Ballooning deficits – in part due to higher than expected patient volumes over summer – and understaffing are revealed in the latest District Health Board financial data.

The Ministry of Health released its latest DHB financial performance update to the Minister late last week with the sector now predicting an $189 million deficit by the end of the financial year – up on the projected $143 million deficit.  The proposed nurses pay agreement – currently in stalemate – could see that deficit balloon again to $225 million if the deal is accepted.

The report – for the first eight months of the 2017-18 year – also shows that district health boards are carrying more than 400 vacancies and had underspent on budgeted salaries by $48 million.  But the money was being spent on temporary staff with ‘outsourced personnel’ costs up $55 million on budget.

A breakdown of DHB staffing show that the sector with the largest number of unfilled vacancies is allied health which is 465 full-time equivalent (FTE) staff down on budgeted staff numbers. The next most affected DHB staff sector is administration and management which are running 257 FTEs below budget.

The statistics also show that the DHBs across the country are currently employing 260 more nurse FTEs than budgeted for and 103 more medical staff, with many of the DHBs reporting that higher than expected patient volumes for the time of year had led to budget blow-outs including personnel costs and the need to outsource staff and clinical services.

Allied health not surprised

Jennifer Pelvin, chair of Allied Health Aotearoa New Zealand (AHANZ), said allied health professionals are not surprised by the figures showing high numbers of allied health vacancies.

“For the last nine years allied health has been absolutely missing in action in all activities related to the Minister and the Ministry (of Health),” said Pelvin.

“There’s been a complete absence of input and consultation with the allied health sector which has made it very difficult for allied health, as it represents such a large and disparate group of health professionals that have been completely ignored.”

She said allied health – that includes physiotherapists, dietitians, podiatrists and social workers – was a vital part of the health sector providing comprehensive services but she was not surprised that was where DHBs had made some efficiency gains because allied health lacked visibility.  The result was that she said, like all DHB staff, allied health professionals were feeling under pressure. Also impacting on the high vacancies were shortages in some allied health professions, a lack of good workforce data and a lack of new graduate programmes to support allied health graduates into the DHB workforce.

But Pelvin said AHANZ, which is an umbrella group for 28 allied health, science and technical professional associations, was encouraged by its recent meeting with Health Minister Dr David Clark who expressed interest in better utilising the allied health workforce across both the primary and secondary sectors.

DHB workforce growing but still under-budget

Compared to the same time in 2017 the latest DHB financial performance data shows that total DHB staff has grown by nearly 2000 FTE over the previous 12 months to 64,192 – which was still 421 FTE less than budgeted for.

The largest area of growth has been in nursing staff (which covers nurses, midwives and health care assistants) which have grown by more than 900 FTE to 28,927 – making them 44 per cent of all DHB staff.  The next largest growth has been in medical staff (14.6% of staff) which are up 382 to 9384 which reversed the trend of medical vacancies from being 234 under-budget a year ago to 103 FTE over-budget.  The smallest growth has been in Allied Health staff  (19.25% of workforce) which grew by 167 to 12,367 – not enough to reduce unfilled vacancies that also grew over the same time period from 336 to 465.

Likewise for administration and management staff, who make up 16.6% of DHB staff, while their numbers grew by 262 FTE to 10,708 their unfilled vacancies also grew from 233 the previous year to 257.

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