Health NZ to be audited over growing surgery wait times, unequal access to operations

Wait-times for elective surgery in New Zealand continue to grow in most regions.

Soaring wait lists for surgery in New Zealand have prompted an investigation at Health New Zealand – Te Whatu Ora.

The Office of the Auditor General said today it would carry out a performance audit of the organisation’s planned care system – also known as elective surgery.

“Demand for planned care has been increasing, waiting lists for treatment have been getting longer, and there are inequities in access to treatment,” the Auditor-General said in a statement.

“People living in rural areas, disabled people, Māori people, and Pacific people can wait longer for treatment than other New Zealanders. This is partly because of inconsistencies in the ways that patients are prioritised for treatment.”

The audit will consider Health NZ’s work to support equitable access to treatment.

It will also look at whether the prioritisation of patients for treatment has been consistent throughout the country.

The planned care system has previously been described as a “postcode lottery” because access to treatment varies significantly between regions.

Addressing this lottery was one of the key reasons why the previous Labour-led Government established the new centralised organisation, Health NZ, in 2022.

At the time, growing surgical wait lists had been exacerbated by the Covid-19 pandemic because elective operations were put on hold. Health NZ set up a planned care taskforce which produced a number of recommendations for change.

Health NZ successfully reduced the number of patients waiting more than a year for surgery. Hospitals went into overdrive in an attempt to reduce wait times, with some running theatres on weekends and offering staff incentives to work more shifts.

However, the wait for specialist appointments and operations has continued to grow in many regions.

The National-led Government has identified elective surgery as a priority, including specialist appointments and surgery wait times in its five national health targets.

Data from the first quarter of the 2024/25 year shows just 61% of patients had a first specialist appointment within the deadline of four months, down from 66% a year earlier. Around 62% of patients had their operation within the four-month deadline – well short of the long-term target of 95%.

A briefing to former Health Minister Shane Reti last year said that the number of people needing acute or unplanned care was rising, as was the complexity of their condition.

This was happening “in a highly resource-constrained environment”, the Health New Zealand Te Whatu Ora officials warned in their briefing.

“Resourced beds, operating theatres, intensive care unit capacity and renal dialysis care are the core constraints on system performance. Most hospital beds are used for acute care.

“As demand grows for acute and urgent care, available capacity for planned care diminishes.”

Hospital capacity could not easily be increased because of workforce shortages and a lack of space and equipment – most hospitals do planned and acute care in the same facility, and acute care is always prioritised.

Isaac Davison is an Auckland-based reporter who covers health issues. He joined the Herald in 2008 and has previously covered the environment, politics and social issues.

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