Latest news with #HNZ
Scoop
6 days ago
- Health
- Scoop
Government's Health Boost Less Than Claimed, Expert Says
$31b for Health in Budget 2025 just 3.6 percent increase, compared with what was 'actually spent' in 2024/25, Professor Tim Tenbensel says Most of last year's boost to HNZ's bottom-line 'absorbed' by Holidays Act remediation payouts to staff Axing pay equity settlements in the health sector 'saved' the Government $420m. A leading health systems expert is questioning the Government's claim of 'record investment' in the public system, saying the real increase to the health budget this year is half of what the government claims. Health Minister Simeon Brown and Finance Minister Nicola Willis have said the $31 billion allocation for health in Budget 2025 represented an operating funding increase of 7.4 percent – or nearly $2 billion – year on year. The two ministers donned hard hats and high-vis vests for a site visit at Wellington Regional Hospital on Wednesday, where they announced details of a further $100 million investment in its ongoing upgrade. Speaking to media following the tour, Brown said Health NZ had also had a $1.4 billion uplift in operating funding this year – the second instalment of a $16.6 billion cost-pressure boost over four years. 'It's a significant uplift to allow them to invest in the front-line workforce required to give New Zealanders and timely and quality healthcare they need,' Brown said. The government's investment in health far outstripped either population growth or inflation, the Finance Minister added. 'For context, that operational funding uplift was more than 7 percent over what it's been, which even on a population basis is more than 6 percent,' Willis said. 'So, we're ensuring that funding is going in at a far faster rate than either population growth or inflation.' In response to RNZ's request for a detailed breakdown of the percentage increase, Brown's office later said the figure of 6.2 percent was 'based on Treasury's annual growth rates set out in Budget Economic and Fiscal Update 2025, and the nominal Vote Health operating spend for Budget 2025'. However, Auckland University health policy Professor Tim Tenbensel said, according to his calculations, the $31 billion allocated for health in the Budget was only 3.6 percent more than what was actually spent last year. 'So, we're pretty much treading water at best, or rather sinking a little, in this budget,' Prof Tenbensel said. Furthermore, operational funding last year only increased about 1.2 percent in real terms. 'And the reason for that is because a lot of the money for this financial year's Budget in health was soaked up to remediate the underpayment of staff under the Holidays Act,' he said. 'So, that might help to explain the reality of people in the sector wasn't matching some of the things said by government.' Tenbensel said the Government's oft-quoted claim of a $16 billion boost to Health NZ's bottom-line was 'a bit like your boss giving you a $3000 payrise each year for four years and then claiming your pay has gone up by $30,000 over that time, not $12,000'. The trick was to keep adding on the previous year's increase as 'new money', ignoring the fact that it would have been eaten up by inflation. 'It's a very creative ploy that one, so I think we need to see it for what it is,' he said. 'All governments do this sort of thing, but in the scheme of things, this one is pretty brazen.' Dumping pay equity claims, including for primary care nurses, saved the Government about $420 million in health, which mostly paid for the near $500 million investment in digital health, after hours and urgent care in the Budget, he said.
Scoop
6 days ago
- Health
- Scoop
Government's Health Boost Less Than Claimed, Expert Says
$31b for Health in Budget 2025 just 3.6 percent increase, compared with what was "actually spent" in 2024/25, Professor Tim Tenbensel says Most of last year's boost to HNZ's bottom-line "absorbed" by Holidays Act remediation payouts to staff Axing pay equity settlements in the health sector "saved" the Government $420m. A leading health systems expert is questioning the Government's claim of "record investment" in the public system, saying the real increase to the health budget this year is half of what the government claims. Health Minister Simeon Brown and Finance Minister Nicola Willis have said the $31 billion allocation for health in Budget 2025 represented an operating funding increase of 7.4 percent - or nearly $2 billion - year on year. The two ministers donned hard hats and high-vis vests for a site visit at Wellington Regional Hospital on Wednesday, where they announced details of a further $100 million investment in its ongoing upgrade. Speaking to media following the tour, Brown said Health NZ had also had a $1.4 billion uplift in operating funding this year - the second instalment of a $16.6 billion cost-pressure boost over four years. "It's a significant uplift to allow them to invest in the front-line workforce required to give New Zealanders and timely and quality healthcare they need," Brown said. The government's investment in health far outstripped either population growth or inflation, the Finance Minister added. "For context, that operational funding uplift was more than 7 percent over what it's been, which even on a population basis is more than 6 percent," Willis said. "So, we're ensuring that funding is going in at a far faster rate than either population growth or inflation." In response