The original business case for the new Dunedin hospital included 24 mental health beds for older people, but the Otago Daily Times understands Health New Zealand Te Whatu Ora (HNZ) has now settled on eight beds upon opening.
If this plan goes ahead, it will mean the dementia and psychogeriatric bed capacity at the new Dunedin hospital will be half that of the existing hospital.
Correspondence seen by the ODT suggests HNZ wants to develop a "new model of care" for psychogeriatric and dementia issues nationwide, but has not yet completed it.
Health New Zealand responded to ODT questions on Friday, saying the new hospital "is proposed to include an 8-bed acute pod for mental health services for older people".
Head of Infrastructure Delivery Blake Lepper said the approach Health NZ had taken to determining bed numbers at the new hospital "has been driven by our development of national standardised models of care".
"These standardised models are the way we offer care, linking between services to support smooth healthcare journeys by providing a consistent nationwide approach to demand modelling."
The plan to cut the number of beds has angered aged-care advocates.
Associate professor of psychiatry and consultant psychogeriatrician Dr Yoram Barak said he had been told of the plans to cut the number of beds to eight "several weeks ago".
"I think it is a very, very unwise decision that will impact our ability to help the older adult community in Otago and Southland for many, many years going forward.
"On a scale of 1, not too bad, to 10, catastrophic, I would give it an 8+.
"I’m really stunned by who makes these decisions and do not know what they are based on."
Dr Barak said with the population ageing, and people living longer, mental health issues among older people would only increase.
One nurse, who spoke on condition of anonymity, said "people could die" as a result of the cutbacks.
Care for older people was a "very complex" and growing part of healthcare, she said.
"I think we are all disappointed, but we also feel despondent and deflated and defeated.
"In the time that this hospital is meant to be built, there will already be a greater need for our services, but with less ability to meet that need, which puts more pressure on the community."
She said under the plans for the new Dunedin hospital, there would be fewer beds than the existing hospital.
"This is also probably a way of saving money in the future in terms of not funding staff.
"The public need to be aware of this and need to have a bigger voice and fight for services for now and in the future."
The ODT understands the plans have also frustrated the clinical transformation group, which has provided advice to HNZ throughout the various stages of the new Dunedin hospital project.
"The very first chop you make is where the older people are involved, because for some reason they’re seen as not mattering any more."
She said resourcing the new Dunedin hospital for older people was absolutely vital, particularly when it came to mental health issues.
"The biggest problem is that when you get older people, and when we’re talking mental health, they put them in the categories of dementia and Alzheimer’s and things like that.
"These conditions affect older people in various different ways, depending on what part of their brain is affected.
"So we end up in a situation where many older people do need to have specialist hospital care."
The present situation of care was a "lottery" for older people, and the new Dunedin hospital needed to be better resourced, she said.
It is the second report of significant cost-cutting in the past week, after the Otago Daily Times revealed this week the government was planning to cut the number of ICU beds on opening from 30 to 20.
Health Minister Simeon Brown has since said the new hospital has the potential to expand the number of ICU beds to 40 over time.
In January, Mr Brown announced the government would proceed with a scaled-back version of the new Dunedin hospital at the former Cadbury’s site at a cost of about $1.88billion.
Mr Brown announced the new hospital would open with 351 inpatient beds — 59 fewer than originally proposed, but with capacity to expand to 404 beds over time.
Cutbacks to the ICU beds and mental health for older people beds were not flagged by the minister at the time of the announcement.
