The future of Waitaki’s hospital and primary healthcare services was at the forefront as the Waitaki District Council this week received the 2023-24 results for its Waitaki District Health Services Ltd Group.
It operated the Oamaru Hospital until July when Health NZ Te Whatu Ora took over.
Outgoing chairman Keith Marshall said the company was effectively now only the landlord for the facility.
Total comprehensive revenue and expenses were just over $4million.
While the latest result reflected the best it had seen in years, the ongoing "funding limitations" were intensifying as the district’s population grew.
"There has been chronic underfunding and it has been endemic ... for the last two decades," he said.
The Oamaru Hospital emergency department was "a perfect example" of the issue.
It had been funded under contract with HNZ’s predecessors in the late 1990s for 4000 ED presentations a year.
This had not kept pace, yet it regularly saw more than 10,000 patients a year.
Mr Marshall said the total revenue for that aspect of the Oamaru Hospital was $1.2m per annum but funding the necessary medical roles was $2.2m, "let alone the cost of nursing staff".
"Actually, the hospital has never done 4000 ED presentations.
"Last year, it was over 10,000, therefore a perfect illustration of endemic underfunding."
Mr Marshall said a negotiated funding "uplift" of over $3m in the past financial year had improved baseline funding, but it was still "below par".
Being able to sustain services in a capped funding regime "couldn’t be avoided".
"Keeping the ED was always below the revenue of the hospital. No amount of cost-cutting would have resolved the situation."
Mr Marshall said the council had been "superb" in ensuring continuous health services.
Deputy mayor Hana Halalele said the Oamaru emergency department volumes had been a clear case for the recent Waitaki Health Futures review.
"It is interesting, we always count healthcare around doctors, but in fact it should be focused more broadly," she said.
Mr Marshall agreed.
They had staunchly insisted on the review in the hospital’s handover to HNZ.
"In fact, the capped funding doesn’t fund primary care or the operational costs of the hospital."
At the same time, Waitaki’s GPs and the aged-care sector in the area were significantly under-resourced.
The district was "well behind" compared with smaller centres such as Greymouth or Ashburton, Mr Marshall said.
"We have two GP practices that only have a full complement until Christmas."
And there had been 26 triage-one (life threatening) patient presentations in the previous year who would have died if the hospital ED was not there.
"There is the rub for a capped level of funding.
"It would serve us all to know what serves us all well."
Cr Jim Hopkins said the issues with the new Dunedin hospital build showed the need to continue "a battle cry" to ensure Waitaki did not lose out.
"There is huge debate about the hospital in Dunedin.
"I fear that it could see our hospital downgraded.
"There are hospitals and health needs in areas greater than Dunedin. We are not out of the woods yet."
Mayor Gary Kircher said advocacy through successive governments would not abate.
The new Dunedin hospital funding shortfall only heightened the need "to advocate for our hospital".