to RNZ's request for a detailed breakdown of the percentage increase, Brown's office later said the figure of 6.2 percent was "based on Treasury's annual growth rates set out in Budget Economic and Fiscal Update 2025, and the nominal Vote Health operating spend for Budget 2025". However, Auckland University health policy Professor Tim Tenbensel said, according to his calculations, the $31 billion allocated for health in the Budget was only 3.6 percent more than what was actually spent last year. "So, we're pretty much treading water at best, or rather sinking a little, in this budget," Prof Tenbensel said. Furthermore, operational funding last year only increased about 1.2 percent in real terms. "And the reason for that is because a lot of the money for this financial year's Budget in health was soaked up to remediate the underpayment of staff under the Holidays Act," he said. "So, that might help to explain the reality of people in the sector wasn't matching some of the things said by government." Tenbensel said the Government's oft-quoted claim of a $16 billion boost to Health NZ's bottom-line was "a bit like your boss giving you a $3000 payrise each year for four years and then claiming your pay has gone up by $30,000 over that time, not $12,000". The trick was to keep adding on the previous year's increase as "new money", ignoring the fact that it would have been eaten up by inflation. "It's a very creative ploy that one, so I think we need to see it for what it is," he said. "All governments do this sort of thing, but in the scheme of things, this one is pretty brazen." Dumping pay equity claims, including for primary care nurses, saved the Government about $420 million in health, which mostly paid for the near $500 million investment in digital health, after hours and urgent care in the Budget, he said.
Otago Daily Times
6 days ago
- Business
- Otago Daily Times
Costs cut despite Treasury warning
The government ploughed ahead with cost-cutting at the new Dunedin hospital despite a warning from Treasury that the plan risked backfiring. Documents released under the Official Information Act show that in August, Treasury — which ultimately recommended the delay — advised "care needs to be taken to understand the full context when committing to a hard budget cap". "Because of this, we also think that Health [New Zealand Te Whatu Ora] should be attempting to understand the opportunity cost of exploring these other options against continuing with the current build scope. "It's possible that in an attempt to shave off the $200 million budget overrun now, we end up facing similar costs later on, due to unforeseen risks from the limited information available." The August documents showed the government's financial watchdog was mostly pleased with HNZ's handling of the new Dunedin hospital project, but noted it was up against "some challenging circumstances with the build". "We don't see any harm in spending more time to understand the options available, but we urge you to be realistic about the level of information Health NZ will be able to collect by December." In late September, the government told the public it was pausing the new Dunedin hospital project to decide whether to continue with a scaled-back version of the project, or retro-fit the existing Dunedin hospital. They set a budget cap of $1.88 billion for the project. However, the ODT can now reveal HNZ had actually prepared four options for deliberation: the other two were exploring developing the hospital as originally promised, or a "staged development" at the Wakari Hospital site. In assessing the Wakari option, HNZ advisers said it could "potentially enable a much more flexible approach to development". "The size of the site enables a different approach to building form and function that could potentially lower construction costs and enable a progressive approach to development that could evolve over time. "While the site can have challenging access on the coldest days, at other times of the year the additional parking creates good accessibility for those travelling from outside of the region and has space for complementary development." The greatest challenge for this option would involve how to manage breaking the existing connections between the hospital and the city centre and the University of Otago, HNZ advisers said. But HNZ eventually nixed the Wakari option because it would require a "start from scratch approach" which would provide "less certainty for bringing new health services to Dunedin, along with transition planning being more difficult". While Treasury ultimately recommended the government delay the project, it warned about the need for regular reporting. "This report back should also include the results of the rapid clinical services review being undertaken and its impact on design choices and health service outcomes." In late January, new Health Minister Simeon Brown announced the government would proceed with a scaled-back version of the inpatients building at $1.88b. Former head of the emergency department Dr John Chambers said Treasury's warnings were "completely unsurprising". "We've been saying this all along; you delay things and they end up costing more." The Wakari option was "daft" and "a distraction". "I've got no idea why they even pursued this idea, it was never a real option. "They seem to be ignoring the fact the business cases were signed off; everything was ready to go. "I think they don't care about Dunedin and the South much."
