How far off the proposed Government’s health targets are we?

Thursday, 1 February 2024

The Coalition Government is set to establish major targets for the health system, which it says will have a “significant impact” on ensuring better, faster, and more convenient healthcare for Kiwis, and ultimately “save lives”.

During the election campaign, the National Party said it would publish progress against targets by region, every quarter, so New Zealanders could see how well the health system was serving their community ‒ prioritised in the Government’s 100-day plan.

So, how far off are we from what has been proposed?

Health Minister Dr Shane Reti is expected to provide details on health targets in the coming weeks, so it isn’t yet clear whether these will be exactly what was proposed in the lead-up to the election.

But we do have some insight into how things are looking against what National talked about during the election campaign.

Te Whatu Ora (Health New Zealand) in December published its most recent clinical performance metrics, for the July to September 2023 quarter.

Emergency department stays

The first target National said it would bring in was around shorter emergency department stays.

Prior to the election, it said the target would be that 95% of patients were admitted, discharged, or transferred from an emergency department within six hours.

Here’s what proportion of patients had a stay within that six-hour window, by health district:

Dr Kate Allan, Aotearoa New Zealand chair of the Australasian College of Emergency Medicine said targets were a great measuring tool of how the system was working, but the system needed to be resourced to respond.

Allan said the emergency department target was a wider hospital/system target ‒ so the majority of solutions to tackle it “lie outside of the ED”.

She said initiatives like hospital care in the home, addressing aged care and mental health care capacity, and supporting primary and urgent care all helped to decrease the number of people presenting to ED, needing hospital admission.

Cancer treatment wait times

National said it was also looking to introduce a target that 85% of patients received cancer management within 31 days of a decision to treat them.

Here’s what proportion of eligible patients received their first treatment within 31 days, by district:

Immunisation coverage

Another target National said it would put in place was that 95% of tamariki would have all age-appropriate immunisations by 24-months of age.

There were some big regional disparities in the latest data:

First specialist assessment waits

During the election campaign, National indicated it would introduce targets to see a “meaningful reduction” in those waiting more than four months to see a specialist, and more than four months for surgery.

Those would be set in government, they said.

Close to 60,000 Kiwis had been waiting longer than four months for their first appointment with a specialist between July-September 2023, up from 35,863 at the end of September in 2022.

System under ‘enormous pressure’

Reti said the health system had been under “enormous pressure” over the past six years, and as health minister he was “committed to drive priorities for change”.

“One way our government will do that is by prioritising the health workforce – improved support for our workforce will be key to solving so many of these other major issues.”

Reti expected Health New Zealand to prioritise wait times, and actions to reduce those.

Te Whatu Ora interim director of hospital and specialist services delivery unit, Duncan Bliss recognised that recent reporting identified the “continuing challenges” the system was facing.

“While we are not able to compare the recent set of these performance metrics to the Government’s health targets until they are announced, the existing metrics and proposed targets are both focused on the same thing – timely and accessible treatment and care for all New Zealanders,” Bliss said.

He said while there had been small improvements in mental health wait times and childhood immunisation rates, hospital pressures continued to present “significant challenges” — particularly impacting specialist appointments, planned care and emergency department performance.

“We know that we have a long way to go, but we are committed to improving the performance of the system and we will work closely with the Government when the targets are confirmed.”

There were plans and initiatives in place - including to improve hospital flow, address resourcing and workforce pressures, and address “falling” childhood immunisation rates - and progress was being made, “but it is important to recognise that this change isn’t going to happen overnight,” Bliss said.

In December, Reti announced a two-year $50 million package to help Māori health providers lift immunisation rates.