A focus on equity
New Zealand health officials on the Planned Care Taskforce have recently released a plan that they claim would solve the problem of wait times in the health sector. The task force was charged with focusing on equity of outcomes in the health services sector and its report has suggested changing 101 things in the industry. 30 of the changes will be implemented in December, with the remainder coming into effect over the next few years.
Margie Apa from Health New Zealand believes that “patients are already seeing benefits from the taskforce.”
Focusing on equity of outcomes in social groups, the task force’s report showed a 5% disparity in wait times between Māori and non-Māori, but since this number is very small, is it even worth mentioning? It is not clear what an ideal range is deemed to be. In any case, the task force believe it is a metric that should be corrected now that the government’s Māori only health service is up and running.
Implementation of the recommended changes will be overseen by Health New Zealand and the Māori Health Authority and managed by individual hospitals and specialty health service providers.
Bay of…..not much
NZ’s public health system has an average wait time of 5.2 months for surgery, with anecdotes of people waiting 2-3 years to even get a treatment date scheduled. As reported recently in the NZ Herald, Tauranga hospital alone has a backlog of around 2000 procedures. When questioned on the state of the Bay of Plenty health sector specifically, health minister Andrew Little said that it’s “the consequence of a system that was routinely underfunded for many many years’ ‘, but yet in 2017, this waitlist was only 12 people long.
During a visit to Tauranga, Prime Minister Jacinda Ardern used COVID as an excuse for the delays, but said health services in the region “had issues” even before the pandemic.
A leaked letter from 30 senior doctors in the Bay of Plenty told of some patients choosing to die rather than traveling to other regions for cancer treatments, due to the lack of services available in the area.
The doctors named in the letter believe the, now passed, COVID crisis is being used as an excuse by bureaucrats for years of chronic miscalculation in regards to allocating resources to treatments and facilities in areas of high growth.
A representative from Health New Zealand said that “letter highlighted why change was needed”. But skeptics are concerned that the ‘change’ the Government is undertaking, creating two new entities and further centralizing the control of healthcare, will lead to greater risk of broad reaching systemic failures.
The current Government has spent considerable resources on creating these two new health departments, which have replaced 20 District Health Boards. Bay of Plenty locals are angry with failures in assessing the health priorities of their district vs the priorities of government working-groups and politicians seeking equity and broader control of the entire health system.
During her visit to Bay of Plenty, the PM raised the point that there is now “a national health system for the first time, that’s able to make sure that no matter where you live, whether you’re in Tauranga or whether you’re in Auckland, that you get a consistent approach in planned care.”
Only time will tell if this will prove to be true and, if it is more consistent, will it be consistently of a higher quality? Recent examples of child poverty or Kiwibuild show that Labour’s ambitious plans do not always result in the intended outcomes.
Bay of Plenty isn’t the only area under strain. There are reports that half of the GP clinics in New Zealand are not taking on new patients, with practices in Auckland turning patients away from making appointments. The pressure on GPs appears to be largely driven by lack of staffing, not by a lack of funding per se.
The Government’s Planned Care task force also concluded that wait times are a result of “insufficient workforce and capacity”. The Government has been under fire for delays in opening borders and failing to make significant progress in attracting and retaining workers in the health sector. Yet many healthcare workers are yet to return to the workforce after being fired under the vaccine mandates. Health NZ has recently commenced an overseas focused recruitment drive, with the goal of attracting new GP’s from North America, Asia and Europe.
Little boasts a little
When speaking on changes in the health system, Little gave a curiously circular remark stating that, “The reasons we are making the changes we are is because we need to see change”. But whether or not this particular change will work to solve the growing problems in the sector, remains unclear.