NZ Herald
27-05-2025
- Health
- NZ Herald
Stroke and road crash victims being treated in corridors, says ED doctor at Middlemore Hospital
'Predictably we will have more presentations this winter than last winter, but we've had no new resource put in,' she said. She said this means patients might not receive the care they deserve. 'You can't underestimate the soul-sucking nature of apologising to every patient you see for waiting eight to 10 hours, moving from one urgent case to another and squeezing past people who are on trolleys and suffering.' The Herald revealed on Monday serious concerns about patient safety and a lack of staff at Middlemore Hospital's ED last winter, which included more than 1500 patients being treated in corridors in the space of just 36 days. The information was detailed in a quality alert report written by clinicians and obtained by the Herald under the Official Information Act. The report also said there were 43 patient harm incidents in the same time period – some of which could have involved death or severe loss of function because of delayed care or medical error. Boys said those ending up in corridors included patients suffering strokes and injuries from road traffic crashes. 'We have no space, and no capacity left in the ED. The wards are full; patients can't move up to the wards [from the ED]. We have more presentations that we can get to and there are inadequate staff to treat people in a timely manner.' Clinicians who raised the alarm about patient harm, lack of staff and ED overcrowding last winter sought $3.6 million in funding to increase staff numbers. Efforts to secure funding for a new 'fast-track model of care' were declined and Boys said nothing had changed ahead of this winter. It's not just Middlemore's ED that's under pressure. HNZ data provided to the Herald reveals several other EDs are seeing huge numbers of patients. The New Zealand chairwoman of the Australasian College for Emergency Medicine and ED physician, Dr Kate Allan, told the Herald it's a worrying trend. 'It is a significant concern, but it's not unique to Middlemore. This sort of thing is happening across the country at a lot of our emergency departments and our hospitals,' she said. Minister: 'Significant' pressure on system Clinicians wanted the quality alert report escalated up the chain to national clinical leaders at Health New Zealand (HNZ), so they were across the risks. However, HNZ admitted national bosses 'delayed' acknowledging the report when it came to them. It was also recommended Minister Brown be made aware of the issues. Brown told Herald NOW the first he knew of the report was when the Herald broke the story. He described it as 'internal clinical assessment' but acknowledged 'significant' pressure across New Zealand's health system. Brown said it was up to HNZ to make decisions on district health budgets. Asked whether he was aware Middlemore ED clinicians had requested funding to improve staffing and patient safety before this Budget, he said that was HNZ's role. 'This is where HNZ is responsible. I as the minister am responsible for the overall budget.' Advertisement Advertise with NZME. He would not say when or if the requested $3.6m would be made available. However, a HNZ spokeswoman said there were plans for additional staff at Middlemore in 'the current budgeting year'. She said in the last financial year 20 fulltime registered nurses, five senior nurses three senior registrars, one urgent care doctor and five security guards were recruited in the last financial year. It was not clear how many of those staff ended up being diverted to the overloaded ED. 'Health New Zealand is committed to growing and retaining its workforce,' the spokeswoman told the Herald. Brown reiterated the Government's commitment to fund 24-hour urgent care services in Counties Manukau, which he said would alleviate pressure on Middlemore's ED. He also said South Auckland needed another hospital and it's likely one would be built in Drury. Michael Morrah is a senior investigative reporter/team leader at the Herald. He won News Journalist of the Year at the 2025 Voyager Media Awards and has twice been named reporter of the year at the NZ Television Awards. He has been a broadcast journalist for 20 years and joined the Herald 's video team in July 2024. The Association of Salaried Medical Specialists (ASMS) says patients suffering from road crashes and strokes are being treated in corridors at Middlemore Hospital's emergency department due to a lack of capacity and staff. ASMS vice president Dr Sylvia Boys who's an emergency physician at Middlemore Hospital described last winter as 'brutal' for staff and patients and didn't think this winter would be any different. That's despite Health Minister Simeon Brown trumpeting 'record' investment for health in last week's budget. Boys told the Herald Now show the number of staff on duty does not match patient demand. 'Predictably we will have more presentations this winter than last winter, but we've had no new resource put in,' she said. She said this means patients might not receive the care they deserve. 