Shane Reti: How shifting health targets rendered the system aimless

In July 2022 Health NZ announced another set of measures called health performance indicators and this time ED wait times and cancer measures were included. Photo / NZME

OPINION:

From 2007, the National government of the day introduced national health targets across a range of measures including emergency department wait times, hospital list wait times and faster cancer treatments. The thinking was that health targets that were also publicly reportable would focus government and public attention and resources on key measures and would lift overall performance.

There were detractors who said the system could be gamed by counting minor procedures and ramping ambulances, but by May 2017 a NZ Herald story reported and the ED specialist college (ACEM) were saying that targets had saved lives.

The incoming Labour government in 2017, however, were not in favour of health targets and the prioritisation of targets was reduced. In June 2021 the health targets were formally “retired”.

Reply 14016 (2022) has been answered [to Dr Shane Reti]

Portfolio: Health (Hon Andrew Little) Question: Further to 12789(2022) why is it nearly a year since emergency department wait times data was last reported publicly to June 2021 and when will the next reporting be?

Reply: The performance measure on the proportion of patients admitted, discharged, or transferred from an Emergency Department (ED) within six hours’ reported on the Ministry website was part of the previous Health Target reporting. The previous Health Targets were retired in June 2021 and public reporting of results was discontinued as part of the introduction of the Health System Indicators framework. The Ministry of Health are currently considering data reporting in the new health system.

In 2021 Labour replaced health targets with 12 new “Health System Indicators”. They drew immediate fire from the Cancer Society for not including cancer measures. Specialists were disbelieving that ED wait times were also not included. Six months after being introduced, the health system indicators were then gone.

In July 2022 Health NZ then announced yet another set of measures called health performance indicators and this time ED wait times and cancer measures were back in.

Last week all of these measures were removed due to inaccuracies in ED wait times.

Removing the health performance measures last week was the final indignity for the Labour government’s six years of confused and aimless wandering through health system measurements. It explains a lot.

There is no denying that targets save lives. They help focus the system on your needs as a patient and provide valuable information on what needs to be done better. They also help provide governments with real-time information so they can target funding in the right places.

Last week the Health Minister said health targets are not a priority for Labour.

I can tell you for National they are.

National will build the health workforce, set targets to hold ourselves accountable, and redirect health funding to the front line.