Doctor strikes and the Havelock North gastroenteritis outbreak helped put Hawke's Bay District Health Board (HBDHB) $2million below target for the year to June, but it still expects to be the best-performing DHB in the country with a $4.5 million surplus.
In a report to the board, executive director of corporate services Tim Evans said the $1.2 million adverse result to February was contingent on the Ministry of Health covering the cost of the Havelock North gastroenteritis outbreak.
To the end of 2016 that cost was $766,000.
Other unexpected costs were $600,000 for less annual leave taken by nurses, greater midwifery needs and paying doctors $400,00 to cover striking Registered Medical Orderlies.
Costs associated with the strikes - recovering surgery rates - totalled more than $700,000.
"The only positive to be taken from these adverse numbers is that many of the factors appear to be one-off events or corrections," he said.
"There will clearly be pressure for the remaining four months of the year - we will clearly have to work hard to reduce, offset and mitigate it, but it looks like this is an exceptional month."
He predicted a $4.5 million surplus for the 2016-17 year, below the target $5 million.
It makes the planned 2018 surplus of $2million more difficult to achieve. The following year also has a planned $2million surplus.
The lower surpluses smoother the one-off gain from the sale of Napier Hospital, which HBDHB chief executive Dr Kevin Snee said was banked with the Health Ministry.
He said HBDHB had an unequalled financial record over the past six years which enabled capital investments. A new gastroenterology unit, renal unit and oncology unit would be built in the coming year.
He said the government's increased National Health Target for Faster Cancer Treatment was expected to be reached by June.
For the second quarter of the year (to the end of June) Hawke's Bay was the poorest performing DHB, missing the target of 85 per cent of patients receiving their first cancer treatment within 62 days of referral. Just 65 per cent were referred in the timeframe.
The target will be lifted from 85 per cent of patients referred to 90 per cent in July.
Initiatives to meet the target included continuous case management of individual patients, executive-led weekly meetings to resolve issues, new IT tools showing all patients across the 62-day pathway and quicker scan reporting and diagnostics.
"There is strong commitment from clinical leads and tumour stream teams in secondary care, with engagement from Primary Care, to ensure best practice is delivered," he said.