The opening of the new inpatients building had been delayed to 2029. Photo:
More than half of the $90 million cut from the new Dunedin Hospital build is related to the building itself - not its clinical contents, the build's Local Advisory Group chair Pete Hodgson says.
Te Whatu Ora confirmed late last year the $1.5 billion project's budget had blown out by $200m.
Officials managed to claw back almost half of that through what opponents had labelled cuts, but what the government insisted was savings.
Questions had been raised in the months before last year's announcement about whether the project would need to be scaled back due to inflation.
The hospital would now have fewer beds and imaging equipment on its opening day, but Hodgson said there was room to expand in future.
Most of the changes would not impact patient care, the former health minister under Helen Clark's Labour government said.
"That is why we are a bit resistant to calling them cuts rather than savings because most of the changes really are genuine savings," Hodgson said.
"It is true that there are also a few changes that affect clinical facilities rather than the building frame itself, but even they are mostly in the form of deferred expenditure and are not permanent cuts.
"The public rightly expect that we continue to review projects like this during their development to ensure efficient use of money while meeting healthcare needs.
"Most structural savings have been made by removing the pavilion building, which was rather attractive but inefficiently shaped and designed, removing various indentations in the façade of the inpatients building, making better use of the light well space, deploying the historic dairy building, and saving on particular pieces of engineering plant."
An artist's impression of the new Dunedin Hospital, March 2022 Photo:
It had taken a lot of work to decide on the changes, Hodgson said.
There would still be "plenty of challenges" getting them to work, he said.
"But absolutely none of those changes affect the care that patients will receive."
Savings that have a clinical impact were usually in the form of deferred expenditure like the temporary reduction of beds from 410 to 398, he said.
"The savings come in the form of a deferred fit-out of half of one ward. In other words the costs are being pushed out a few years until demand grows for their need. The same can be said for some imaging equipment such as the third MRI machine.
"On the other hand, a few clinical savings are permanent and can therefore be thought of as real cuts. The best example is the number of acute, planned and day surgery operating theatres which has been reduced from 16 when the inpatients building opens, to 15. Similarly the number of additional shelled theatres will reduce from four to three. The total number is therefore reduced from 20 to 18. The current hospital has 12.
"That is an example of design changing as the result of changes in thinking. There is an increasing trend in New Zealand from 8 hour to 10 hour theatre days, and an increase in throughput and asset efficiency as a result. With the need to find savings, that increasing trend means reducing theatre numbers makes good sense. Models of treatment and care continue to evolve and one objective is the most effective use of scarce surgical resources of all kinds."
The project had been beset by delays and budget blowouts since the beginning.
Cabinet initially signed off on a 421 bed inpatient facility, however that was an error due to double counting of 11 medical/surgical beds that were later assigned to other parts of the hospital.
But even that was down on 454 bed capacity which was contained in the 2019 master plan.
The opening of the inpatients building had now also been delayed by a year to 2029.
The outpatients building had already had its opening delayed from next year until 2025.
Labour campaigned in 2017 to get the rebuild started before the 2020 election - a promise which was not fulfilled - and getting it completed before the 2027 timeframe claimed by the then National-led government.