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Thread ID: 97981	2009-03-06 08:51:00	"Health Minister Riled at DHB Budget defecits"	Poppa John (284)	PC World Chat

Post ID	Timestamp	Content	User
754031	2009-03-06 08:51:00	This was in the news the other day. Now I know that Hospitals are inneficient. The Govt supplies each DHB a sum of money to last a year. The answer is clear. When that sum of money has gone, simply send all the staff home & shut down the Hospital till next year. Can you just hear the screams? From Patients, hospital staff, & not least The Govt. PJ	Poppa John (284)
754032	2009-03-06 09:12:00	Just imagine what good the money being spent on criminals would do for these hospitals.	qazwsxokmijn (102)
754033	2009-03-06 09:20:00	Maybe to save money they should refuse to admit smokers and fat people.	prefect (6291)
754034	2009-03-06 20:11:00	Maybe to save money they should refuse to admit smokers and fat people. I find this statement offensive and without reason. Neither being over weight or a smoker is illegal and if fact could be argued that they are caused by society. Why not stop treating those who don't pay tax, children, elderly, those on the DPB, those on the sickness benefit. Or those who break the law e.g. those not wearing seat belts, people that speed, those who do illegal drugs. Singling one group out from others is a very dangerous precedence ESPECIALLY with little or no reasoning.	porkster (6331)
754035	2009-03-06 20:32:00	If the DHBs dont have the money they have to cut something. There arent any money trees around. Some people are just going to miss out sad but true. The DHBs are underfunded but thanks to last labour government who wrecked the economy there isnt anymore money. Hospitals in some cases do not do operations on obese people and smokers who wont quit because of medical reasons. I am not trying to be offensive just saying the cuts have to come where and hospitals are already targeting these people so why not take it a step further. Smokers and fat people are carrying out slow suicide.	prefect (6291)
754036	2009-03-06 20:46:00	If the DHBs dont have the money they have to cut something. There arent any money trees around. Some people are just going to miss out sad but true. The DHBs are underfunded but thanks to last labour government who wrecked the economy there isnt anymore money. Smokers and fat people are really just committing slow suicide anyway. As a smoker and a fat bastard, I find your comments rather offensive. But if we are talking about banning the drains on our hospitals, we should also include runners, drivers, and the elderly. Because lets face it, no point on giving medical treatment to old people that haven't long to live anyway.	plod (107)
754037	2009-03-06 22:00:00	A DHB/hospital deficit isn't a true deficit - yes it might be a shortfall but it isn't necessarily a result of bad management or practices etc. Allow me to explain: the Govt provides bulk funding to each DHB and the DHB enters into contracts with the local service provider (ie the hospital and others). The hospital gets funding for procedures on a volume basis (eg number of hip replacements, births etc), outpatient clinical services (eg attendances at the ear throat and nose clinic or eye clinic etc etc) and general services (eg emergency dept, wards etc.). If the emergency dept budget funding (being a fixed cost contract) was based on an expected number of visits, but the actual number of attendances is considerably higher, then the hospital gets no additional funding but have to incur additional expenses. That is a fact. Also, if the hospital has to perform say more hip joint replacements (funded based on volumes) than budgeted, then to stay within their total budget they have to try and not spend money elsewhere. This is nigh on impossible given 99% of costs are either fixed or directly variable, so there is little to no ability to actually influence the final costs. Also consider that we expect (quite rightly) a success rate of 99.999% from a public hospital. We would not be happy if they only got it right 95% or say 99% of the time. The private sector does not work to the same standard. Consider if something goes wrong at a private clinic, guess where they send the patient? You guessed it - the public hospital. And who picks up the cost? The local DHB. And who misses out? Those on the waiting list. Simplistic I know but this is conceptually how it operates. So any such 'deficit' is a function of events outside of the control of the DHB/hospital or insufficient funding from the Govt to actually fund the events that are happening at ground level. Some degree of rationalisation is needed at the hospitals. For instance, is it really necessary for every hospital to offer the same full blown services? If some of the regional hospitals got together and specialised in various areas, you could get a number of procedural efficiencies. However, the downside is that if a patient presents for some sort of non-acute surgery, they expect their family to be able to visit them at the local hospital - not the specialist provider 300km away. The voting public doesn't want this so we have to accept this comes at a price. So any such talk of 'deficits' needs to considered in light of what is really going on - the issue is a lack of funding at the appropriate level for each DHB..... Andrew	andrew93 (249)
754038	2009-03-06 22:14:00	[QUOTE=andrew93; Consider if something goes wrong at a private clinic, guess where they send the patient? You guessed it - the public hospital. And who picks up the cost? The local DHB. And who misses out? Those on the waiting list. Simplistic I know but this is conceptually how it operates. Andrew[/QUOTE] **** man didnt know that, that really sucks, they shouldn't be allowed to dump patients back to the public hospitals once they started work on them.	prefect (6291)
754039	2009-03-06 22:51:00	If the DHBs dont have the money they have to cut something. There arent any money trees around. Some people are just going to miss out sad but true. The DHBs are underfunded but thanks to last labour government who wrecked the economy there isnt anymore money. Hospitals in some cases do not do operations on obese people and smokers who wont quit because of medical reasons. I am not trying to be offensive just saying the cuts have to come where and hospitals are already targeting these people so why not take it a step further. Smokers and fat people are carrying out slow suicide. Smokers more than pay for themselves by huge tax on fags.	Cicero (40)
754040	2009-03-06 23:03:00	**** man didnt know that, that really sucks, they shouldn't be allowed to dump patients back to the public hospitals once they started work on them. That is the common reaction to these sorts of facts. I worked within the industry from 1996 to 2008 and this really is the tip of the iceberg. A good analogy would be deciding your weekly household budget for food (for a family of 4) is $50 per week. Then you give $50/week to your spouse. 4 weeks down the track you find out she has spent more than that (impossible with todays prices) so you get 'riled' at this deficit. The issue isn't the overspend - the $50 wasn't enough. So any ministers getting 'riled' at such deficits really need to look at the funding before looking at the DHBs.	andrew93 (249)
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