'You can't underestimate the soul sucking nature of apologising to every patient you see for waiting 8 to 10 hours, moving from one urgent case to another and squeezing past people who are on trolleys and suffering.' The Herald revealed on Monday serious concerns about patient safety and a lack of staff at Middlemore Hospital's ED last winter, which included more than 1500 patients being treated in corridors in the space of just 36 days. The information was detailed in a quality alert report written by clinicians and obtained by the Herald under the Officials Information Act. The report also said there were 43 patient harm incidents in the same time period - some of which could have involved death or severe loss of function because of delayed care or medical error. Advertise with NZME. Boys said those ending up in corridors included patients suffering patients stokes and injuries from road traffic crashes. 'We have no space, and no capacity left in the ED. The wards are full; patients can't move up to the wards [from the ED]. We have more presentations that we can get to and there are inadequate staff to treat people in a timely manner.' Clinicians who raised the alarm about patient harm, lack of staff and ED overcrowding last winter sought $3.6m in funding to increase staff numbers ahead of this winter. Efforts to secure funding for a new 'fast track model of care' were declined and Boys said nothing had changed as they head into the winter months. Clinicians wanted the report escalated up the chain to national leaders at Health New Zealand (HNZ), so they were across the risks, however HNZ has acknowledged leaders 'delayed' acknowledging the report when it came to them. It was also recommended Minister Brown be made aware of the issues. Brown told the Herald Now the first he knew of the report was when he read the story on Monday in the Herald. He described it as 'internal clinical assessment' but acknowledged 'significant' pressure across the health system. Brown said HNZ makes decisions on district health budgets. Asked whether he was aware Middlemore ED clinicians had requested funding to improve staffing and patient safety ahead of this budget, he said that's HNZ's role. 'This is where HNZ is responsible. I as the Minister am responsible for the overall budget.' He would not say when or if the requested $3.6m would be made available. Brown reiterated the Government's commitment to fund 24-hour services in Counties Manukau which he said would alleviate pressure on Middlemore's ED.
Otago Daily Times
27-05-2025
- Business
- Otago Daily Times
Fear hospital contractor may quit
One of the former leaders of the new Dunedin hospital project is worried the protracted negotiations will convince the lead contractor to "walk away", resulting in the project's costs spiralling out of control. It comes after the Otago Daily Times reported CPB Contractors' lawyer, Tom Horder, had publicly slammed the government's approach to contracting major infrastructure projects. The Australian construction giant is set to build the new Dunedin hospital, but Mr Horder said New Zealand governments over the past decade had gone with the lump-sum model for contracts, which had been inappropriately applied to major projects, with "disastrous" results. Former Labour health minister Pete Hodgson, who led the early stages of the project, said Mr Horder's remarks were "concerning, to say the least". "If Health New Zealand Te Whatu Ora [HNZ] go back to the market, sooner or later CPB are going to say, we will not build this thing at a fixed price at $1.88 billion because we won't get subbies [subcontractors] to come and do their bit." Mr Hodgson said there was always a risk of unknown problems with major infrastructure projects. "It probably just goes with the territory that you walk into problems that will have to be resolved once they've been discovered — and you can't prediscover them." He described HNZ's approach to contracting the new hospital as a "shambles" and a potential reputational risk. "If CPB pull out, then I'm sure [Christchurch-based construction company] Southbase and others would look at it, but they would be adding money, and some of that money would be the risk of the client's behaviour. "They cannot stop changing their minds." This would lead to further delays and ballooning costs beyond the $1.88b set aside by the government, he said. "HNZ have been deciding and undeciding themselves for years now and that means that the Crown, or the health system, will get a reputation across Australasia for being a bad client. That puts the price up." The project was delayed for several months last year after the government deliberated over whether to build a new hospital on the former Cadbury's site or retrofit the existing hospital. Financial commentator Bernard Hickey told the ODT he would not be surprised if CPB decided to walk away from the contract. "It was a mistake [to stop work] because it alienated and shocked so many people who had geared up for significant infrastructure spending for many years; they had invested in people, invested in plant. "When you're in the contracting game, you need certainty." An HNZ spokesman said it was progressing commercial negotiations with CPB and was also finalising designs following decisions announced by the new Minister of Health, Simeon Brown, in January. "While negotiations are continuing, Health NZ is progressing work to get pile capping and foundations work under way by the middle of this year." Mr Horder has been contacted for comment. Mr Brown met CPB on February 3. "Contract negotiations for the completion of the new Dunedin hospital are being led by HNZ," Mr Brown said yesterday. "What matters now is getting the best possible value for taxpayers — and delivering the hospital that the people of Otago and Southland have been waiting far too long for. "New Zealanders elected this government because they wanted action, not excuses. ... This government is focused on delivery — and that's exactly what we are doing."
