St Vincent's Hospital in Sydney has tripled its usual holiday slowdown period to stanch its budget blowout, temporarily suspending most non-urgent elective surgery.
The inner-city hospital has stretched its "reduced activity period" from December 18 to January 28 in an effort to claw back savings in hospital resourcing and staff wages.
Doctors, nurses and other staff who expressed concerns over the length of the slowdown were also dismayed by bonus packages of more than $25,000 paid to two executives.
In November, Fairfax Media revealed St Vincent's had called in external consultants to audit the hospital's operations, after St Vincent's was $18 million in the red, despite the hospital's executive touting on budget performance in September.
Elective surgery slowdowns or shutdowns are not uncommon over holiday periods at NSW hospitals, to help level annual leave liabilities and balance budgets.
The low activity periods usually last about two weeks. St Vincent's staff have raised concerns about the extended length of the current slowdown on top of other bed closures or bed "consolidations" since July that include palliative care and rehabilitation services.
The hospital's emergency department will continue operating as usual over the slowdown period, and will have the capacity to ramp up its capacity during peak times.
Fairfax Media understands at least two executives were rewarded with $25,000 bonuses for making budget at the end of the 2016-17 financial year, despite the hospital being over budget less than one month later.
The bonuses have become a source of resentment among some staff members, who told Fairfax Media they were pushed to make unrealistic cuts to services that were back in the red in August.
St Vincent's Hospital Sydney's director of media and communications, David Faktor, said the modest bonus system was built into the executives' salary arrangements.
Since the budget shortfall was disclosed to staff, St Vincent's has closed a number of beds on wards for refurbishments and changes to how services are delivered. Palliative care and rehabilitation wards will lose 18 of their 38-bed capacities respectively.
St Vincent's said in a statement it was "consolidating our inpatient palliative care beds" while one ward was being renovated, and the hospital was increasingly providing more palliative care services in patients' homes.
"The hospital is working to ensure it delivers its commitments within the funding parameters it has been given, the statement read.
Mr Faktor said the slowdown affected only non-urgent elective surgery services and accounted for fewer than 100 beds, which would gradually reopen during January.
He said the slowdown was the best opportunity to remedy the hospital's budget issue and the temporary bed closures affected only the number of non-urgent elective operations and would gradually reopen throughout January.
He said it would have been remiss of the hospital not to take advantage of a low activity period to reduce the hospital's deficit.
"The most important area to make inroads into reducing the deficit is the low activity period when there is low demand without impacting emergency and trauma capacity."
Mr Faktor said the extended slowdown was possible because of the hospital's elective surgery success over the past year. St Vincent's performed second best in the state for non-urgent elective surgery timeliness. Just 13 patients were still on elective surgery waiting lists overall at the end of the September quarter, according to the Bureau of Health Information.
The Health Services Union (HSU) said overstretched staff were being shunted between units, a clear sign that staffing levels were inadequate.
"Staff are at their wit's end. Morale is very poor and confidence in management is poor," said HSU NSW secretary Gerard Hayes.
The HSU and the NSW Nurses and Midwives' Association have called on the state government to launch a review of St Vincent's operations considering the not-for-profit healthcare provider received substantial public funding.
St Vincent's Hospital was allocated more than $362 million in state government contribution in the 2016-17 financial year, according to its service agreement with NSW Health.
"It beggars belief that St Vincent's has this length of closures because of the financial management of the hospital," Mr Hayes said.
In a statement St Vincent's said: "We remain committed to achieving our waiting list obligations to the NSW Ministry of Health and maintaining our capacity to respond to patient demand."