HUNTER New England Health did not meet its budget in the 2021-22 financial year, recording a $59.6 million loss.
The health district's chief executive Michael DiRienzo said the COVID-19 pandemic has had a significant impact on the health district's budget during another "challenging" year.
With a total budget of $2.7 billion in 2021-22, the local health district's net result against budget was largely "unfavourable", with more than $173 million attributed to COVID-related expenses.
The state of the district's finances were revealed at Hunter New England Health's annual public meeting on December 14.
"To remind our community, we are a very large organisation when it comes to funding," Mr DiRienzo said.
"Ultimately the result has been affected by COVID... It includes over $173 million of COVID expenditure.
"In the last financial year, we had $174 million of funding provided to us to undertake our COVID response during that year."
Mr DiRienzo explained that ultimately, the district was able to perform to its "budget expectations", and their annual financial audit resulted in "no material movements".
In a breakdown of the health district's expenses, the CEO showed that 47 per cent of the total budget was spent on inpatient hospital services, 17 per cent went to community and outpatient services, and 12 per cent went to emergency services.
Mental health services received 8 per cent of the budget, 2 per cent went to research and education, and COVID-19 attracted 6 per cent - or about $174 million.
The biggest expenses were salaries and wages of more than 17,000 staff, followed by the cost of visiting medical officers, or VMOs, employed across the health district.
"There is a large proportion of our costs based around our workforce, and our ability to be able to attract and retain that workforce," Mr DiRienzo said. "We also fund the Calvary Mater Hospital to provide a public health service to our community as well."
The health district raised about $145 million via patient fees in the financial year, with another $239 million in "other revenue".
Mr DiRienzo said this "greatly assisted" the health district in providing services across the Hunter and New England.
He thanked staff working across the district's health services for their extraordinary efforts in another challenging 12 month period.
He said on any given day, the health district may have almost 19,000 staff working across their facilities, 1220 people attending emergency departments, and 274 ambulances arriving at hospitals.
He listed the district's 23 per cent reduction in carbon emissions this year as a key achievement in 2021-22.
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