New Zealand / Health

DHB worries census data will reduce funding to deprived area

14:19 pm on 21 August 2019

A district health board in one of the country's poorest areas is determined to retain the funding it needs in the face of serious problems with the latest census.

Photo: 123RF

Census data helps decide how DHB funding is allocated, but response rates for the 2018 Census dropped dramatically, particularly for Māori.

Gisborne-based Tairāwhiti DHB serves 50,000 people, more than half of them Māori, and with a high level of deprivation.

Like many others, the DHB is in deficit and expecting to end this financial year in the red to the tune of $12 million.

Accurate census data matters to the DHB, because the information helps determine some of its funding under what's known as the Population-based funding formula.

The DHB's chief executive, Jim Green, said Census data was vital to this process.

"It's very very important because the way in which we're funded as DHB is based on the populations that we serve, and the dynamics of those populations.

"So factors such as the proportion of Māori and Pacific people within our populations are important parts of the funding formula, because of the way in which it works.

"So we need to have a really good degree of accuracy around how that is, so that we make sure that the funding is devolved in the right way across the country."

He hasn't seen any results for the 2018 Census yet, but when he gets it he'll be cross-checking the details with GP groups, including primary health organisations or PHOs.

"We're expecting to get that soon, and then we'll be able to start off our analysis ourselves so that we can see what it looks like compared to where we think we are, what the projections were from the last census that were used in the current funding round, and what other data we've got like our PHO enrolment data."

Mr Green said potential for inaccurate information in the census is a concern.

"Our population is the most deprived and needing of health services in the country, and if this has got in the way of us having the resources to be able to work with the people and provide the care they need then that's very significant for us and we need to do all that we can to make sure that that is not disadvantaging people in our population."

The chair of a group representing all DHB chief executives, Kathryn Cook, said Statistics New Zealand had bolstered the census data with other administrative data, and DHBs have been reassured it will be accurate.

"That does remain to be seen to a certain point but we have been reassured that this data will be of sufficient standard to drive the population based funding formula," Ms Cook said.

"We clearly haven't seen that [the data] yet so I'm not in a position to judge for ourselves but that's the reassurance that we've had," she said.

She added DHBs have been told the lack of input into the census by Māori is being addressed.

"We have been reassured that particularly for Māori and Pacific people that additional data has provided a level of assurance to Stats abut the full data set that will then flow to the Ministry of Health."

National's health spokesman, Michael Woodhouse, said he believed health is the sector that will be most affected by what he labels the census debacle.

"My concern is that this is going to make things much much worse and it's going to be hard for DHBs to justify the sorts of financial allocations that they're going to get from the Ministry," Mr Woodhouse said.

He worried that DHBs - all but one of which expect to end the year in deficit - will give up trying to achieve financial viability.

The Health Ministry said the new census data will be included in the 2021-22 planning round, adding it's working closely with Statistics New Zealand regarding use of the data in health.