That sums up the charm offensive by Te Whatu Ora Health New Zealand (HNZ) officials in Dunedin this week trying to sell the cuts to the hospital rebuild.
The emphasis was that much of the $90 million savings the Government has required it to make on the Dunedin Hospital business case signed off by Cabinet last May have been achieved through more efficient design methods, rather than cutting clinical capacity.
The cost-cutting, cynically announced just before Christmas, was sought following a $200 million budget blow-out for the now $1.58 billion project. The Government agreed to stump up $110 million, with the rest coming from cuts to the signed-off proposal. The requirement for changes so soon was a slap in the face to clinicians who had spent years of difficult negotiations and compromise over what should be in the complex.
We are all for clever architecture, but the brilliance of efficient design does not alter contentious issues such as the reduction in the number of operating theatres and beds originally agreed, and the removal of a PET scanner. It has not removed "shelling" from various areas (where areas are built but not fitted out). It is hard to grasp how these things are somehow divorced from clinical capacity.
Clinical transformation group deputy chairman and a senior doctor at the hospital, Prof Patrick Manning, said the group was largely satisfied with design changes made but still had areas of concern.
He spoke of still fighting a plan to shell 1000sq m of non-clinical space, something he described as a significant clinical risk. He was also concerned about the shelling of 12 mental health beds for older people, which is reliant on beefed-up community services being able to fill that gap.
His statements seemed more of a gritted teeth acceptance of a least worst scenario, rather than a ringing endorsement of what HNZ has come up with.
Such a lukewarm response sits alongside various serious concerns expressed by other senior doctors, including Martyn Fields, John Chambers and John Adams, representatives of the New Zealand Nurses Organisation, and the New Zealand Institute of Medical Laboratory Science.
We do not find it reassuring.
Nor is it reassuring that in an election year neither major political party has been prepared to commit to a rebuild containing all of the features of the business case. It smacks of arrogance and a high-handed attitude towards issues their prospective voters hold dear.
The same can be said for shelling. The cheapest time to fit out an area is when it is first built. As costs continue to rise it will be all too easy for politicians to fob off funding fit-outs.
And, as we have previously said, patients who might have received treatment in those areas will have to be treated elsewhere and often that treatment might be delayed as a result.
The ongoing haggling over the hospital design and the inevitable delays are wearying for staff, many of whom may have been hanging on in Dunedin in the hope they would soon be working in a promised state-of-the-art facility.
Since we are in the midst of a global health workforce shortage unlikely to be resolved any time soon, attracting and retaining staff will become increasingly important if we are to provide a cohesive and comprehensive health service.
We remain of the view the way to do that is to build the hospital with the facilities announced last May and to stop messing about.
If this week’s public relations exercise was designed to deter us and the Dunedin City Council from our campaign on that, it has failed.
