 change of leadership from Andrew Little to Jacinda Ardern.

The CDHB’s funding battle with the Ministry of Health has turned into an ugly public stoush that blew up in the media and brought the issue to national attention. Public opinion tends to side with the hard-working frontline doctors and nurses that most of us encounter in hospitals rather than politicians desperate to keep their departments out of the headlines during the weeks before the election.

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 seems likely that ideas about funding and expectations of performance from our district health boards must be reconsidered. - Fairfax NZ