Debate on Crown Entities, Public Organisations, and State Enterprises — Auckland District Health Board

I am delighted to speak in the Committee stage of this debate on the Auckland District Health Board. First, I would like to acknowledge the Minister of Health, the Hon Tony Ryall, for his leadership in the health sector, which is now, happily, a very settled sector that is in stark contrast to what it was before we took over. Back then it was a demoralised and disenchanted sector, where clinicians were considered part of the problem, not the solution, where women with breast cancer were shipped off for radiotherapy in Australia, and where tens of thousands of New Zealanders had been culled from waiting lists.

I would like to focus on the 2010-11 financial review of the Auckland District Health Board, which the Health Committee viewed in conjunction with that of the Waitematā District Health Board. The committee made this decision in its timetable because both district health boards had worked collaboratively for some years and were working towards practical collaboration, and it seemed sensible to review both district health boards together.

Both district health boards share a chair—that is, Dr Lester Levy, a Māori board member—and integrated back-office functions. I would like to acknowledge Dr Levy for his leadership, in particular with reference to the Waitematā District Health Board, which was quite a troubled district health board prior to his taking the chair. Dr Levy reported collaboration at every level, which the committee was very pleased to hear.

Waitematā had quite serious financial difficulties in the past, recording deficits in 3 out of the last 5 years, but the financial result in the year under review shows it recorded a surplus. The committee felt that this was actually an outstanding, dramatic, and astonishing turn-round, and I think that that is all down to Dr Levy’s leadership.

I will just make some general comments about Auckland District Health Board. It is responsible for 87 percent of the people in the Auckland Council wards; it is the fourth-largest of the 20 district health boards. It covers almost half a million people, which is about 10 percent of New Zealand’s population. As at June 2011 Auckland District Health Board received about $1.8 billion in revenue and employed 10,000 staff, which is the equivalent of nearly 7,500 full-time equivalents. It had a small net surplus for the year under review of $142,000, which is slightly up from the budgeting surplus of $58,000.

To get some perspective around this district health board, I would just like to make the comment that it is the largest trainer of doctors, with approximately 1,200 doctors, and at any point 630 of them are at various stages of training. It is the largest clinical research facility in New Zealand. It provides local hospital and outpatient services for more than 400,000 people living in the Auckland City area. It provides tertiary services for the northern region, and over 50 percent of services are provided to people outside the district. There is a significant what we call inter-district flow.

It is a provider of many specialist services such as organ transplants—that is, heart, lungs, and livers—acute massive pulmonary embolism treatment services, paediatric intensive care, major head trauma following neurosurgery, high-risk obstetrics, and a number of other tertiary services such as clinical genetics and paediatric oncology for patients in the northern and midland regions. It is a very busy district health board and there are many layers and complexities in its operation.

The committee was very pleased to hear from Dr Levy that improving productivity was a priority area for the Auckland District Health Board, and that it was focusing on greater productivity done more efficiently with lower costs, shorter hospital stays, and more satisfied patients—and who could complain about that?

I would like to just talk about the health Minister’s introduction of health targets, because that really has put the minds of district health boards on productivity. These health targets are national performance measures specifically designed to improve performance. They have been accepted widely through the sector. They have not been seen as threatening by clinicians. They provide a focus for action. They are published quarterly, and they cover such matters as emergency departments, elective surgery, cancer treatment waiting times—particularly radiotherapy—immunisation, helping smokers to quit, diabetes, and cardiovascular services.

The health targets work as benchmarks for district health boards, and in reality are a league table, but, as I said earlier, they are not seen as threatening. In fact, district health boards have used them to benchmark each other and to step up. Quite frankly, Waitematā has turned from being one of the poor performers to being one of the top performers.

Report noted.

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