False beliefs about Canterbury’s population are jeopardising the region’s health system, the health board boss says.
Canterbury District Health Board (CDHB) chief executive David Meates’s comment was made in an email to Ministry of Health director general Chai Chuah in December last year and obtained by Stuff under the Official Information Act.
* Bad blood or sly moves? Canterbury’s health funding puzzle
* Canterbury District Health Board’s annual plan, budget yet to be signed off
* Canterbury DHB’s bill for elective surgery backlog could reach $24 million
Population data including age, ethnicity and deprivation levels underpin the amount of money DHBs receive.
Chuah wrote to the CDHB on November 24 and said population data used for a presentation on mental health funding had not been adjusted for socio-economic factors which explained the DHB’s funding allocation.
“Canterbury has a high proportion of working-age residents (ie. lower numbers of elderly compared with the national average), lower deprivation, a predominantly European population and depopulation since the earthquakes.”
Meates challenged the ministry’s view of Canterbury’s population.
He said Chuah’s information was “considerably out of date” and was having “material consequences on the assumptions made about the [Christchurch] hospital rebuild and beds required”.
“These assumptions will leave the DHB exposed to untenable circumstances. The population is now significantly larger (and growing faster) than was forecast post-quake.”
Canterbury has 13,0000 more people in the current financial year than was projected in 2012, Meates said.
While the Canterbury DHB population declined from 510,500 in 2010 to 497,800 by 2012, it has grown rapidly since 2013. In 2014 the population had overtaken the pre-quake level and sat at 515,100. In 2016 the population was estimated to be 539,600.
Chuah defended the Population Based Funding Formula (PBFF) used to distribute DHB budgets and said the ministry had provided an additional $106 million “to help you balance your books and absorb earthquake-related costs”.
Meates told Chuah the board was “confused by the population changes you refer to”.
He said Canterbury had more than average proportions of over 65s and over 75s and this had a “material impact on our costs of service delivery”.
Statistics New Zealand estimated Canterbury’s over 65s population was 15.8 per cent, compared to 15.2 per cent nationally for 2016-2017. The over 75s population for Canterbury was 6.8 per cent compared with 6.5 per cent nationally.
Meates said the Maori population in Canterbury was growing at the fastest rate of all DHBs and had increased by 31 per cent in the past 10 years.
Levels of deprivation, which affect the region’s funding package, appeared to decrease after the earthquakes and had further reduced funding.
But Meates said the deprivation index based on 2013 Census data did not account for the movement of deprived households all over Canterbury post quake.
“While the subsequent decrease in “reported” deprivation is stunning we do not believe this reflects the true situation…”
In a response to Meates’ email Chuah wrote to the board chairman on December 13. He said the ministry accepted the PBFF had not been able to meet all of Canterbury’s post-earthquake needs and this was why additional funding had been provided.
Chuah said ministry supported the board to ensure management “redirects its its energy and efforts into how it can deliver high quality health services to the people of Canterbury, within the funding provided and in line with board and government priorities”.
Labour Party leader Andrew Little spent time with Meates and members of CDHB senior management on Thursday and said the PBFF was not “fit for purpose” for Canterbury.
“The amazing staff of the CDHB have kept this place going under extraordinary circumstances, but I think there’s a sense that because they’ve been able to do so well under difficult circumstances that it is business as usual and actually they can’t carry on.”