Plunging DHB deficits prove the pie is too small – Association of Salaried Medical Specialists


Reports that DHB deficits are set to plunge even further this year are yet more proof that underfunding is bringing hospitals to their knees, says the new Executive Director of the Association of Salaried Medical Specialists, Sarah Dalton.

A New Zealand Herald report – “Sheer Incompetence: DHBs continue financial nosedive” – says new figures from the Ministry of Health show the financial situation for DHBs is continuing to deteriorate and the overall DHB deficit is expected to rise to up to $534 million by June this year. Earlier forecasts predicted $508 million.

Sarah Dalton says the fact DHBs are carrying such large amounts of debt is unsustainable and symptomatic of years of underfunding.

“DHBs are dealing with a significant rise in acute demand which is higher than both population growth and funding increases, coupled with almost nine straight years of underfunding of public hospitals”.

“Basically they’re continuing to have to do way more with way less,” she says.

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Post-budget analysis last year by the CTU and ASMS found that DHBs received an estimated $139 million less than needed for anticipated increased costs and population changes.

It also found that compared with the previous year health spending as a proportion of the economy continued to fall well short of what is needed and in 2019/20 was an estimated $134 million behind what is required just to stand still.

Sarah Dalton says “we are seeing hospitals running under enormous pressure and services stretched beyond their limit, including a shortfall of more than 1000 hospital specialists around the country”.

“Our public health system is too important to be used as a political football. DHBs, patients and staff should not be carrying the can for long-term failures to invest in health”.


  1. The state of the DHBs reflects badly on the Labour Coalition in NZ. Trying to force efficiency of government-run entities by forcing down spending and budgets ishould be a short exercise, to bring any profligate body to heel.
    To carry on with this inappropriate method of ‘selection’ will surely cause the death of the most needy DHBs as far as being reliable, helpful and well-run organisations.

    One person with long-term experience of serving the public in DHBs says of recent budget rises, that she has fears that they will vanish in holding meetings, of which there are many without apparent improvement or change to anything requiring it. And we know from news reports from past years how many DHBs have predatory capitalistic managers involved in managing hospitals, while spruiking their own private business for hospital supplies. The system is rotten, and we should return to realistic funding with a travelling accountant experienced in hospital running keeping an eye on the country.’s outcomes from medical health spending and where and why better is required. This person should be replaced every ten years to avoid the well-known ‘capture’. Also the working staff should be encouraged to make suggestions of how to improve service and cut down on inefficiencies. The ones adopted should carry a small monetary prize, and also the reports of the accountant with watching brief should be available on-line so interested staff can read as to how their hospital area rates compared to others, and what measures are being adopted successfully in other areas.

    This would produce a sort of competition to be good, and proud of their own area, or to find ways of bringing their hospital up in the stakes. It would also share with all the problems being had, the trends both good and bad, and show respect for each one of the workers involved in the hospital activities which require teamwork and responsibility and loyalty to the idea of their hospital being a good institution that the citizens can rely on.

  2. Hospitals running down, viruses running up = disaster ahead. Perhaps the thinking is apolytic? Do we get to thinking on these narrow lines?

    18 Jan 2020

    Nearly 50 people are known to have been infected and so far involve only individuals who have travelled to or live in Wuhan, but the World Health Organisation (WHO) has warned that a wider outbreak is possible.
    Many of China’s 1.4 billion people will be travelling abroad during the Lunar New Year holidays next week, raising concerns about the disease spreading to other countries.

    Researchers at the Imperial College in London have estimated there are more than 1700 cases in China.
    Otago University’s Michael Baker says the findings contradict claims from China’s government.

    Consider the autocratic, dictatorial, conservatives in NZ who cannot look at either the big picture, or the individual small one, when it comes to euthanasia. Their answer to those wishing to have autonomy, practicality and acceptance of reality is to refuse to allow individual death in terminal illness! And the death notices may be one-third up of people in 85-99 range.

    And we know we cannot look after the physically and mentally virtual-dead now, and their children can’t manage or are suffering age-related illness also. How can we cope with such irresponsibility of citizens, such denial of humanity, such hypocrisy when we send Defence Forces to other countries to kill and maim children, women and men? Can we grow up, and grow old, and the practical old citizens press for good measures of care for us all from cradle to grave, with the elders calling on their mature knowledge while their brains can best function from both experience and sharpness before the onset of deterioration.

  3. Have not this COL just announced a large surplus which will allow a big spend on roads. Surely DHBs need money as well. The Labour promise was to reverse the decline in health but in fact they have spent less . Why we need to finance 20 DHBs head offices in a country of 5 million is beyond me. Before you say what about National I was not happy with their approach either.
    In Chch he new wing is behind schedule and is already too small and parking was never taken into account for patients or workers. One demolished hospital site has been vacant for years while another is a earthquake risk. I have spent a long time in hospital and the workers are all doing the best they can but there is only so much they can take when they can earn so much more in Australia. They will need a large workforce to rebuild after the fires and many couples will be drawn to go there.

  4. I worked in the health sector for many years. I began working in the days of Hospital Boards and the old Department of Health, left not long after the establishment of the utterly wrong-headed and mercifully short-lived CHEs.

    I’ve retained a longstanding interest in the DHBs: who’s doing what and so on. My conclusion is that they’ve been underfunded since they were first established; each year, the situation grows more dire.

    Both Labour and National administrations are at fault. For the life of me, I cannot understand why governments have allowed the deficits to reach the levels that they have. Are they and their advisors blind, that they cannot see the demographic tsunami coming over the hill at them and already breaking on the steps of the DHBs?

    Yet at the same time, the holier-than-thou in the community, who don’t want those of us who are ill or older to have the choice of when to end our lives, have by their activism succeeded in crimping the provisions of David Seymour’s Bill and forcing it to referendum. What do they want? For us to suffer the tortures of the munted health system successive governments have brought about, and thus use up even more of the scant DHB resources? They’re blithering idiots, every one of them!

    Failure to improve DHB funding is yet another of the many failures of the current government. Enough already: I certainly won’t be voting Labour again. And it’ll be a cold day in Hell before I’ll vote Green.

    • TOP then? Is it going? Steady as she goes NZF? pRAY HARDER AND bE gOOD OR eLSE Christian-type parties? Roll up you smarties who want everything for less taxes, throw the ball into the Gaping Mouths of the Near Destitute. Set up new parties that play on our sensitivities, our bitterness, our anger, our displacement from our citizenship in our country of which we were an integral part, and work on our lack of loyalty to our country’s previous values, successes, and ethical beliefs.

  5. Labour got trapped by NACT’s challenge that Labour would increase taxation. Labour responded that the would not in the coming term.
    That was a hamstringing response.
    Its either more debt or higher taxation for corporate bodies and high income levels.
    NACT have run the public health sector down for years so supporting private health empires that have grown steadily and are now hiring their services out to the state who can’t afford to build the infrastructure needed.

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