Canterbury's recently resigned director of nursing says it was no longer tenable to remain working there.
Mary Gordon, Photo: CDHB
Mary Gordon was among seven of the health board's executive team to have resigned since July, with some citing the 'adversarial' attitude of the board as a reason.
She spoke today with RNZ's Nine to Noon about her departure, and the looming $16 million of funding cuts for nurses.
In total nearly $57 million of savings across the DHB have been agreed to get a $180 million deficit down.
The draft annual plan signed off by the board last Thursday included plans to slash $13 million in nursing staff costs.
Other cuts would come for senior medical staff and community services, but the Crown Monitor Lester Levy insisted there will be no reduction in services.
Gordon said she could not say there would be no impact on services and there was potential to adopt the plan with as little impact as possible, but a new team was going to need leadership and governance that was committed to the values of the organisation.
"They're good values that are held dear by health professionals and people that work in health."
Departing nursing head on CDHB funding cuts, 'divisive' board
Planned cuts to nursing costs included a two thirds reduction in jobs previously available for newly qualified nurses, which equated to another $3.5 million in savings.
The nurses' union also told Nine to Noon today that would have a negative impact on patient care.
The New Zealand Nurses Organisation's professional nursing adviser, Kate Weston, said it was deeply concerning.
"The other really concerning thing for us, in terms of patient services is the loss of support for frail elderly in the community and it's particularly ridiculously short-sighted."
Weston said the cuts may have the reverse effect on the budget because they would likely increase demand for hospital services.
She said the existing budget would have to be maintained or increased to avoid a negative impact on the care of the frail elderly. It would need to cover a support plan that included nursing staff, GPs, support for family and whānau, and rehabilitation programmes.
"We will unfortunately see increases in people needing acute hospital care, or needing long-term aged residential care because if the support's not there then they're not going to reach their goals to be independent."
Gordon said the board's savings plan was ambitious, but it had a lower chance of succeeding now the executive team was no longer intact.
She said cuts to nursing costs was less about reducing current numbers than it was about preventing the need for further wards at Christchurch Hospital.
"This plan was to avoid putting in two more wards - that has less impact than removing two wards so to say there'd be no impact would be incorrect of me, but I do believe we can have a moderate impact, but it's a huge ask to achieve that.
Gordon said a plan that involved fewer beds as opposed to cutting staff meant finding other ways of managing patients. That meant some would remain in the community, the need to find alternative ways to manage frail elderly people, and improvements to patient flow - getting patients through hospital faster.
Kate Weston had serious concerns around the extra pressure it would place on nurses and other staff.
She said nursing staff appeared to be the easy target.
"We are really concerned that nearly a third of the overall financial savings that are being proposed, directly affect nursing which can only really affect patient care - there's no way that it won't.
"Nurses don't have the capacity to provide high quality care when there's not enough of them to meet patient demand."
Weston said nursing was the backbone of the health service, and it made little sense to cut it.
Gordon said reduction in graduate nurses would have a major impact on the future workforce, as the pool of available staff to cover staff leaving through various means would not be there.
"What it means is we'll have to wait for nurses to resign before we can go and offer new grads positions."
It could also mean greater reliance on agency nurses for which high premiums were paid, and which Canterbury DHB had historically been a relatively low user of, compared to similar DHBs.
"In the last six months we've hardly used any external agency."
Gordon said Canterbury was in line with other DHBs when it came to full-time equivalent staff members, but it had the lowest average cost per FTE nursing, and across all workforce groups.
She said they had tried for a plan that had the least impact on patient care. Despite this, Gordon said her resignation was the result of an "untenable divisiveness" within governance.
Nine to Noon has repeatedly asked health minister Chris Hipkins to discuss the crisis at the Canterbury District Health Board, but he has declined.