"A lot of people had to do a lot of work to get to this point.”

(4-minute read)

Waitaki District Health Services chief executive Keith Marshall said a $3.5m funding boost for Ōamaru Hospital was a “huge lift” and was crucial in addressing the pay gap faced by staff, which was now the priority. 

The new funding contract with Te Whatu Ora – Health New Zealand was a 32% increase on the current amount of about $11m per annum the hospital had been receiving.

Te Whatu Ora funding covered 85-90% of the hospital’s operating costs, Keith said.

The hospital is owned by the Waitaki District Council, and operated by Waitaki District Health Services.

It offers inpatient and emergency services, maternity, and radiology, as well as acting as a base for district nursing, social work, clinical needs assessment, physiotherapy and occupational therapy.

The extra money allowed WDHS to offer staff pay parity with their Te Whatu Ora colleagues, he said.

“There are an amazing group of people working at Oamaru Hospital who have continued to provide a high level of healthcare through many years of demanding circumstances, and everyone can be very proud of their ongoing commitment to our community. I know I am.

“The priority for WDHS is to address the significant pay gaps faced by all our staff so that we can properly ensure the future of Oamaru Hospital . . . Pay parity will also assist in attracting new staff to Oamaru.”

Like everybody in the health sector, the hospital was “horrifically short-staffed” and had been trying to recruit “flat out”, Keith said.

For example, to run the nursing roster - without provision for leave - 17.6 full-time equivalent (FTE) staff were required.  

“To fill a roster over the shifts - it’s not like a 9-5 job, you’re running three 9-5 jobs throughout the day. So to fill 17.6 you probably need 60, 70, 80 nurses . . . we’re currently trying to do that on 12 FTEs. So we are really stretched, and everywhere is just the same.

“If we need 17.6 and we’re trying to do it on 12, that means there are an awful lot of people there who are doing extra shifts and covers - so those crazy things do not help anybody.

“I use nurses as an example, but we have the same issue with doctors, we have the same issues with physios, occupational therapists, you name it, it’s universal.” 

The last two years of closed borders have made the situation worse. 

He said being able to offer pay parity with larger hospitals, didn’t solve the problem.

“But it puts us back in the game.

“So that’s the first priority - and then we have a bunch of other issues we haven’t tackled for a period of time, so they’re all in train as well.” 

WDHS had a close working relationship with Te Whatu Ora and getting to this point had been “incredibly complex and required significant analysis, extensive operation, and a positive spirit by all involved”, he said. 

“We wouldn’t have made this, if Te Whatu Ora hadn’t come to the party and had a discussion about doing the right thing. And we wouldn’t have made it, if council hadn’t stood by us along the way.”

The Ōamaru Hospital funding structure had remained largely unchanged since it became independently owned by the council, operated by WDHS, and contracted to the government for the provision of health services, in 1998.

The contract was “very slightly tweaked” in 2004-2005 when the hospital came down from up on the hill, to its new location at Takaro Park, but that core contract had not been looked at since, Keith said.

“The hospital has always been under financial pressure, but those pressures started to get more and more intense from about 2013 onwards, and the hospital started making losses from 2015-2016 onwards.”

Securing the funding from Te Whatu Ora meant having to work through some of what the “financial puzzle” was, he said.

“We had to understand exactly what our situation looked like, we had to understand … what all our pressures looked like, we had to pick apart our budget, we had to understand our current financial situation.

“You can say, ‘oh yeah, we’re in a dire mess’, but why were we there? What are the drivers behind it? How do we address it? What are the means of doing that, before we went knocking on the door to Te Whatu Ora saying ‘oh it’s not fair, we don’t get funded enough’.” 

There was still a long way to go, and the conversation WDHS had just gone through for the new funding contract wasn't the end of the discussion, he said.

“In a way it solves a problem that’s been building for the last quarter of a century and bides us the time to have the next part of the conversation.”

WDHS chair Helen Algar said the new agreement provided certainty around the continuity of health care services for the Waitaki community.

She acknowledged the enormous effort by the WDHS management team to secure the new contract, and the ongoing support of the Waitaki District Council.

Waitaki Mayor Gary Kircher said Oamaru Hospital was an essential cornerstone of the community. 

“That’s why we have backed them so strongly over the years. The new funding contract that has been secured with Te Whatu Ora is a great result for all concerned, not the least the people of Waitaki,” he said.

Te Whatu Ora

Keith felt positively about the implementation of Te Whatu Ora, which was introduced by the Government in July last year, to replace the country’s 20 district health boards.

“We can finally, in New Zealand, have a conversation about what a national health service should look like, and what equity for everybody in access to health should look like, which we were never able to do when the districts were their own individual districts.

“We’re talking about, for the first time in New Zealand’s history, having a national health service.”

Under the DHB system, the Waitaki River was “like a concrete wall” for healthcare, because north of it was a different district health board, he said.

“And yet, in terms of, for the patient, or the health outcomes - really if we can access it in Timaru, or do a transfer to Timaru, rather than a transfer to Dunedin - really, should it matter if there’s a river in the way?”

For WDHS, having Te Whatu Ora in place allowed more of “how do we fit into a national network rather than how do we fit into a district locality area”.

“Your entitlement to services shouldn’t differ depending on where you live. As a citizen, we should have a minimum entitlement to healthcare and it should be the same as everybody else’s.”