The doctors’ union has dashed Southern District Health Board hopes of a quick deal to part-privatise Queenstown’s hospital.
A delay of up to six months is now likely before Lakes District Hospital’s future is finalised.
The hold-up follows a meeting in Queenstown last Wednesday between SDHB and two unions – the Association of Salaried Medical Specialists, and the New Zealand Nurses Organisation.
Health board boss Brian Rousseau says ASMS chief Ian Powell talked tough, threatening legal action because of inadequate consultation over the health board’s desire to wash its hands of the hospital.
Powell won’t confirm the legal threat but hints as much.
“We’ve had to forcibly remind the health board of its obligations to engage and consult with both the doctors at the hospital and ourselves – because they hadn’t done so.”
In March, the health board released a proposal to hive off the hospital to a trust and part-privatise it by having GPs screen incoming patients at the emergency department – and charging fees to those not hospitalised.
“There was no real substantive discussion with doctors and nurses who work there – so they were disenfranchised,” Powell says.
ASMS has agreements with health boards for high levels of clinical input over decisions like this and it’s also government policy, he says.
What’s now agreed is that a working party of doctors from Queenstown, Dunedin, Invercargill and Dunstan hospitals – and two local GPs – will critique the health board’s proposal and explore alternative models of care.
“[Alternatives must be] clinically and financially sustainable,” Rousseau says.
The SDHB boss forecasts a $15 million loss for his new financial year beginning today, and getting shot of Queenstown’s hospital would undoubtedly improve that.
The working party has up to six months to report, Rousseau says.
“I always like things to be done yesterday so any delay is unfortunate. They’ll take as long as they need but I’m keen to move on with the process.”
Powell pans parts of the health board’s proposal for the hospital.
“There’s alarm bells ringing [over emergency department fees],” he says.
Queenstown would become the only place in New Zealand where a public hospital charges emergency department patients, Powell says. GPs on hospital duty would also face a perceived conflict of interest, he says.
And if the hospital is hived off – either to a trust or GP practice such as Queenstown Medical Centre – the health board would inevitably squeeze the hospital financially, Powell says.
“We’re noticing other rural hospitals coming under the financial squeeze like they’ve never had before.”
Health boards have greater power to squeeze costs when a service is contracted-out rather than run directly, Powell warns.